Nailba.org

Print Page
E-mail Page
COMMON MEDICAL
IMPAIRMENTS SUMMARY
CONDITION
UNDERwRITING FACTORS
Alcohol:
History of Condition:
Alcohol abuse, addiction or dependency leading to social, medical, • When did condition begin?and legal issues. Alcoholics have an uncontrollable need for alcohol • Time since stopped drinking?and continue drinking despite adverse social and occupational • Reason for stopping?• Traffic violations or legal problems caused by alcohol? If client has received treatment in the past and uses any alcohol Treatment/Therapy:
• Hospitalization required?
• In/out-patient therapy?
• Member of AA or support group?
• Any use of Antabuse?
Current Condition:
• Normal blood studies? (i.e. Liver) Function tests: SGOT,
Related Issues:
• Client treated for drug problem?
• Court-appointed treatment?
Alzheimer’s Disease:
History of Condition:
Dementia caused by degeneration of the brain resulting in loss of cognitive function, memory loss of recent or past events, • Impaired judgment?• Rate of progression?• Activities of Daily Living?• Living independently?• Any assistance required?• Medication: type and dosage?• Any other medical conditions? History of Condition:
Decrease in the number of red blood cells or hemoglobin in the blood due to blood loss, decreased production in the bone marrow, • Type of anemia?or increased destruction (hemolysis) of red blood cells.
• Cause of anemia?• Treatment—type and dosage?• Recent red blood count (RBC), hemoglobin (Hgb), and mean• corpuscular volume (MCV) results?• Any other medical conditions? 18 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.
Aneurysm:
History of Condition:
An aneurysm is a dilation or ballooning in the wall of an artery that • Type of Aneurysmcan be caused by atherosclerosis or uncontrolled blood pressure.
Rupture of the aneurysm can be life-threatening. Aneurysms can • Dates of imaging studies, and size at each test be found in any artery, but the most common are: • Stable in size or increasing? If stable, for how long? • Treated surgically? If so, what type of treatment, and date? • Smoker? If previously a smoker, how long since quit? • Other health issues (pain in legs when walking? Elevated Cho- lesterol? Hypertension? Diabetes? CAD or Cerebrovascular Disease?) Angina Pectoris
Angioplasty
Anorexia Nervosa:
History of Condition:
A psychiatric disorder characterized by a fear of obesity, low body • Age at diagnosis?• Current and prior height/weight?• Type of treatment?• Hospitalization required?• Medication: type and dosage?• Does client have a normal lifestyle now?• Length of recovery?• Any other mental health disorder/issue? Anxiety Disorders:
History of Condition:
• Severity of disorder?• Frequency of any panic attacks?• Type of treatment?• Medication: type and dosage?• Dates of any suicidal thoughts or attempts?• Dates of any hospitalization(s)?• Functional and/or recovered? Related Issues:
• Driving history?
Arrhythmia:
Description of Condition:
Deviation from the normal rhythm of the heart. • Date of diagnosis?• What is the specific arrhythmia? Sinus bradycardia, sinus tachycardia, paroxysmal tachycardia, paroxysmal atrial tachycardia, paroxysmal ventricular tachycardia, sick sinus syndrome, irregular/ectopic pulse, atrial fibrillation, atrial • Client’s symptoms?flutter, ventricular fibrillation, and wandering pacemaker.
• Any associated conditions/health problems? Treatment:
• Dates and type of treatment received?
• Medication: type and dosage
• Any complications from treatment?
• Does client have a pacemaker?
Arteriosclerosis
19 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.
History of Condition:
Lung disorder characterized by reversible obstruction of the bronchi (bronchospasm) or increased hypersensitivity of the • Type and severity? Any status asthmaticus? airways to various stimuli (allergens, dust, chemicals, exercise, or • Results of pulmonary function tests (FVC and FEV1)?cold air). Symptoms include coughing, shortness of breath, and • Frequency of attacks? Dates of first/most recent attacks? • Any hospitalization or ER visits?• Medication: type and dosage?• Client’s occupation?• Current and prior smoking history? Barrett’s Esophagus
Overweight, underweight, or rapid weight loss • Weight gain/loss in past year?• How and why did weight change?• Gastric bypass?• How long has current weight been maintained?• Any other impairments or conditions? Bulimia Nervosa:
History of Condition:
A psychiatric disorder characterized by self-induced vomiting, use of laxatives or diuretics, binge eating episodes, and a • Current and prior height/weight?• Type of treatment?• Hospitalization required?• Medication: type and dosage?• Does client have a normal lifestyle now?• For how long?• Other psychiatric disorders? Bypass Surgery
History of Condition:
Cancer, neoplasia, and malignancy are interchangeable terms used to describe a pathological condition of cellular growth that is • Date of diagnosis?invasive and has a tendency to metastasize (spread to other parts • Pathology results: tumor size, stage, and grade? of body). Prognosis varies by tumor type, stage, and grade.
