Do You Have A Case?

What is POTS Syndrome?

Postural Orthostatic Tachycardia Syndrome, or “POTS” is a type of Dysautonomia. This autonomic nervous system disorder affects the body’s ability to regulate heart rate, blood circulation, blood pressure, digestion, and more. Common symptoms include fainting, chronic fatigue, chest pain, heart palpitations, tremors, anxiety, and dizziness. People living with POTS often experience a spike in heart rate when standing up from a sitting or prone position. According to Johns Hopkins Medicine, it is a condition that affects 1-3 million Americans.

Is POTS Syndrome a disability?

Many individuals living with POTS may find it disabling. Because it affects many primary functions of the nervous system, it can limit some people from adequately fulfilling their job. For jobs that require a lot of being on your feet or jobs where you have to get up and down from a sitting position often, POTS can be severely limiting.

While some may experience POTS as a singular diagnosis, it is found alongside other debilitating conditions as well. Ehlers-Danlos Syndrome (EDS), Mast Cell Activation Syndrome (MCAS), and Chronic Fatigue Syndrome (CFS) are not uncommon debilitating diagnoses that accompany POTS. Having more than one debilitating condition can seriously affect your ability to do your job.

What are the disabling symptoms of Postural Orthostatic Tachycardia Syndrome?

Orthostatic Tachycardia is the medical term for a spiking heart rate when sitting or standing up. Overall, those living with this syndrome deal with a variety of different symptoms. Many of these can be debilitating or disabling. Symptoms include:

• Chronic fatigue
• Chest pain
• Nausea
• Lightheadedness
• Low Blood Pressure
• Fainting
• Sweatiness
• Heart palpitations
• Shortness of breath
• Anxiety
• Difficulty sleeping
• Difficulty focusing
• Tremors
• Weakness

Generally, symptom occurrence and severity can vary case by case. In many cases, the spike in heart rate when sitting or standing can be 30-40 beats per minute extra.

Why Does Heart Rate Increase So Much with POTS?

Generally, standing up or sitting down causes gravity to affect our blood a little differently. While standing up, gravity pulls down more on your blood. Your body naturally releases hormones such as epinephrine and norepinephrine in response. These hormones tighten blood vessels and minimally increase your heart rate to compensate, and continue efficient blood flow. Unfortunately, for those living with POTS, lower blood pressure makes these effects more severe. Blood pools more in the lower half of your body, and cannot efficiently return to the heart and brain. This results in lightheadedness, fatigue, and dizziness.

Different Types Of Postural Orthostatic Tachycardia Syndrome

There are 4 different classifications of POTS. While the origins of this condition are not fully understood, the type you have may give you a better understanding of how it affects your body.

• Neuropathic POTS is generally associated with small fiber nerve damage. This is related to small-fiber neuropathy. Usually, these nerves regulate your body’s ability to constrict or relax the blood vessels in your body.
• Hyperadrenergic POTS refers to elevated levels of the stress hormone norepinephrine. Norepinephrine, along with adrenaline, increases your heart rate. With more of it being produced and released by your body, your heart rate tends to spike more often.
• Hypovolemic POTS describes a form of this condition caused by lower overall blood levels. With less blood than average in your body, it becomes harder for blood to flow effectively throughout your body.
• Secondary POTS is a form of this condition that is generally caused by another condition that affects the nervous system. This may include Diabetes, Lyme Disease, Lupus, or Sjögren’s Syndrome.

Is Postural Orthostatic Tachycardia Syndrome Fatal?

While POTS can be a life-altering condition, it is generally non-fatal. The biggest risk for those with the condition is falling from fainting. However, not everyone living with this condition will experience fainting. If you know that you have POTS, you may want to take precautions against trauma from falls.

How Do I Prove POTS as a Disability?

Most people living with this condition find that the best position to be in to reduce symptoms is a reclined posture. Generally, this is not something you can do in the vast majority of work environments. Overall, it may be difficult to properly perform your work duties when living with POTS. When you file a long-term disability claim for POTS, you will need to provide proof of your diagnosis and symptoms. Your insurance company will need documents proving your claim. You will need to provide medical evidence of how your symptoms limit your ability to work.

