Scleroderma as a Disabling Condition

At the O’Ryan Law Firm, we have represented several clients who have become disabled due to the severe symptoms of Scleroderma.

According to the American College of Rheumatology:

WHAT IS SCLERODERMA?

Scleroderma (also known as systemic sclerosis) is a chronic disease that causes the skin to become thick and hard; a buildup of scar tissue; and damage to internal organs such as the heart and blood vessels, lungs, stomach and kidneys. The effects of scleroderma vary widely and range from minor to life-threatening, depending on how widespread the disease is and which parts of the body are affected.

The two main types of scleroderma are:

  • Localized scleroderma, which usually affects only the skin, although it can spread to the muscles, joints and bones. It does not affect other organs. Symptoms include discolored patches on the skin (a condition called morphea); or streaks or bands of thick, hard skin on the arms and legs (called linear scleroderma). When linear scleroderma occurs on the face and forehead, it is called en coup de sabre.
  • Systemic scleroderma, which is the most serious form of the disease, affects the skin, muscles, joints, blood vessels, lungs, kidneys, heart and other organs.

HOW IS SCLERODERMA DIAGNOSED?

Diagnosis can be tricky because symptoms may be similar to those of other diseases. There is no one blood test or X-ray that can say for sure that you have scleroderma.

To make a diagnosis, a doctor will ask about the patient’s medical history, do a physical exam and possibly order lab tests and X-rays. Some symptoms he or she will look for include:

  • Raynaud’s phenomenon. This term refers to color changes (blue, white and red) that occur in fingers (and sometimes toes), often after exposure to cold temperatures. It occurs when blood flow to the hands and fingers is temporarily reduced. This is one of the earliest signs of the disease; more than 90 percent of patients with scleroderma have Raynaud’s. Raynaud’s can lead to finger swelling, color changes, numbness, pain, skin ulcers and gangrene on the fingers and toes. People with other diseases can also have Raynaud’s and some people with Raynaud’s do not have any other disease.
  • Skin thickening, swelling and tightening. This is the problem that leads to the name “scleroderma” (“Sclera” means hard and “derma” means skin). The skin may also become glossy or unusually dark or light in places. The disease can sometimes result in changes is personal appearance, especially in the face. When the skin becomes extremely tight, the function of the area affected can be reduced (for example, fingers).
  • Enlarged red blood vessels on the hands, face and around nail beds (called “telangiectasias”).
  • Calcium deposits in the skin or other areas.
  • High blood pressure from kidney problems.
  • Heartburn; this is an extremely common problem in scleroderma.
  • Other problems of the digestive tract such as difficulty swallowing food, bloating and constipation, or problems absorbing food leading to weight loss.
  • Shortness of breath.
  • Joint pain.

HOW IS SCLERODERMA TREATED?

While some treatments are effective in treating some aspects of this disease, there is no drug that has been clearly proven to stop, or reverse, the key symptom of skin thickening and hardening. Medications that have proven helpful in treating other autoimmune diseases, such as rheumatoid arthritis and lupus, usually don’t work for people with scleroderma. Doctors aim to curb individual symptoms and prevent further complications with a combination of drugs and self-care. [1]

 

If you have been diagnosed with Scleroderma and are considering applying for short term or long term disability benefits, it is important to seek regular treatment from a rheumatologist, the most appropriate specialist for diagnosing and treating Scleroderma. It also is helpful to obtain confirmation of the diagnosis from a major clinic such as Mayo or Cleveland Clinic in order to bolster the medical support for your disability claim.

During the claim process, the insurance company will request that your rheumatologist complete forms explaining the severity of your condition and why you are restricted from working. Make sure that your rheumatologist is comfortable completing disability forms and has no problem certifying your disability.  Otherwise, it may be difficult for  you to prove that your condition keeps you from working.

Scleroderma can be a horribly disabling condition, especially in the later stages. We recently had a client curled up in a ball on the floor of a conference room, while we were trying to mediate her case, due to the extreme fatigue and pain she was experiencing related to the Scleroderma.  If you are suffering from Scleroderma and your short term or long term disability benefits have been denied by any of the major insurance companies such as Cigna, Prudential, MetLife, Hartford, Aetna, Liberty Mutual or Sedgwick, please contact the O’Ryan Law Firm so we can discuss a strategy for overcoming the denial of your claim.

[1]http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Scleroderma_(also_known_as_systemic_sclerosis)/