• Did cancer spread (metastasize)? Where? Treatment:
• Describe treatment and start/end dates (including surgery,
• chemotherapy, and radiation)
• Medication: type and dosage; start/end dates?
Current Condition:
• Recurrence?
• Results of interim testing?
• Date and outcome of last physician visit?
20 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.
Cerebrovascular Disease:
History of Condition:
• Cerebral vascular accidents (CVA) or strokes resulting from • Type and dates of episodes? interruption of blood flow to the central nervous system. Tests and Treatment:
• Hypotension (low BP) due to arrhythmias • Results of carotid ultrasound, angiography, Stress EKG treadmill testing, coronary angiogram, and echocardiography? Current Condition:
• Transient ischemia attack (TIA) is a short interruption in blood supply to a portion of the brain, resulting in tempo- rary neurological symptoms usually lasting 24 hours or less. • Any other medical problems or issues with circulation? Cirrhosis
Congenital Heart Disease:
History of Condition:
Congenital heart disease is a type of defect or malformation in one • Type of congenital abnormality?or more structures of the heart or blood vessels that occurs before • Severity?birth. Congenital heart defects may produce symptoms at birth, • Treatment including dates and type of any surgical proce- during childhood, and sometimes not until adulthood. Examples • Atrial and ventricular septal defects • Any other medical conditions?• Current and prior smoking history? COPD (Chronic obstructive pulmonary disease) /
History of Condition:
Emphysema / Chronic bronchitis / Chronic
obstructive lung disease (COLD):
• Medication: type and dosage?• Results of pulmonary function tests (FVC and FEV1)? Chronic obstructive pulmonary disease (COPD) is a group of lung • Shortness of breath at rest or with exercise? diseases where airflow through the airways leading to and within the lungs is partially blocked, resulting in difficulty breathing. As the disease progresses, breathing becomes more difficult and • Chronic bronchitis: Inflammation occurs in the bronchial • Emphysema: Permanent lung damage to the air sacs (alveoli) COPD is a gradually progressive disease with more rapid progression in individuals who continue to smoke. In many individuals with COPD, the airway obstruction is partially reversible in response to bronchodilators.
21 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.
Coronary Artery Disease:
History of Condition:
Restriction of oxygen to the heart cause by atherosclerosis (narrowed arteries), thrombosis, or spasm. When blood flow becomes compromised due to stenosis, it leads to symptoms of • Severity of disease—Number and names of vessels affected? chest pain (a.k.a. angina or ischemia). Plaques can rupture and • Surgical history—bypass or angioplasty (with or without release debris that prompts the formation of blood clots, a common cause of heart attacks and strokes. If the plaque blocks the artery completely, the area of the heart that is being supplied by • Medication: type and dosage?the artery dies, resulting in a myocardial infarction (heart attack).
• Dates and results of angiograms, stress tests, and perfusion• studies?• Ejection fraction (EF) > 50%?• Any symptoms post-operatively?• Blood pressure and cholesterol levels?• Active lifestyle?• Family history of early death from coronary disease?• Current and prior smoking history? Crohn’s Disease:
History of Condition:
Crohn’s disease may also be called ileitis or enteritis. Crohn’s disease usually occurs in the lower part of the small intestine, called the ileum, but it can affect any part of the digestive tract, from the mouth to the anus. Attacks can be chronic or isolated. Complete remission can occur, but surgery is frequently required due to failure of drug therapy or complications. Crohn’s can recur • Any ongoing symptoms orcomplications?• Underweight or anemic? Depression:
History of Condition:
• Manic depression/Bipolar disorder: cyclical swings between • Reactive depression: depression caused by an external situa- tion that is relieved when situation is removed.