Getting a Diagnosis for POTS

Firstly, you will need to have a proper diagnosis of your condition. Generally, a POTS diagnosis is found through a variety of tests. The most common test for this condition is the Tilt Table Test. A Tilt Table Test is where the patient is harnessed to a special table that can be tilted back and forth. Your doctor will monitor your heart rate as the table moves you from a prone to a standing position. This recreates the motion of standing. Changes in blood pressure and heart rate during the test may determine a proper diagnosis. Abnormalities during this test may also indicate other conditions. Additionally, a physician may have you stand up from a sitting position and record your heart rate and blood pressure before and after. However, a Tilt Table Test offers a more objective diagnostic report, so it may be more effective in proving your case.

Medical Evidence of POTS Symptoms

Having a medical diagnosis of this condition isn’t technically enough evidence to prove it as a disability. Rather, you also need medical evidence that your POTS symptoms affect your ability to perform work tasks. These symptoms must be documented and verified through objective means. This can be somewhat difficult, as some symptoms can be subjective. Subjective symptoms can include things such as fatigue and lightheadedness. Generally, symptoms such as those are self-reported. Insurance companies are often skeptical of subjective self-reporting of symptoms. They may assume you are exaggerating claims of how you feel.

However, you can work with your doctor to bolster your claim by providing more concrete evidence. Look for a supportive doctor who understands the symptoms and potential work restrictions of your condition. Due to the varying symptoms of POTS, you may need to see multiple doctors of different specialties to best handle your condition. Cardiologists are often the most equipped to diagnose and report on your condition. Your primary care physician may also be able to help you obtain the records you need. Evidence from a neurologist may also be useful in building your case.

Medical Records of Your Condition

Proper medical records that show your limitations due to your condition are vital to building a POTS long-term disability case. Whenever you visit a doctor’s office, the details of your visit are recorded in the visit notes. These records are often essential to creating a strong foundation for your case.

When visiting your doctors regarding your POTS symptoms, be sure to tell them of all of the symptoms you are experiencing, even if it is not the reason for your visit.

Additional Testing Options

Multiple testing options can help you objectively document the effects of your POTS condition. While the Tilt Table Test can serve as a good way to record and diagnose your condition, you will likely need other tests to show that it is a disability. One such way to do this is by employing a Functional Capacity Evaluation (FCE).

A Functional Capacity Exam assesses your capacity for physical activity. Your POTS may affect your muscle strength, endurance, and more. Chronic pain or fatigue from your condition can also limit your ability to perform effectively at physical tasks. An FCE involves a series of tests conducted over the course of 2 days. Generally, the test measures different aspects of your physical capabilities such as strength, balance, and level of fatigue.

Additionally, mental fatigue can be a symptom of POTS. Cognitive dysfunction as a result of such mental strain can also be disabling. In order to document these symptoms, you may need to undergo a Neuropsychological Evaluation. This is a type of test performed by a neuropsychologist to help determine how your condition affects your mental capacity. Aspects such as your memory, attention span, verbal function, mental speed, and executive function are usually part of the evaluation. Then, the neuropsychologist evaluates the data from the test to determine any cognitive defects, and possibly link them to your condition.

Both FCE’s and Neuropsychological Evaluations include “validity measures.” These are tests within the evaluations that can confirm whether you are exuding your maximum effort. In short, they help add value and legitimacy to the results. These tests help provide objective evidence of how your condition affects your daily life and your ability to work.

Your POTS Disability Claim and Vocational Evidence

Vocational Evidence refers to an assessment that proves that your condition limits your work capacity. Basically, not every job requires the same amount of physical or mental ability. Some insurance companies will argue that POTS may not limit your ability to do a desk job, which may be considered “sedentary.” However, some desk jobs may require activities that can trigger your condition, such as getting up from your desk to attend meetings.

A Vocational Assessment looks to provide 4 key points. Firstly, it provides a comprehensive description of your job responsibilities. Next, it highlights the abilities and skills necessary to provide a successful fulfillment of your role. Then, it helps clearly explain whether you have the ability to meet these requirements. Lastly, the Vocational Assessment provides an expert conclusion as to whether or not you can perform such tasks at this or other jobs.

Can an Attorney Help Me Get Long-Term Disability for POTS Syndrome?

If you are looking to file a long term disability claim for your POTS condition, you should seek out an experienced attorney. At D’Agostino & Associates, we help people living with disabling conditions such as POTS Syndrome file long-term disability claims. We help you through the process step by step to help you build a strong case. Our law team is here for you.

At D’Agostino & Associates, our team of lawyers can help you sort through all the details, understand what you are entitled to, and fight to get what you deserve. D’Agostino & Associates P.C. has offices in New York and New Jersey. Contact us, or call us at 1-888-245-2924 to schedule a free consultation with our attorneys.