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Abdominal Aortic Aneurysm – Hardening of the Arteries |
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The aorta is the largest artery in the body. It arises from the heart at the aortic valve as the ascending aorta. The ascending aorta then turns, forming an arch, and descends through the diaphragm into the abdomen. After passing through the diaphragm, it is called the abdominal aorta. Disease in the descending and abdominal aorta is much more common than in the ascending aorta and will be due to atherosclerosis with the associated risk of Coronary Artery Disease (CAD). Atherosclerosis is vascular disease due to lipid and calcium deposition in arterial walls; the layman's term is “hardening of the arteries”. The disease leads to narrowing (stenosis) or dilation (aneurysms) or tearing (dissection) between the layers of the arterial wall. Ultrasound and CT scanning are excellent ways to measure aortic aneurysms and dissections. Simple physical examination of the abdomen is a good screening method for abdominal aortic aneurysm which can be detected as an enlargement or by a bruit. Due to the high mortality of ruptured aortic aneurysms, surgery is done when the aneurysm is 5-6 cm. in size.
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What was the date and size of the following test?
Ultrasound? CAT Scan? Surgery? Has it Stabilized? Is there pain in the legs when walking?
Do you have elevated cholesterol?
Hypertension? Diabetes? Coronary Artery Disease? Cerebrovascular disease?
What medications are you currently taking?
Do you smoke?
Are there any other associated health conditions?
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Acid Reflux |
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Acid reflux is a condition in which liquid content of the stomach regurgitates (backs up, or refluxes) into the esophagus. The liquid can damage the lining of the esophagus, causing inflammation (esophagitis) although this occurs in a minority of patients. The regurgitated liquid contains acid and pepsin that are produced by the stomach. (Pepsin is an enzyme that begins the digestion of proteins in the stomach.) |
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When is it more serious than acid reflux? |
If the acid reflux is more severe, excessive acid is refluxed from the stomach up into the esophagus. This causes an inflammation in the lower part of the esophagus. This scarring will produce damaged tissue in the form of a ring that narrows the opening of the esophagus, and is called an esophageal stricture.Treatment for an esophageal stricture involves dilation of the esophagus, medication, and sometimes surgery. |
Have you had an EDG (esophageal scope test) done?
If yes, how severeWere the strictures?
Are you taking any prescription medications?
Have you had your esophagus dilated? If yes, how many times?
Have you had surgery or has surgery
been recommended?
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Addison’s Disease – Adrenal Insufficiency |
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Addison's Disease is a hormonal (endocrine) disorder involving destruction of the adrenal glands (small glands adjacent to the kidneys). In patients with Addison's disease, the diseased glands can no longer produce sufficient adrenal hormones (specifically cortisol) necessary for the normal daily body functions. The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin in both exposed and non-exposed parts of the body. |
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When was the diagnosis? |
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What medications are you taking? |
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Have you ever been hospitalized for Addison's Disease or secondary insufficiency? |
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Any other illnesses present? |
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Have you been prescribed steroids? |
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Do you smoke? |
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Alcoholism |
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If someone has been treated for alcohol abuse, they will be underwritten as an alcoholic. If someone used AA to quit drinking or checked themselves into an alcohol cessation program, assume you will be underwritten as an alcoholic. |
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If you have been treated for alcoholism and currently use alcohol you will likely be declined. |
An exception may be an adult who was treated as a teenager, who is now a “responsible” adult (employed and a good Department of Motor Vehicles Record. |
Associated risks with Alcoholism: |
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Cardiac: Atrial fibrillation, cardiomyopathy, hypertension. |
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Nervous system:
Blackouts, seizures, delirium tremens (DTs), peripheral neuropathy, tremors, brain damage, psychosis, balance and gait impairments. |
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Gastrointestinal:
Fatty liver, hepatitis, cirrhosis, pancreatitis, gastrointestinal bleeding (sometimes massive) due to gastritis, varices, and esophagitis, cancer, and diarrhea.
