ERISA Experience You Can Rely On.

Sleep apnea sometimes unacknowledged despite ERISA

On Behalf of | Jun 16, 2019 | Firm News

If you have or think you may have, or have been diagnosed with, sleep apnea, you probably know it’s often not often taken seriously. If another condition caused headaches in the morning, insomnia at night, difficulty staying awake during the day, an inability to focus, and mood disorders, it probably would be more easily recognized as serious and debilitating.

For some sufferers, one of the condition’s hardest aspects is knowing that your spouse or partner is unable to sleep due to your snoring, or out of worry after they find you gasping for air or not breathing at all.

ERISA may back you, but the rules are complex

Probably because of its name, the Employee Retirement Income Security Act (ERISA) is best known as the federal law setting standards for retirement plans. But it also protects the rights of workers when it comes many other issues, including long term disability insurance.

ERISA not only protects your rights as an employee, a retiree, and as a patient, it also determines the process and reasoning your insurer must utilize for granting or denying long term disability benefits.

Insurance companies have a financial interest in turning down your application for long term disability benefits even as you and your doctor have interests in getting you diagnosed and treated. If you are turned down, your chances of forcing a change in the decision will be greatly improved if you have good evidence on your side.

That’s one of many reasons it’s important to have your sleep apnea diagnosed as soon possible, and to make sure that its complications are noted in your medical records. Insurance companies need to have these facts spelled out clearly and early.

Sufferers of sleep apnea can fight to be recognized

It’s taken generations for insurance companies to meet their obligation to pay disability benefits for the sometimes-devastating condition of sleep apnea.

Because sleep apnea often causes dramatic oxygen deprivation in the blood, it increases your risk of high blood pressure, stroke, heart attack and other serious complications. Poor sleep and low oxygen also increase your risk of liver disease, type 2 diabetes, depression, workplace accidents and vehicle crashes. In people with heart disease, it sometimes causes sudden death.

Although many of sleep apnea’s complications cause a disability claim, sleep apnea itself may be difficult to get accepted as a basis for your disability. Getting diagnosed and treated as soon as possible will help develop evidence of the disabling effects of sleep apnea.