• Dates of any hospitalization?• Medication: type and dosage?• Dates of any suicidal thoughts or attempts?• Functional and/or recovered? Related Issues:
• Driving history?
22 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.
Diabetes Mellitus:
History of Condition:
A chronic disease occurring when the pancreas does not produce enough insulin. The body’s ability to utilize carbohydrates and break down fats is reduced. Sugars build up in the blood and urine, • Client’s age at onset?leading to complications affecting the heart, brain, legs, eyes, kidneys, and nerves. Uncontrolled diabetes can result in angina, Tests and Treatment:
heart failure, stroke, leg cramps on walking (claudication, periph- eral vascular disease), poor vision, renal failure, and damage to • How often does client test sugar levels at home and visit his/ The diagnosis of diabetes is made when an individual has high blood sugar levels in the blood, increased thirst, urination, hunger, Current Condition:
frequent infections, or signs of any of the complications associated • Degree of control?with diabetes. • Latest and average of hemoglobin A1C readings?• Any complications or other medical impairments? To confirm a diagnosis, physicians will measure the level of a pro- tein in the blood, hemoglobin A1C (a.k.a. glycolated or glycosylated • Current and prior smoking history?hemoglobin).
Types:
• Type 1, Insulin dependent (IDDM), Juvenile onset diabetes
• Type 2, Non-insulin dependent (NIDDM), Adult onset diabetes
• mellitus (AODM)]
• Gestational diabetes
• Pancreatic failure
Diverticulosis and Diverticulitis:
History of Condition:
Diverticula are small pouches that form through the muscular layer • Date of diagnosis?of the intestinal wall. Diverticulitis is the inflammation of one or more of these pockets. Complications include abscess, fistula, or obstruction of the colon that require surgery.
• Hospitalization or surgery?• Medication: type and dosage?• Any ongoing symptoms or complications? History of Condition:
A chemical substance that alters mental, emotional, or bodily function. Usually applied to narcotics, it also includes prescription • Amount?drugs, which can be abused when dosages are exceeded.
• Frequency of use?• How long client has been clean?• Any relapses?• History of drug overdose? Treatment:
• Rehab program?
• In/out patient?
• Duration of stay?
Related Issues:
• Use or abuse of alcohol?
• Suffer from depression?
• Stable job and home life?
• Any other medical problems?
• Traffic violations or legal problems caused by drug use?
23 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.
EkG and Stress EkG Abnormalities:
History of Condition:
Electrocardiograms measure the electrical activity of the heart through special sensors placed strategically on the chest, arms, and legs. The electrodes are connected to a machine that translates • How long have the findings been stable over time?the electrical activity into line tracings on paper. The tracings are • Results of any advanced testing: i.e., resting or stress analyzed by the machine, the physician, skilled underwriters, or • echocardiograms, MUGA, thallium stress tests, angiograms, • doppler? • Any underlying vascular disease? A resting EKG may suggest:• Problems with heart rhythm or rate (arrhythmias)• Heart enlargement• Inflammation of the lining of the heart (pericarditis)• Insufficient blood flow (ischemia)• Prior injury (myocardial infarction)• Electrical abnormalities caused by electrolyte imbalance in the Stressing the heart through exercise (treadmill or bike) or using a
medication increases the heart rate, blood pressure, and demand
on the heart muscle. Ischemia may occur during exercise in areas
of the heart supplied by narrowed coronary arteries. Other
symptoms (shortness of breath, chest pain, claudication) can be
strong predictors of this or other vascular impairments.
Emphysema
Epilepsy/Seizures:
History of Condition:
Abnormal discharges within the brain characterized by recurring attacks of motor, sensory, or psychic malfunction, with or without loss of consciousness, convulsive movements, and urinary incontinence. Seizures can cause falls, drowning, and accidents. A prolonged seizure condition called status epilepticus can lead to • Medication: type and dosage?coma or death.
• Client’s occupation?• Any traffic violations or incidents? 24 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.
Esophagitis:
History of Condition:
Inflammation of the esophagus is a complication of gastroesopha- geal reflux disease (GERD). If GERD is left untreated, esophagitis can cause bleeding, ulcers, and chronic scarring. This scarring can • Hospitalization or surgery?narrow the esophagus, eventually interfering with swallowing.