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Bone marrow:
Abnormal blood counts including anemia. |
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Psychiatric and social:
Depression, anxiety, suicide, violent behavior, marital/occupational/familial problems, abuse of other drugs as well as alcohol.
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Miscellaneous:
Aspiration pneumonia, accidents and trauma Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease can be progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic.
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Binge drinking is highly risky for accidental mortality. It is defined as heavy drinking to the point of intoxication on a periodic basis.
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Risky drinking ( per the NIAAA - National Institute on Alcohol Abuse and Alcoholism ) is:
- For men, > 14 drinks per week or > 4 per occasion
- For women, > 7 drinks per week or > 3 per occasion
Note: One drink = 12 g of pure alcohol = 12 oz of beer = 5 oz of wine = 1.5 oz (a jigger) of hard liquor.
If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114.
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Angina |
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“Chest pain” is often a vague and nondescript symptom which can becaused from many conditions, such as: esophageal disease, hiatalhernia, peptic ulcer disease, pleurisy (inflammation of lining of the lung),chest wall muscle or ligament strains, anxiety disorders, pericarditis(inflammation of lining of the heart), and tumors.Ischemic chest pain (angina) is usually associated with exertion, or it canbe brought on by cold, eating, or emotional stress. It is caused by a lackof blood flow to the heart muscle. It can be relieved by rest, oxygen, ornitroglycerin. Angina is often described as a squeezing or crushing substernal pain radiating to the jaw, neck, shoulders or arms. The likelihood that the chest pain is angina is determined by the presence of well recognized cardiac risk factors such as: male sex, age over 40, smoker, family history of heart disease, diabetes, hypertension, and abnormal lipid profile such as an elevated cholesterol level.
You will want to provide the results and dates of testing for:
EKG Stress Test, Thallium Stress Test, MUGA Scan, Stress Echo, Ultrafast CT of the heart, Angiogram (cardiac catheterization)
If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
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Anemia (Iron Deficiency) |
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Anemia is having less than the normal number of red blood cells or less hemoglobin than normal in the blood. (Red blood cell, one of the blood cells that carry oxygen). Be specific in which type of anemia is present, if known.
|
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Is there a history of iron deficiency? |
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Any Complications? |
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Is current hemoglobin near or above 120? |
If you have an impaired risk, we
encourage you to complete the appropriate
impaired risk form. When granted
the privilege to work for you; we
will look at the bigger picture
and provide creative solutions in
easy to understand language. We
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Sickle Cell Anemia |
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Sickle Cell Anemia is a disorder of the blood caused by inherited abnormal hemoglobin [an oxygen-carrying protein within the red blood cells]. The abnormal hemoglobin causes distorted (sickled) red blood cells. The sickled red blood cells are fragile and prone to rupture. Anemia occurs when the number of red blood cells decreases from a rupture (hemolytic). These cases are difficult to insure and will likely result in extraordinary premiums.
If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114.
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Aneurysm- Abdominal Aortic |
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This is a dilation of the blood vessel wall that can lead to rupture. It is usually due to atherosclerosis. It may be rarely secondary to arteritis or connective tissue disease. If this is inoperable you will likely be declined or have a very expensive premium.
If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114.
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Angioplasty / Bypass |
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How long has it been since the procedure? You are ok to be considered after 6 months after the procedure. How many vessels were treated? If you still smoke you will likely be declined. The more time that has passed since the procedure, the better it will be in your favor. If diabetes or any other heart issues like arrhythmia's are present, this could cause an increased premium. Age of onset will be considered when this condition is present. Brackets of age ranges that may be considered will be < 45, 50 -59, 60 -79, 80+
If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114 .
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Anxiety |
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A panic attack typically lasts for several minutes and is one of the most distressing conditions that a person can experience. Most who have one attack will have others. When someone has repeated attacks, or feels severe anxiety about having another attack, he or she is said to have panic disorder. |
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If you are on disability for anxiety, you are likely to be declined. Concerns may be any suicidal gestures, hospitalizations or excessive quantity of medications.
