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Can you obtain long-term disability benefits for sleep apnea?

On Behalf of | Aug 25, 2021 | Long Term Disability Claim Denial

If you suffer from sleep apnea, you know how debilitating this condition can be. However, most people don’t know much about the condition; they think of it as little more than excessive snoring.   Because of this, you might wonder whether you are eligible for long-term disability benefits for sleep apnea.

If you are covered by a work-provided long-term disability policy, you are covered under ERISA law, which was designed to protect the rights of the claimants. This is a complicated area of law and the process of obtaining benefits can be challenging. Knowledge is among your most powerful resources.

What is sleep apnea?

Sleep apnea is a medical condition in which the patient’s breathing stops sporadically during sleep. According to the Mayo Clinic, sleep apnea can be caused either by the relaxing of the throat muscles that results in a blockage of the central airway through the throat; or by a failure of the brain to send the appropriate messages to the body’s breathing muscles.

Either of these situations can lead to serious complications.

Loss of sleep in general, as well as the more formal diagnosis of sleep apnea, can result in:

  • Serious, ongoing fatigue throughout the day
  • Coronary complications
  • Diabetes and metabolic problems

This is just a small sampling of possible conditions that result from sleep apnea. It is important to note that lack of effective sleep tends to increase the chance of almost any other kind of physical or emotional illness. Sleeplessness makes it much more difficult to focus throughout the day, to manage one’s emotional health and to stay sharp to avoid physical risks in more physically dangerous jobs.

Obtaining benefits

Although sleep apnea is clearly a medical condition that should make one eligible for long-term disability benefits, obtaining your needed benefits can be much more difficult than it should be.

In many instances, the insurance company will say that sleep apnea does not quality as a “disability.”  Although the disability insurer is required to adhere to the terms of the employer’s policy, it is common for it to also its own policies and procedures.  This allows the insurance company to deny disabilities due to sleep apnea — or any disabling condition — while it claims to be following the terms of the employer’s policy.

Although failing to meet the definition of a disability is the most common reason for sleep apnea long-term disability claims to be denied, insurance companies also claim pre-existing conditions, lack of verifiable symptoms and other reasons for denying sleep apnea claims.

Although there are numerous hurdles in obtaining the long-term disability benefits you need, working with an experienced ERISA disability attorney can be invaluable in helping you through the process.