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Retinitis pigmentosa is a rare group of eye disorders that causes a person’s vision to gradually deteriorate over time.

That can make it difficult for those with a retinitis pigmentosa diagnosis to continue working as they always have. Despite this, many retinitis pigmentosa insurance claims are initially denied.

While the disorder is rare, it affects an estimated 100,000 Americans. However, getting approved for retinitis pigmentosa work disability benefits can be difficult.

Claimants must be able to demonstrate to their insurer that the disorder has materially affected their ability to perform their work duties. That’s where Fields Law can help.

Our disability attorneys have experience working with clients experiencing a wide range of medical conditions, including retinitis pigmentosa. We can help you build a strong claim that is backed by medical and vocational evidence. Even if you’ve already had your retinitis pigmentosa disability claim denied, Fields Law may be able to help you appeal the decision.

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Retinitis pigmentosa (RP) is a rare group of eye disorders affecting the light-sensitive cells in the retina. It’s an inherited genetic disorder, and individuals can experience symptoms as early as childhood, or later in life.

It is generally a progressive disorder, meaning vision loss can worsen over time as retinal cells deteriorate.

The retina is the part of the eye responsible for detecting light and sending visual information back to the brain. As the retinal cells slowly break down, the disorder can eventually cause patients to lose different aspects of their vision.

The actual effects of retinitis pigmentosa can vary from person to person. Some are initially able to see quite normally, and only begin to experience symptoms later in life. The age at which symptoms start as well as the extent and pattern of vision loss can all differ.

These conditions can make it difficult to cope with everyday life, but because there is so much variation in the types of mental health conditions, a diagnosis of a specific disorder alone isn’t typically enough to qualify for work disability benefits.

A claimant must be able to demonstrate to their insurer through medical and other evidence that their condition prevents them from performing their work duties under the policy’s definition of disability.

Cervical radiculopathy refers to nerve issues affecting the neck, while lumbar radiculopathy affects the lower back. Cervical radiculopathy is often referred to as a pinched nerve in the neck, while lumbar radiculopathy commonly causes sciatica, a radiating pain down the leg.

These nerve issues can stem from a few different causes, including herniated spinal discs, bone spurs, and degenerative disc disease. Symptoms are often closely related to conditions like spinal stenosis or spondylolisthesis, or they can appear as a result of a physical injury or a post-surgical complication.

The most common symptoms of retinitis pigmentosa are loss of night vision and peripheral vision. As the disorder progresses, symptoms can increasingly restrict a person’s vision.

Individuals who experience RP may have difficulty seeing in low-light or dark environments, and have difficulty adjusting from light to dark conditions.

Peripheral vision can also be affected. The disorder often causes a person’s visual field to narrow, sometimes called “tunnel vision”.

As the disorder progresses, it can begin to affect a person’s central vision and ability to distinguish colors. In the most severe cases, RP can eventually cause significant vision loss or blindness.

The severity of the effects of retinitis pigmentosa can vary from person to person. A person may be able to read a book or document directly in front of them, but can struggle detecting people or objects to the side.

Retinitis pigmentosa can make it difficult for a person to see, but the actual effects on a person’s job can be far greater.

Someone who has retinitis pigmentosa may have difficulty navigating stairs or walking in a dimly lit area. They may have trouble detecting obstacles, moving through unfamiliar spaces, and even trouble working with detailed visual information.

They may also have trouble recognizing people or objects outside their field of vision, and performing tasks that require hand-eye coordination.

A person with retinitis pigmentosa may also be unable to drive, especially at night, and may be unable to safely use machinery or equipment.

However, not all diagnoses of retinitis pigmentosa will automatically qualify for work disability benefits. How severely RP affects a person’s job depends heavily on the specific degree of visual impairment they are experiencing, as well as their actual job duties.

For example, a forklift operator with RP experiencing tunnel vision may encounter more significant deficits in their ability to work than a person with the same degree of visual impairment working in an office setting.

If you’re unsure of how severely your retinitis pigmentosa affects your ability to work, consulting with a disability attorney can help you understand your options.

Can You Get Disability for a Retinitis Pigmentosa Diagnosis?

Retinitis Pigmentosa

Why Retinitis Pigmentosa Disability Claims Are Denied

To qualify for Long Term Disability related to retinitis pigmentosa, a person will need more than a diagnosis. They will need to prove to their insurer that the disorder substantially limits how they are able to perform their work duties.

