Heart disease is common. However, successfully applying for a long-term disability claim in Canada on the basis of heart disease is no easy task. Complications often arise as individuals with heart disease may present as generally healthy on the outside without showing obvious signs of being “disabled” or unable to work.
According to the Canadian Chronic Disease Surveillance System, based on data from 2018, approximately 1 in 12 Canadians over the age of 20 live with diagnosed heart disease. Early detection and management of various medical conditions, such as high cholesterol and diabetes, is important. However, heart disease is a silent killer, and untreated conditions can greatly impede an individual’s ability to work and perform certain daily activities.
Types of Heart Disease and Cardiovascular Conditions
Heart disease covers many diseases and conditions that involve the heart and blood vessels which affect the function or structure of the heart. A claim for long-term disability on the basis of heart disease will typically require a surplus of supporting evidence that an individual’s symptoms or condition is due to a blockage of the coronary artery. Common conditions which meet this requirement are:
- Myocardial infarction (heart attack) – blood flow to a part of the heart is stopped, which damages the heart muscle, often resulting in the individual experiencing pain for a few minutes
- Stable angina – chest discomfort which can be caused by stress or physical activity, often dissipating once the trigger ceases
- Unstable angina – chest discomfort which can occur when an individual is at rest, often worsening in each instance
- Silent ischemia – the blood flow to a certain part of the body is restricted, which can often lead to a heart attack
Testing and Criteria for an Invisible Condition
While a heart condition is invisible from the exterior, several tests are available to healthcare practitioners to assist in locating and diagnosing heart disease in patients. Many patients must subject themselves to several types of testing before obtaining a formal diagnosis and proceeding with a claim. These tests may include the following:
- Abnormal stress test or EEG (abnormal electrocardiographic testing) is often the main screening test to show a blockage in the coronary arteries as it shows how a patient’s heart reacts to an increased heart rate through physical activity
- Electrocardiogram (ECG) to help detect arrhythmias
- Echocardiogram, which uses soundwaves to produce an image of the heart
- Brain natriuretic peptide (BNP) tests to determine the level of BNP in the bloodstream
- Cardiac catheterization can show the heart’s arteries and provide information about the structure and function of a patient’s heart
Unique Challenges in Successful Claims Based on Heart Disease
The challenges in successfully applying for a long-term disability claim for heart disease can vary. Aside from conditions and symptoms being invisible, some test results may be misleading or produce false positives or negatives, often due to factors such as medication, making it difficult for doctors to provide supporting evidence for their claims.
Clinical tests can sometimes provide a small piece of the bigger picture. Just because a claimant obtains a normal result in a walking stress test in a controlled environment does not necessarily mean they are still able to complete the activities and tasks required in their regular work environment. Factors such as temperature, physical requirements and workplace stress can worsen an individual’s symptoms. However, these are difficult to capture in a testing environment.
Diagnosis Alone is Not Enough
Canadians diagnosed with heart disease and unable to perform their job duties may be eligible for long-term disability benefits under their insurance plan. However, claims are not approved solely based on diagnosis, severity and symptoms alone, and it is up to the claimant to prove the impact of their disease and symptoms on their ability to work.
The stability of one’s condition, combined with the forms of treatment or condition management, can dictate an individual’s ability to perform work-related duties and can also impact how safely someone can perform these duties. Someone who is managing their condition with medication or other treatment may be experiencing fatigue and weakness, which can create potentially dangerous situations, particularly when the individual is involved in physical labour or operating machinery. There may also be fear of having a cardiac event in the workplace. Further, individuals who have undergone surgical procedures may require extensive recovery and rehabilitation, preventing them from performing any job-related tasks.
Adverse Impact on Work
Many individuals who suffer from heart disease find that their work becomes negatively impacted to the point where a claim for disability benefits can feel like their only option. When heart disease prevents someone from remaining gainfully employed, it can create additional stress and financial uncertainty, which may exacerbate one’s symptoms.
It is important for anyone who has been diagnosed with heart disease to document the limitations they experience and to also record the ways in which they have modified their tasks and accommodated their restrictions in an effort to maintain their employment.
Aside from medication and drastic lifestyle changes, the most common form of treatment for a cardiovascular condition is an invasive surgical procedure; individuals can require extensive cardiac rehabilitation for prolonged periods while creating significant physical limitations. Many types of treatment and rehabilitation will require the claimant to focus on managing their new normal, which may limit their physical abilities. Taking the advice of a medical team with respect to testing, treatment and symptom management is critical, particularly when pursuing a disability benefit claim.
Contact Calgary Long-Term Disability Lawyers at Cuming & Gillespie LLP For Advice on Heart Disease Claims
The trusted long-term disability lawyers at Cuming & Gillespie LLP have years of experience guiding clients through long-term disability claim denials, including claims for heart disease. Your health and condition management is your top priority as you navigate your new normal. Our lawyers understand the financial and emotional difficulties that can arise in the event of a long-term disability claim denial. Suppose your claim for disability benefits has been denied. In that case, it is important to speak with one of our lawyers as quickly as possible to allow us to evaluate your claim and help you determine the best way to pursue your claim further. Contact us online or call us at 403-571-0555 to schedule a confidential consultation.