If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114.
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Aortic Valve Replacement |
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One of the four valves in the heart, this valve is situated at exit of the left ventricle of the heart where the aorta [the largest of all arteries] begins. The aortic valve lets blood from the left ventricle be pumped up [ejected] into the aorta but prevents blood once it is in the aorta from returning to the heart. If you are not declined, expect to pay a high amount in premium.
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When was your surgery? |
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Is the replacement valve artificial or porcine? |
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Do you have high blood pressure? |
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Do you have left ventricle hypertrophy? |
| |
If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114.
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Aortic Valve Disorder |
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Aortic Stenosis (AS) |
Aortic stenosis is a narrowing of the opening of the aortic valve. It may be acquired or congenital. Acquired AS is usually caused by rheumatic fever or valvular calcification. An individual with congenital aortic valve disease may be born with stenosis already or may be born with a bicuspid aortic (a valve with 2 valve cusps instead of the normal 3) that can become stenotic over time. Aortic stenosis produces a low-pitched, systolic ejection murmur. The murmur is commonly transmitted to the neck (carotid arteries). The principle symptoms of AS are shortness of breath, chest pain, exertional syncope, and congestive heart failure. Because this valvular impairment does not cause symptoms until the disease is advanced, unoperated symptomatic individuals are usually uninsurable.
If you have an impaired risk, we encourage
you to complete the appropriate
impaired risk form. When granted
the privilege to work for you; we
will look at the bigger picture
and provide creative solutions in
easy to understand language. We
look forward to your email and/or
call. 1-800-264-8114.
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Aortic Sclerosis |
Aortic sclerosis is a thickening or calcification of the aortic valve without stenosis. This disorder occurs almost exclusively in the elderly population. Aortic sclerosis can be distinguished from aortic stenosis by an echocardiogram. A diagnosis of aortic sclerosis with no evidence of aortic stenosis is usually not rated.
If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114 .
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Aortic Insufficiency (AI) |
|
Aortic insufficiency
is the failure of the aortic valve
to close properly, thus allowing the
flow of blood backward into the left
ventricle. Most cases are due to rheumatic
fever, a congenitally bicuspid aortic
valve, or endocarditis ( infection
of the heart valve). AI may exist
for many years without producing symptoms.
Eventually, palpitations, shortness
of breath, chest pain, and congestive
heart failure develop. Aortic insufficiency
produces a high-pitched, blowing,
diastolic murmur which is widely transmitted.
Aortic insufficiency is also referred
to as aortic regurgitation.
How long has the abnormality been present? What type of disorder is present? Have any of the following occurred? Chest Pain? Palpitations? Trouble Breathing? Fainting? Dizziness? Heart Failure? Are there any other problems with other valves? Has an echocardiogram, cardiac catheterization been completed? What medications have been prescribed? Do you smoke? Are there any other health issues present?
If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114.
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Arrhythmia |
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Any change in the normal rhythm of the heart. The heart rate is normal, but the rhythm is irregular. A full APS (Attending Physician's Statement) will likely be sought.
If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114.
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Arthritis - Osteoarthritis |
|
| Osteoarthritis is a type of arthritis that is caused by breakdown of cartilage with eventual loss of the cartilage of the joints. Cartilage is a protein substance that serves as a "cushion" between the bones of the joints. Osteoarthritis is also known as degenerative arthritis. Among the over 100 different types of arthritis conditions, osteoarthritis is the most common. |
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Have you had any joints replacements? |
 |
Do you take steroids? If yes, how often? |
| |
If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114.