• Results of upper GI series and endoscopies? Any Barrett’s?• Medication: type and dosage? Chronic or longstanding GERD can lead to Barrett’s esophagus. • Any ongoing symptoms or complications (i.e., hemorrhage or Barrett’s esophagus results when the normal cells of the esophagus are replaced with cells similar to those of the intestine. • Underweight or anemic?It is a precancerous lesion that increases the risk of esophageal • Current and prior alcohol use—type, quantity, and frequency? Fatty Liver
Fibrocystic Breast Disease:
History of Condition:
Generalized breast lumpiness, also called fibrocystic breast changes or benign (noncancerous) breast disease.
• Any hyperplasia or dysplasia on biopsy?• Any personal or family history of breast cancer?• Breast exams and mammograms performed regularly? Gilbert’s Disease (Familial Hyperbilirubinemia):
History of Condition:
Gilbert’s Disease is a benign, hereditary condition disorder leading • Date of diagnosis?to a defect in the removal of bilirubin from the liver. Blood tests • Results of any liver biopsies or ultrasounds? reveal elevated unconjugated/indirect bilirubin. Most people avoid • Past and recent liver function test results—bilirubin, alkaline serious health problems for normal life expectancy.
Glomerulonephritis (Bright’s disease):
History of Condition:
The kidneys’ filters (glomeruli) become inflamed and scarred, los- ing their ability to remove wastes and excess water from the blood • Details/type of treatment?to make urine. As the kidney damage progresses, symptoms may develop, such as: blood (hematuria) and protein (proteinuria) in the • Results of latest urinalysis?urine; swelling (edema) in the hands, feet, and ankles; and elevated • Past and recent kidney function test results—BUN, creatinine, blood pressure. If left untreated, the condition can lead to kidney failure. Treatment aims to slow the progression and prevent 25 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.
Heart Enlargement/Cardiomegaly:
History of Condition:
Enlargement can be diagnosed on examination, by X-ray, sug- gested on a resting EKG, or through “the Gold Standard,” an echocardiogram (ultrasound of the heart). The enlargement can be a concentric or asymmetric thickening (hypertrophy) of the left ventricular wall or dilation of a heart chamber (atria or ventricles) Current Condition:
• Congenital heart disease• Hypertension• Obesity• Pericardial effusion• Pulmonary hypertension• Sleep apnea• Valvular heart disease Normal Ranges on Echocardiogram:
Left atrial dimension (LA): 1.9–4.0 cm
Left ventricular dimension at end-diastole (LVED): 3.7–5.6 cm
Right ventricular dimension at end-diastole (RVED): 0.7–2.8 cm
Interventricular septum (IVS) thickness at enddiastole: 0.6–1.2 cm
LV posterior wall (LVPW) thickness at end-diastole: 0.6–1.2 cm
IVS/LVPW ratio: < 1.3 cm
Aortic root dimension: 2.0–4.0 cm
Heart Murmur
Hemochromatosis (Bronzed Diabetes):
History of Condition:
Hemochromatosis is a condition that develops when too much iron • Date of diagnosis?builds up in the body, resulting in damage to tissues and eventually • Severity of liver disease?organ dysfunction. Diagnosis is made through blood tests of iron, • Results of any liver biopsies or ultrasounds? • Type and dates of treatments?• Past and recent liver function test results—SGOT, SGPT, • Past and recent serum transferring saturation, ferritin level, • Cardiomyopathy• Liver failure• Liver cancer Hemochromatosis is treated by getting rid of extra iron in the body through regular blood loss (phlebotomy) or use of chelating agents that gather up excess iron and remove it through the urine.
If hemochromatosis is treated early, most people have a normal life
expectancy.
Hepatitis
26 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.
Hypertension:
History of Condition:
Age, gender, genetics, obesity, salt consumption, psychological stress, trauma, pregnancy, kidney disease, endocrine disorders, and tumors can affect blood pressure levels. When BP levels are • Compliant with treatment and visits to their physician? elevated over time, the risk for developing coronary artery disease, • Degree of control—Current BP levels and readings for the cerebrovascular accidents (CVA, stroke), kidney disorders, and congestive heart failure (CHF) increases. The risk of death from hy- • years?pertension is further increased when combined with other coronary • Any other medical conditions?risk factors such as build, smoking, diabetes, family history, and • Normal results on EKGs, stress tests, perfusion studies, and elevated lipids (cholesterol and triglycerides).
kidney Disease:
History of Condition:
Chronic kidney disease (CKD) is a condition that occurs when the kidneys lose their ability to remove waste or maintain the proper fluid and chemical balances in the body.
