 IMPAIRMENTS |
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The following summary of impairments is intended as a guide, which can assist you when meeting with clients. These guidelines serve as a preliminary estimate only. Since it is difficult to accurately assess a case without all of the medical information available, final offers received from underwriting may differ, depending on the whole case review. As always, if you would like additional information, please contact a Symetra Financial underwriter.
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| A |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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Absence Seizures
Petit Mal
Minor Epilepsy
These are names for generalized seizures that are manifest by brief attacks of altered consciousness, confusion, a dazed look or staring.
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Date of last seizure
How many attacks per month
Name of medication and dosage
Who is prescribing medication
Date of last visit to physician
Results
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APS
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0 to 1 year since last attack-Table 2 to 3 and up
1 to 2 years since last attack-possible Standard
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Grand Mal Seizure
The principal feature of this seizure disorder is a momentary loss of consciousness followed by convulsive movements of the body.
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Date of last seizure
How many attacks per month
Name of medication and dosage
Who is prescribing medication
Date of last visit to physician
Results
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APS
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Last episode within one year-Table 6 and up
Last episode two years ago-Table 2 to 4
Last episode three to five years ago-Standard to Table 2
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Acquired Immune Deficiency Syndrome - AIDS
Related Complex - HIV Infection
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Cannot consider
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Alcohol Abuse
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Date of last drink
Member of AA or other group
If so, how long
Treatment program
If so, dates and names of facilities
List all medical complications
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APS
Inspection Report
MVR
Full Blood
Urinalysis
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History of two or more DWI/DUI's within two years-Postpone
Current alcohol use-Decline
Treatment within one year-Postpone
Treatment within two years-Minimum Table 4 and up
May be Standard after five years
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Alzheimer's Disease
A progressive dementia of unknown cause, which can affect both young and older adults.
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Cannot consider
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Anemia
Develops as a result of blood loss from bleeding, reduced or faulty production of red blood cells by the bone marrow, or premature destruction of red blood cells.
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Exact type, if known
Name date and results of last visit to physician
Treatment
Name and dosage of medication
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APS
Possible blood studies
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Rate will be based on type of anemia and can range from Standard to Decline
Iron Deficiency-usually Standard unless chronic
Pernicious Anemia-usually Standard if recovered
Sickle Cell Disease:
Under age 40-Decline
40 and up, will depend on date and severity of last crisis-possibly Table 4 and up
Sickle Cell Trait-usually Standard
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Aneurysm
A localized dilatation of the wall of a blood vessel, usually an artery.
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Type or location
Treatment and dates
Symptoms
Names, addresses and dates of all physicians consulted
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APS
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Present-Decline
Rating will depend on the type of aneurysm, location, treatment and symptoms
Contact your Home Office Underwriter with above information for possible offer
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Angina Pectoris
Chest pain which occurs due to the inability of narrowed coronary arteries to deliver an adequate supply of blood to meet the oxygen demand of the heart muscle.
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Description of symptoms
How frequent
Dates of Emergency Room visits
Date of initial diagnosis
Name and dosage of medication
Name, date and results of last visit to physician
What treatment has been advised
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APS
EKG
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Consider after 6 months from date of diagnosis
Under age 40-usually Decline
Otherwise-Table 4 to Decline
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Angioplasty
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See Bypass Surgery
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Anorexia Nervosa
Persistent refusal to eat a balanced diet due to a morbid fear of being or becoming overweight.
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Date of diagnosis
Current weight and weight loss past year
List all complications
Name and address of attending physician
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APS
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Under treatment-Postpone
Thereafter depends on current weight, residuals, psychiatric status-may be Standard to Moderate Substandard after two years full recovery
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Apnea / Sleep Apnea
Apnea is a cessation of breathing for a period of at least 10 seconds during sleep.
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Obstructive, Central or Mixed
Treatment
Have sleep studies been advised and/or completed
If yes, where, when and results
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APS
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Rating dependent on age, apnea index, and treatment
This impairment can be Standard, but is usually rated Table 2 to 4
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Arteriosclerosis
Lipids are deposited on the walls of the arteries, which causes the formation of plaque. The result is thickening and loss of elasticity of the arterial walls.
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Date of diagnosis
Symptoms
Treatment
Names, addresses and dates of all physicians consulted
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APS
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Rating will depend on location, age, symptoms and degree of arterial narrowing
See specific discussion under Bypass Surgery
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Arthritis
Several different diseases with one symptom in common-inflammation of one or more joints.