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Arthritis, Psoriatic |
|
| Psoriatic arthritis is a specific type of arthritis that has been diagnosed in approximately 23 percent of people who have psoriasis, according to the Psoriasis Foundation's 2001 Benchmark Survey. It commonly affects the ends of the fingers and toes. It can also affect the spine. The disease can be difficult to diagnose, particularly in its milder forms and earlier stages. Early diagnosis, however, is important for preventing long-term damage to joints and tissue. Most people with psoriatic arthritis also have psoriasis. Rarely, a person can have psoriatic arthritis without having psoriasis. |
 |
Your medications will be considered |
 |
Has if affected fingers? (Progressive?) |
 |
Any swelling of the joints, deformities or bone loss? |
| |
If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114.
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Arthritis - Rheumatoid |
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Rheumatoid arthritis is an autoimmune (i.e. the body attacks itself) disease that causes chronic inflammation of the joints. Rheumatoid arthritis can also cause inflammation of the tissue around the joints, as well as other organs in the body. |
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How has the rheumatoid arthritis affected your locomotion? (Any unassisted walking, use of a cane, or wheel chair use, etc.) |
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Has the rheumatoid arthritis affected any other parts of your body besides the small joints (i.e. eyes, lungs, heart, bone marrow, blood vessels, etc.)? |
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Are you anemic? |
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If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114.
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Asthma |
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Asthma is a lung disorder with attacks of breathing difficulty. The attacks can range from occasional periods of wheezing, mild coughing, and slight breathlessness to severe attacks that can lead to airway obstruction and total inability to breathe. Asthmatic attacks are caused by narrowing of the airways. This results from muscle spasm in the lungs, inflammation and swelling of the bronchial tubes, or excess mucus. The episodes can be started in a variety of ways including allergies, exercise (especially in cold, damp weather), occupational hazards (breathing in fine particles), or intrinsic (all other categories).
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Do you taken oral steroids? |
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Any injections of epinephrine? |
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Aerosolized (nebulized) bronchodilator? |
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Continuous use of steroids? |
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Number of inhalers and frequency of use? |
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Any hospitalizations? |
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Persistent wheezing or dyspnea that limits activity? |
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If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114.
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Athletes Heart |
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“Athlete's Heart” is a physiologic adaptation of the heart to vigorous physical training. It has not been shown to cause increased mortality, but this condition must be carefully distinguished from true heart disease. Often in attending physician statements, the term “athlete's heart” is used to describe many situations of heart enlargement - not all of which are truly benign athlete's heart syndrome.
One of the main distinguishing features is that the person must be a competitive level athlete who is undergoing vigorous physical training. The occasional jogger or “weekend warrior” should not have an enlarged heart and, if present, would point to the presence of heart disease. The sport that the athlete is involved in is also important. For example, competitive rowers have increased heart muscle mass but those who do track or weight lifting does not. |
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When were you first diagnosed?
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Are you a competitive athlete?
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Do you have chest discomfort? |
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Fainting spells? |
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Dizziness? |
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Shortness of breath? |
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Palpitations? |
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Have there been any cardiac studies completed? |
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Exercise treadmill? |
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Thallium? |
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Resting and/or exercise echocardiogram? |
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If you have an impaired risk, we encourage
you to complete the appropriate impaired
risk form. When granted the privilege
to work for you; we will look at the
bigger picture and provide creative
solutions in easy to understand language.
We look forward to your email and/or
call. 1-800-264-8114.
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Atrial Fibrillation |
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Atrial fibrillation is an abnormality in the heart rhythm, which involves irregular and often rapid beating of the heart. The abnormal heart rhythm leads to the diminished delivery of blood and its nutrients [oxygen, glucose and other electrolytes] to the brain and other organs. The lack of oxygen and nutrients causes symptoms such as weakness, fatigue, dizziness, fainting spells, and shortness of breath.
Our age is going to be a strong consideration. Also, the number of years you have had the condition. < 3 years, 3-5 years, 5-10 years, 10+ years; Were you under the age of 50 or older than the age of 50 at onset of the condition? Favorable cardiac tests will be sought. |
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How often are your episodes? |
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