When the claimant can’t provide evidence that establishes their condition meets their policy’s definition of disability, their claim may be denied.

Insurance companies will often try to argue that despite your condition, you are still able to perform your job. The best way to strengthen your claim is with clear medical evidence supported by documentation of the impact of your condition on your ability to work.

Without the extra dimension of evidence, your claim is more likely to be denied.

Before you file a claim, keep in mind some of the reasons why retinitis pigmentosa claims are denied:

  1. Your visual impairment isn’t severe enough to meet your policy’s definition of disability.
  2. Your medical records don’t adequately document your functional limitations.
  3. The insurer determines you can still perform your occupation.
  4. Your policy includes “any occupation” language, and the insurer believes you can perform the duties of another occupation.
  5. Your reported limitations aren’t adequately supported by medical records, testing, or other evidence.

Filing a Retinitis Pigmentosa Disability Claim

A strong retinitis pigmentosa insurance claim should document the effect the disorder has on a person’s ability to consistently perform their work duties.

Fields Law’s retinitis pigmentosa disability attorneys can help you gather the appropriate evidence.

We help our clients:

  • Collect detailed medical documentation
  • Gather physician statements that document your limitations
  • Connect your limitations to your work duties
  • Work with vocational experts to further demonstrate how the condition limits your ability to work

When a claimant isn’t able to show the insurer evidence that proves they meet the terms of disability, the claim may be denied.

Carefully documenting the medical and functional effects of your disorder for your retinitis pigmentosa disability claim can help you build a stronger claim. Fields Law can help.

Social Security Disability Benefits and Retinitis Pigmentosa

It’s important to understand that Long Term Disability benefits and Social Security Disability Insurance are two different programs. LTD benefits are private insurance, often offered through an employer, while Social Security is a government program.

Some individuals may also qualify for Social Security Disability, but it’s important to remember that the Social Security Administration (SSA) has different rules and evaluation criteria than private or employer provided disability insurance.

Approval still largely depends on the severity of your specific condition, and its limitations on your ability to work.

Applying for Social Security Disability is a separate process from filing a retinitis pigmentosa insurance claim. However, Fields Law may be able to assist with Social Security Disability benefits claims depending on your situation.

What Happens If Your Claim Is Denied?

When your retinitis pigmentosa disability claim is denied, it can leave you feeling shocked and uncertain of what to do next.

The important thing to remember is that a denial does not necessarily mean your claim is over. Many Long Term Disability insurance claims are denied initially, but claimants may have the options to appeal the insurer’s decision.

Many employer-sponsored Long Term Disability policies are governed by the Employee Retirement Income Security Act (ERISA). This federal law requires an ERISA-covered plan to provide a claimant with the opportunity for a full and fair review of their denial, however, not every plan is subject to ERISA.

In most ERISA-governed plans, there is a window of at least 180 days to appeal disability claims. That deadline typically runs from the day you receive your denial letter.

With only a limited time to appeal, it’s important to seek legal help as soon as possible after you are denied.

Fields Law’s retinitis pigmentosa disability lawyers can help you understand the reasons for your denial and begin your appeal. We can help you gather the evidence to create a strong appeal, and help you file it within the appropriate deadline.

Our team of retinitis pigmentosa disease Long Term Disability attorneys can help you:

  • Gather additional medical evidence
  • Collect detailed statements from your treating physicians
  • Obtain a written statement from your doctors that explains how your specific retinitis pigmentosa symptoms restrict your work capacity
  • Work with vocational experts to further document how your condition affects your work duties
  • File an appeal within ERISA deadlines

When you’re already dealing with the fallout of an illness, the process of appealing an insurance denial can feel overwhelming. We can handle much of the paperwork on your behalf, address the reasons for your claim denial, and advocate for the full extent of benefits available under your policy.

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Get Help With Your Retinitis Pigmentosa Long Term Disability Claim Today

Whether you’re just beginning to file a claim, or your retinitis pigmentosa disability claim has already been denied, Fields Law can help you take the next step.

We provide nationwide advice and representation in disability claims involving retinitis pigmentosa and other illnesses.

Contact Fields Law today for a free initial consultation. We represent clients on a contingency basis, through our Win-Win Guarantee®. There are no up front legal costs – we only get paid if you get paid.

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