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Type of arthritis
Limitations
Treatment
Medication (name and dosage)
Joints involved
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APS
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Gouty or Osteoarthritis
Usually Standard; severe cases may require rating in Table 2 to 4 range
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Rheumatoid Arthritis
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Degree of deformity
Date of onset
How frequent are attacks
Name, address and date last consulted with physician
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APS
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Rating will depend on age of onset, extent of deformity, residuals, treatment and frequency of attacks
Usually Table 4 to 6 if moderate disease
Some very mold cases can be Standard
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Asthma
Characterized by recurrent attacks of shortness of breath with wheezes due to spasms of the bronchioles.
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Frequency of symptoms
Date of last attack
Medication and how frequently used
Dates of Emergency Room visit or hospitalizations
Name, date and results of last visit to physician
Date of diagnosis
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APS
Possible Timed Vital Capacity (a pulmonary function test)
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Mild-Standard
Moderate-Standard to Table 4
Severe-Table 4 and up
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Atherosclerosis
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See Arteriosclerosis
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Atrial Fibrillation-Atrial Flutter
A variation of the normal rhythm of the heart's upper chambers.
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Date of onset
Frequency of episodes
Name and dosage of medication
List all doctors consulted and the dates of consultations
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APS
EKG
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Well-controlled on medication, with no underlying heart disease:
- One year from onset-Postpone
- Two years from last episode-Table 3 and up depending on age, with reductions possible for each further year without an attack
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| B |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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Benign Prostatic Hypertrophy Prostatitis
Enlargement of the prostate gland-common in men past age 60.
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Onset
Last PSA level
Date
Treatment
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APS
Possible PSA
blood test
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Most can be taken Standard if diagnosis based on urological workup and PSA levels stable
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Blood Pressure-Hypertension
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Date of onset
Date and level of last blood pressure reading
Treatment
Name of medication and dosage
Date last consulted physician
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Possible APS and/or exam
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If controlled, usually Standard
Any rating will depend on level of control maintained
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Bronchitis
Inflammation and/or infection of the bronchi.
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Acute or chronic
Date of diagnosis
Treatment
Associated with any other impairments
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Possible APS and Timed Vital Capacity
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Acute, fully recovered-Standard
Chronic, not associated with other impairments:
- Mild-can be Standard
- Moderate-Table 2 to 4
- Severe-Table 6 to Decline
If currently smoking, rating may be higher.
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Bulemia
Binge eating is characteristic, usually followed by self-induced vomiting and use of laxatives.
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Date of diagnosis
Treatment
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APS
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If fully recovered-possibly Standard
Consider after one year, possibly earlier for more favorable cases
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Bypass Surgery-Coronary
Involves grafting a vein, or artery to a coronary artery, past the site of obstruction to restore circulation to the heart muscle. Several arteries may be bypassed.
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Date of surgery
Chest pain history before and since surgery
Number of vessels bypassed
History of heart attack
Working full-time
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APS
Possible EKG
Submit Trial Application
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No offer first 6 months following recovery
Thereafter, rating will be dependent on age, EKG findings, number of arteries bypassed (or blocked), follow-up care and compliance, and coronary risk factors
Usually minimum Table 2 to 4 and up
A flat extra ranging from $5.00 per thousand and up is likely for 5 years following recovery
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| C |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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Cancer
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Type and location of cancer
Stage of cancer's invasion or Clark's level
Any chemotherapy or radiation treatment
If yes, the date of last treatment
Any metastasis (has cancer spread from primary organ or site)
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APS which must include pathology report from surgery and follow-up notes
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The extent of rating will depend on the type of malignancy and length of time since treatment
Contact your underwriter with all details for a tentative offer
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Cardiac Pacemaker
Pacemakers are battery-powered devices that can be implanted into the heart muscle for the purpose of electrically stimulating the heart muscle to contract.
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Date of implant
Name and address of all doctors consulted to include date and reason last seen
Complications
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APS
EKG
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Due to congenital heart blocks, with no other significant cardiovascular impairments:
- 1st year-Postpone
- Thereafter, individual consideration based on age and time since implant:
- 2 to 3 years-Table 6 and up
- 4 to 5 years-Table 4 and up
- 6 years-Table 2 and up
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Cerebral Palsy
A congenital disorder manifested by lack of coordination of muscular movement and speech defects of varying severity.
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Degree of development delay
Any mental impairment
Bowel and bladder impairment
Physical handicap
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APS
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Mild physical handicap:
- To age 10-likely flat extra rating
- Age 10 and up-Standard to Table 4 and up
Moderate physical handicap:
- To age 10-Postpone
- Age 10 and up-Table 4 and up
Others usually Decline
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Chest Pain
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Date of symptoms
Diagnosis
Specify if muscular, cardiac, or unknown origin
Date of hospital stays
Disability
Treatment
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APS
Possible EKG
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Depends on cause, EKG findings and frequency
If diagnosed as muscular, or chest wall pain-usually Standard
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Chronic Obstructive Pulmonary Disease (COPD)/Emphysema
Irreversible, generalized airway obstruction.
