HomeDisability InsuranceIs Narcolepsy a Disability? A Claimant's Guide

Is Narcolepsy a Disability? A Claimant’s Guide

If you or a loved one struggles with severe narcolepsy, you know how difficult it can be to maintain a consistent daily routine. While medical treatments and other reasonable accommodations can help many people manage their daytime sleepiness and reduce the risk of dangerous sleep attacks, sometimes even the best care is not enough to enable suffers to work safely.

If you fall into this category, you may be able to receive short-term or long-term disability benefits. However, proving that your narcolepsy prevents you from working will not necessarily be easy and may require significant medical evidence.

In this blog post, we will briefly cover what narcolepsy is, how symptoms can impact your ability to work, and how an experienced disability lawyer can help you get the disability benefits you deserve.

What Is Narcolepsy and How Can It Impact My Ability to Work?

Narcolepsy is a chronic sleep disorder that frequently results in one or more of the following symptoms:

Excessive daytime sleepiness. People with narcolepsy often experience severe fatigue throughout the day and have trouble staying awake for extended periods of time.

Sleep attacks. As a consequence of extreme fatigue, people with narcolepsy may suddenly fall asleep. While this can be preceded by a short period of significant drowsiness, for some people sleep attacks come with almost no warning.

Sudden muscle weakness. Some people with narcolepsy are prone to sudden loss of muscle tone and voluntary muscle control, for up to a few minutes at a time. Also known as cataplexy, this may cause the person to slump, slur their speech, or in extreme cases even fall over.

Sleep paralysis. Occasionally, people with narcolepsy may be unable to move or speak just before falling asleep, or for a few seconds to a few minutes after waking.

Narcolepsy symptoms can make certain kinds of work dangerous, particularly if it involves driving or operating machinery. However, excessive daytime sleepiness can also make it difficult to focus, be present and attentive during meetings and appointments, and perform other essential tasks in a wide range of job roles.

Getting Disability Benefits for Narcolepsy Approved Can Be Challenging

Although it may be obvious to you that your narcolepsy symptoms make it impossible to perform your essential work tasks and thus qualify you for disability benefits, you may still encounter significant resistance from the insurance company. Below are a few of the biggest obstacles.

Skepticism About Self-Reported Symptoms

Narcolepsy may not be as immediately apparent to an outside observer as a more obvious physical disability—for example, a broken leg in a cast. Because of this, the insurance company may accuse you of exaggerating your narcolepsy symptoms and their effect on your ability to work.

To have any chance at having your disability claim approved, you will need to back it up with a clear diagnosis and strong medical evidence.

Own Occupation vs. Any Occupation Disability Insurance Policies

An “own occupation” disability policy means you only need to prove that you cannot perform your current job in order to be eligible for benefits. This is the ideal situation for claimants, and makes it much easier to get approval, particularly if you work in a field where extreme daytime sleepiness or sleep attacks would obviously be dangerous for yourself or others—like doctors, drivers, or people who work around unprotected heights or with heavy machinery.

However, many long-term disability policies use an “any occupation” definition, meaning you need to prove you are unable to do any work to which you are reasonably suited, even outside your current occupation. It is much harder to get benefits under these kinds of policies.

Narcolepsy Is Not a Qualified Disorder for Social Security Disability Insurance

Just because a condition is not recognized as a qualifying disorder by the Social Security Administration (SSA) does not mean you cannot qualify under a separate short-term or long-term disability policy. However, some long-term disability policies will require you to file for Social Security disability before filing a private insurance claim.

That said, you may still be able to get Social Security disability benefits too, although you will have to prove that the symptoms impair your ability to work and that they are similar to a condition that is listed. (People with narcolepsy who are attempting to get social security benefits typically do so under the epilepsy listing.)

At Bryant Legal Group, we primarily represent people who have disability claims with a private insurer. However, if we believe your condition also qualifies you for Social Security disability benefits, we can help you with that as well. Our disability insurance lawyers do not handle stand-alone Social Security claims.

an older couple walking together discussing their disability policy and narcolepsy

How to Strengthen Your Long-Term Disability Case

To win your disability case, you will need to bring as much medical evidence and non-medical evidence as you can to conclusively show how your condition impacts your life. Here are a few things you should focus on.

Establish a Clear Medical Diagnosis

Simply claiming to be constantly fatigued or prone to sleep attacks will not be sufficient. You will need a diagnosis and supporting medical evidence from a qualified physician, which will require participating in at least two essential sleep studies:

  • Polysomnogram: You stay overnight at a sleep center while a machine records brain waves, eye movements, breathing, and other essential indicators for nacolepsy and other sleep disorders.
  • Multiple sleep latency test: You take five scheduled naps throughout the day, and a specialist measures how quickly it takes you to fall asleep, whether or not REM sleep is achieved, and if so how quickly REM sleep is achieved.

Carefully Follow the Treatment Plan From Your Treating Physician

Although there is no known cure for narcolepsy, many people are able to successfully manage their narcoleptic symptoms by taking certain medications, as well as lifestyle modifications (such as regular exercise and strict bedtimes, wake times, and a nap schedule).

Some people are able to control their narcolepsy well enough to work a regular job, at least with reasonable accommodations made by the employer. However, this is not true for everyone, and despite your best efforts you may not be able to get through the workday without significant difficulty.

By following your doctor’s treatment plan to the letter, you show the insurance company that you are serious about your condition and making a good faith effort to manage it, and your disability is out of your control.

Ask Your Doctor to Write a Letter Supporting Your Diagnosis and Your Disability Claim

Again, it is important to remember that a narcolepsy diagnosis in and of itself is not evidence of a disability. You need to link your diagnosis to specific symptoms that make it impossible for you to work under the terms of your disability insurance policy.

Self-reported symptoms will be treated with skepticism. A letter from your doctor outlining your diagnosis, your symptoms, and how those symptoms impair your ability to work can, along with detailed medical records, provide the evidence you need to support your claim.

Keep a Careful Record of Your Condition

It is a very wise idea to keep a journal of your experience with narcolepsy. Record any periods of intense drowsiness, the duration of any naps (expected or unexpected), instances where you were unable to concentrate or complete a task due to symptoms you could not control. Also record the medications you are taking, lifestyle techniques you are using to control symptoms, and even any triggers you can identify.

This information can be very useful for your treating doctor as they construct an appropriate treatment plan, but it can also help your disability case.

RELATED POST: Learn How a Disability Journal Can Help Your Disability Claim

Carefully Review Your Disability Insurance Policy

Each insurance policy is different, and will contain important information about how disability is defined (“own occupation” vs “any occupation”), what conditions are and are not covered, how “self-reported” conditions are covered, what standards of evidence must be met to qualify, and more.

Carefully reviewing your policy will help you figure out whether or not you have a legitimate claim for disability insurance benefits, and what evidence and information you will need to provide to the insurance company in order to receive them.

Bryant Legal Group: The Long-Term Disability Experts

If narcolepsy is keeping you from working, chances are you will need some help getting your disability claim approved. Whether you are just at the start of that process, or you just received your first denial notice, our experienced disability lawyers are ready to assist.

Bryant Legal Group is recognized in Chicago and beyond for our aggressive legal strategies, compassionate client care, and great results. To request your free consultation with our team, complete our online form or call us at 312-561-3010.