• Results of biopsies/ultrasounds?• Type and dates of treatments?• Kidney function test results: BUN, creatinine, 24-hr. urine kidney Transplant:
History of Condition:
Surgical replacement of diseased kidneys with a healthy (donor) kidney. There are two types of donors.
• What condition led to transplant?• Source of donated kidney? • Living donors—a family member (living related donor [LRD]) • Signs of rejection or infection with transplanted kidney? or a spouse or close friend (living unrelated donor [LURD]). • Type of immunosuppressive therapy used? Transplants using kidney of first-degree relative (father, • Results of current kidney function tests? (BUN, creatinine, mother, brother, sister) are most successful.
• • Cadaver donor: If there are no compatible living related or unrelated kidney donors, transplant patients are placed on a waiting list to receive a kidney from a person who has recently died (cadaver kidney).
To reduce the likelihood of rejection and ensure the donor kidney
matches the patient’s tissue blood type, blood tests are done prior
to transplant.
Liver disorders:
History of Condition:
Liver disease can include the build-up of fat (fatty liver), inflammation from a variety of causes (hepatitis), viral infection (viral hepatitis), scarring/fibrosis, and cell damage (cirrhosis).
• Liver biopsies/ultrasound results?• Type and dates of treatments?• Recovered?• Past and recent liver function test results—SGOT, SGPT, • Hepatitis cases: viral load?• Current and prior alcohol use—type, quantity, and frequency? 27 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.
History of Condition:
Systemic lupus erythematosus (SLE) is an autoimmune disease, meaning that the immune system turns against the body it is designed to protect. Lupus can affect many parts of the body, • What are primary symptoms and any complications? including the joints, skin, kidneys, heart, lungs, blood vessels, blood levels, and central nervous system. Some of the most • Any physical limitations/disability? common symptoms are fatigue, swollen or painful joints (arthritis), • Any other medical conditions?unexplained fever, and skin rashes.
Kidney function test results? BUN, creatinine, 24-hr. urine protein Mitral Valve Prolapse
Multiple Sclerosis:
History of Condition:
Degenerative disease of the central nervous system, in which hardening of tissue occurs throughout the brain and/or spinal cord. • Suspected or definite diagnosis?Symptoms include visual and sensory disturbances, weakness, lack of coordination, tremor, and spastic paraplegia.
• Dates and frequency of attacks and remission?• Medication: type and dosage?• Is client’s condition stable?• Is client ambulatory and independent?• Using braces, walker, or wheelchair?• Any problems with kidneys or bladder?• Currently employed or disabled? Muscular Dystrophy:
History of Condition:
Inherited, progressive muscular weakness due to irreversible • Type of muscular dystrophy?• Degree of physical impairment and rate of progression?• Type of treatment?• Medication: type and dosage?• Any other medical conditions? Osteopenia and Osteoporosis:
History of Condition:
Osteopenia and osteoporosis refers to lower bone mineral density (BMD—bone mass and strength) that results when the rate of bone • Results of BMD, X-ray, MRI, and CT scans?destruction exceeds the rate of bone formation. Osteoporosis does • Stable? Rate of progression?not result in death, but hip fractures can lead to pulmonary emboli • Medication: type and dosage?and impaired mobility. Vertebral fractures can lead to back pain, • Any fractures, mobility problems, spinal curvature, or dis- Paraplegia, Quadriplegia:
History of Condition:
Paralysis of legs, or arms and legs.
• Date of onset?• Cause of paralysis?• Any respiratory problems?• Any bowel or bladder issues? Parkinson’s Disease:
History of Condition:
Neurological disorder characterized by tremor, rigidity, and loss of • Medication: type and dosage?motor control. The cause is unknown, but it can result from toxins, • Onset date of symptoms?ischemia, infection, or trauma.
• Severity and degree of physical impairment?• Rate of progression?• Living independently?• Any assistance required?• Medication: type and dosage?• Any other medical conditions?• Impaired judgment? 28 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.
Peptic Ulcer Disease:
History of Condition:
Sores in the inner lining of the stomach (gastric) or upper small intestine (duodenal) develop when the stomach’s digestive juices irritate and damage the tissue. Infection with Helicobacter pylori (H. pylori) promotes ulceration and inflammation.