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Date of diagnosis
Treatment
Name and dosage of medication
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APS
Possible Timed Vital Capacity (a pulmonary function test)
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For best cases (mild, nonsmoker)-could be Standard, depending on pulmonary function studies and degree of impairment
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Colitis
An inflammatory disorder of unknown cause, affecting the intestinal tract.
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Indicate type-such as spastic or ulcerative
Date of diagnosis
Frequency of symptoms
Treatment
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APS
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Irritable bowel, mucous colitis, or spastic-usually Standard
Ulcerative
Depends on duration and response to treatment-offer range from Standard to Decline
See Ulcerative Colitis
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Collagen Diseases-
Connective Tissue Diseases
The term refers to a general category of different diseases, characterized by inflammation of the collagen-containing structures, such as blood vessels, muscles and skin.
Systemic lupus erythematosus is an example.
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Type
Duration
Medication
Complications
Extent of involvement
Stabilized
In remission
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APS
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Depends on type
Mild, localized, well-controlled forms of SLE:
- After 1 year-can be rated
- 2nd to 5th year-Table 6 and up
- 5 years after treatment has ceased-Standard rates may be offered
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Congestive Heart Failure
Failure of heart muscle to supply oxygenated blood to meet the oxygen demands of the peripheral tissues.
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Acute or chronic
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APS if diagnosed as acute
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Chronic-Decline
Acute-will rate for cause, can be associated with heart attack or arrhythmias
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Coronary-Angioplasty (PTCA)
Reduces the obstruction of a blocked artery by using a balloon-tipped catheter.
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See Bypass Surgery for handling
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Coronary-Infarction (Heart Attack)
Myocardial infarction occurs when one or more blocked coronary arteries cause a severe enough reduction in blood/oxygen supply to the heart muscle, resulting in tissue destruction; muscle damage is permanent.
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Date of heart attack
Treatment
Working full-time
Medicine and dosage
Has surgery been suggested, or scheduled
Any symptoms following attack
If yes, frequency and date of last symptoms
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APS
EKG
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Rating will depend on age, EKG findings and current risk factors (smoking and blood lipids)
Offer minimum six months after recovery date-minimum Table 2 and up with some offers having a Table rating and temporary Flat Extra of $5.00/1000 and up
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Crohn's Disease
A subacute and chronic inflammation of the entire gastrointestinal tract.
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Date of diagnosis
Treatment
Date of last attack
Complications
Surgery date
Any problems since surgery
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APS
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Under age 45-Table 2 and up
Age 45 and older-Table 2 to 4 and up
With surgery and no recurrence:
- Within six months of surgery-Postpone
- Six months to one year-Table 4 and up
- One to two years-Table 3 and up
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| D |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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Diabetes Mellitus
A disorder of carbohydrate metabolism.
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Treatment
Date of onset
Control
Complications
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APS
Full blood profile with glycohemoglobin (instruct paramed to request on lad I.D. slip)
Urinalysis
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If any history of heart disease, kidney disease, severe retinopathy or neuropathy-likely Decline
If well-controlled-could be Standard, depending of age at onset
Oral medication-Standard to Table 4
Insulin dependent and age:
- 0 to 14 - Postpone
- 15 to 25 - Table 8 and up
- 26 to 35 - Table 6 and up
- 36 to 40 - Table 4 and up
- 41 to 50 - Table 3 and up
- 51 and beyond - Table 2 and up
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Depression, Major
Unipolar/Bipolar
Marked by a loss of interest or pleasure in most activities, changes in sleep patterns, thoughts of death and suicide.
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Date of diagnosis
Treatment
Dates of hospitalizations
Dates of episodes
List all doctors consulted and dates
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APS
Inspection Report
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Mild-Standard to Table 2 and up
Major-Table 2 to 4 and up, depending on severity and age at onset
Likely Decline if any signs of drug, alcohol abuse, or suicidal ideations
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Dialysis
Artificial urinary filtering required due to kidney failure.
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Acute or chronic
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APS
Full Blood
Urinalysis
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Acute, full recovery, rate depends on cause-Postpone first six months
Chronic-Decline
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| E |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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Back to Search
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| G |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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| H |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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Hepatitis
An inflammatory reaction of the liver to the presence of infectious or toxic agents.
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Date of diagnosis
Treatment
Type
Names and addresses of all doctors consulted
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APS
Results of any liver biopsy
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For all types within 6 months from recovery-Postpone
Hepatitis A & B, full recovery, no residuals-probably Standard
Hepatitis C-usually Decline
Chronic Active Hepatitis-Decline
Chronic Persistent Hepatitis, recovery with no residuals:
- Within one year-Postpone
- Second year-Table 6 to 8
- Third to fourth year-Table 2 to 4
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Heart Attack
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See Coronary-Infarction.
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Heart Murmur
Normally, blood passes through the heart valves and chambers almost without a sound. If the smooth blood flow is interfered with by either obstruction or leakage of a valve, or other heart structure defect, turbulent side currents are created which produce abnormal effects and sounds (called heart murmurs).
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Specific diagnosis
Symptoms
Treatment
Date found
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APS
Possible M.D. Exam
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Mitral Valve Prolapse-usually Standard, unless complicated
Many types of heart murmurs do not affect heart function and are benign
These are usually accepted at Standard rates, some murmurs affect heart function and these are usually rated and occasionally declined, depending on their severity
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Hernia
The protrusion of an organ or part of an organ or other structure through the wall of the cavity normally containing it.
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Type
Symptoms
Treatment
Complications
Medication (name and dosage)
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Complete details on application will usually suffice
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Small, with minimal symptoms-usually Standard
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High Blood Pressure-Hypertension
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See Blood Pressure.
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HIV Infection
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Cannot consider.
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| M |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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Mitral Valve Prolapse
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See Heart Murmur.
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Multiple Sclerosis (MS)
A chronic disease which can eventually cause disturbances of vision, muscle weakness and incoordination.
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Date of diagnosis
How many episodes
Date of last episode
Residuals
Names and addresses of all physicians consulted
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APS
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One or two episodes with no or minimal residuals, last episode:
- Within one year-Postpone
- Second and third years-Table 6 to 10 and up
- Fourth year-Table 2 to 4 and up
There will be higher ratings for more residuals and frequent episodes
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Muscular Dystrophy
Disease of the muscles.
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Usually decline
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Usually decline
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Usually decline
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| P |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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Pacemaker
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See Cardiac.
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Paraplegia
Complete paralysis of both legs.
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Date of onset
Bowel and bladder function under control
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APS
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Within six months-Postpone
Thereafter-minimum Table 4 and up, depending on severity
With bowel and bladder function impairment-Table 8 and up
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| Q |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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Quadriplegia
Complete paralysis of arms and legs.
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Date of onset
Bowel and bladder function under control
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APS
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Within one year-Postpone
Second to third year-Table 10 and up
Fourth year and on-Table 8 and up
With bowel and bladder function impairment-usually Decline
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| S |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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Seizure
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See Absence Seizure.
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Stroke/TIA
A TIA (Transient Ischemic Attack) is a temporary interruption of the blood supply.
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Date of stroke
Residuals
More than one episode
Medication and/or treatment
Names and addresses of physicians consulted
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APS
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Stroke
First year-Postpone
Thereafter-Table 4 and up
TIA
6 months-Postpone
Thereafter-Table 2 and up
More than one attack-usually Decline
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| T |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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Tachycardia
Very rapid heart beat, this does not mean heart disease per se; it can occur with many other impairments and situations.
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Date of first symptoms
List all Emergency Room visits and dates
Medication prescribed
Date of last symptoms and how frequently symptoms occur
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APS
EKG
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If attacks are short, infrequent, and occur in an otherwise healthy applicant with no known heart disease, may be Standard
Prolonged, or symptomatic attacks, which require drug treatment, may be rated
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Transient Ischemic Attack
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See Stroke.
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| U |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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Ulcerative Colitis
Recurrent disease of the colonic and rectal mucosa with inflammation and ulceration. There is an increased risk of carcinoma of the colon and rectum.
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Date of diagnosis
Treatment
Date of last attack
How many attacks per month
Any complications
Any surgery advised or contemplated
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APS
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Low to high substandard, depending on number of episodes, treatment, complications and duration
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Ulcer
Gastric
Peptic
Ulceration of the stomach results when an area of mucous membrane in the stomach is damaged by the hydrochloric acid and pepsin present in gastric secretion.
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Date of diagnosis
How many attacks
Date of last symptoms
Any bleeding or perforation
Treatment
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APS
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Usually Standard, unless complicated
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| V |
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Impairment and Description
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Field Underwriting Questions to Ask Proposed Insured
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Probable Additional Requirements
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Probable Underwriting Action
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Valley Fever
An infection endemic in the Southwestern part of the U.S. It most often involves the skin and lungs, but may spread into the bones, joints and brain.
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Date of diagnosis
Symptoms
Treatment
Location of involvement
Name and address of physician and date last consulted for this impairment
Results
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APS if recent and involves more than skin
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Within 6 months of diagnosis-Postpone
Treated and reported cured-probably Standard
Internal involvement-individual consideration; many in this category will be rated and possibly Declined
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