• Amount of any weight loss?• Any anemia—hemoglobin level?• Any difficulty swallowing (dysphagia) or jaundice?• Any obstruction?• Dates of any surgeries?• Current and prior smoking history?• Current and prior alcohol use—type, quantity, and frequency? Peripheral Vascular Disease (PVD):
History of Condition:
Atherosclerosis of the aorta and peripheral arteries. Peripheral vascular disease is most common in the vessels in the legs but can be present in the abdominal aorta, iliac, and renal arteries. Complications include skin ulcers and renal failure.
• Any other conditions such as hypertension, elevated lipids?• Claudication (exercise-induced pain in legs)?• Normal kidney function?• Smoking history? Polycystic kidney Disease:
History of Condition:
Enlargement of the kidneys due to the formation of bilateral multiple cysts. Hereditary condition with no known cure, although • Results of kidney function tests (BUN, serum creatinine tests, Rheumatoid Arthritis:
History of Condition:
A chronic, inflammatory disease of unknown cause. The characteristic feature is joint deformity and persistent inflammation • Medication: type and dosage?of the lining of the joints. Severity of the disease ranges from mild • Any steroid or immunosuppressant use?to a relentless, progressive polyarthritis with severe functional • Any complications from medication used? impairment. Some toxic forms of treatment can result in systemic • Rheumatoid factor level and sedimentation rate? • Details re: any physical limitations or disability?• Any other medical conditions?• Any anemia—hemoglobin level? Schizophrenia/Paranoia:
History of Condition:
Group of severe mental/emotional disorders, often involving delusions, hallucinations, and bizarre behavior.
• How severe is disorder?• Type of treatment?• Hospitalization required?• Medication: type and dosage?• Client capable of managing own affairs?• Is client employed?• Taking drug therapy?• Type and dosage? 29 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.
Sleep Apnea:
History of Condition:
Cessation of breathing for at least ten seconds during sleep. Apnea Index is the number of apnea episodes per hour. Hypopnea is 30 to 50 percent impaired airflow lasting ten seconds or more. Respiratory distress index (RDI) is the total of apneas and hypopneas. The term “sleep apnea” is used to describe a wide • Results of pre- and posttreatment sleep studies spectrum of complaints from loud snoring to periods of (polysomnograms): apnea index, hypopnea index, O2 satura- respiratory arrest long enough to lead to hypoxemia. Usually caused by upper-airway obstruction (obstructive) or loss of brain • Any daytime sleepiness?• Any motor vehicle incidents?• Heart condition or arrhythmias?• Blood abnormalities (hemoglobin)• Use of alcohol or other sedatives? Suicide Attempt
History of Condition:
• Date of attempt?
• Reason for attempt?
• Multiple attempts?
• Has client been hospitalized?
• Medication: type and dosage?
• Is client leading a normal life?
Transient Ischemic Attack (TIA)
Ulcerative Colitis:
History of Condition:
An inflammation of the mucosal layer of the wall • Frequency and severity of attacks?• Date of last attack? Treatment?• Hospitalization or surgery?• Medication: type and dosage?• Ongoing symptoms?• Underweight or anemic?• Any other medical conditions? 30 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.
Valvular Heart Disease:
History of Condition:
Heart murmurs are classified as functional murmurs and
organic murmurs based on the timing, loudness, duration, and • Type and severity of murmur?
location.
Functional Murmurs (also known as physiologic or innocent
Treatment:
• Non-radiating• Present and unchanged for long periods Related Issues:
• Any cardiac, arrhythmia, or congestive heart failure history?
Organic Murmurs are:
• Deformed heart valve caused by congenital heart disease, rheumatic heart disease, or atherosclerotic heart disease.
Current Condition:
• Variety of heart murmurs caused by blood flow through a • Aortic stenosis• Mitral insufficiency• Mitral stenosis• Mitral valve prolapse• Pulmonary insufficiency• Pulmonary stenosis• Tricuspid insufficiency• Tricuspid stenosis 31 NAILBA Field Underwriting Guide, Version 3.0 | Copyright January 2011. The National Association of Independent Life Brokerage Agencies (NAILBA). All rights reserved.

Source: http://www.nailba.org/sites/default/files/11-CommonMedical_Impairments_0.pdf