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Back/Neck Injury | Long Term Disability Claim Tips

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Neck and back injuries can significantly diminish mobility and cause excruciating pain. A back or neck injury can be the result of work or recreational activities, disease, a fall or other accident, or a degenerative disorder. Back and neck pain is one of the most common reasons why claimants file for long term disability insurance benefits. Insurers routinely deny back and neck pain claims for lack of objective evidence.

Below are tips on how to best get your back and/or neck pain disability claim approved.

What Are Common Disabling Neck and Back Conditions?

Your disability claim hinges on proving to your insurer that you have a back and/or neck injury, and the specific ways that your condition disables you from working. The first step is receiving a diagnosis from your doctor.

Neck Injuries

Neck injuries occur in a wide variety of ways, such as:

Regardless of the cause, neck injuries are very serious. Disabling symptoms of neck injuries can include:

      • Pain
      • Numbness
      • Difficulty swallowing
      • Limited range of motion
      • Dizziness
      • Severe headaches

Even if you work in a primarily sedentary job, a neck injury may leave you with a long term disability. A neck condition can limit your ability to move freely or hold your head in a static position for periods of time. Pain, headaches, and dizziness may affect your ability to perform the high executive functions required of your job.

 

Back Injuries

As is the case with neck injuries, back injuries often originate with some damage to the spine. Examples of back conditions include:

      • Arachnoiditis: Spine inflammation that causes severe pain and an inability to sit still for extended periods of time.
      • Spinal stenosis: A narrowing of the pathway through which nerves run down the spine. As such, compression of the nerve occurs, causing considerable pain.
      • Degenerative disc disease: Wear-and-tear of discs on the spine that separate bones, leading to chronic pain.

Disabling symptoms of back injury conditions can include:

      • Severe pain in the back
      • Numbness and tingling sensations
      • Muscle spasms
      • Pain radiating into legs
      • Difficulty standing for extended periods of time
      • Stiffness and/or difficulty in movement

Back injuries and degenerative conditions can be devastating. They can significantly affect your ability to carry out your day-to-day activities, including working.

How Do I Get Disability Benefits For A Neck or Back Condition?

A successful claim for long term disability benefits requires a complete package of supporting medical and vocational evidence. Insurance companies place great weight on objective medical evidence in back and neck injury cases.

Examples of objective evidence that can substantiate a neck and/or back injury include:

By contrast, pain—often the principal reason why a claimant with a back or neck injury cannot work—is a subjective complaint. It cannot be verified by objective testing or clinical observation, which is why insurers so frequently deny claims based on back or neck pain. Yet, insurers find subjective evidence more believable when it corresponds with objective evidence. For instance, if a claimant’s MRI shows a herniated disc, the claimant’s subjective complaint of back pain is more credible (and the claim more likely to be approved) because a herniated disc is expected to cause back pain.

Unfortunately, X-rays and MRIs cannot always prove how severe a person’s back pain is. Some people who report excruciating back pain have minimal abnormalities. Similarly, a person can have a normal range of motion and still experience considerable pain. In these cases, the insurer may deny a valid claim on the grounds that the claimant is exaggerating their disability.

To counter this problem, a thorough report from the treating physician is essential. The treating physician must provide maximum detail and explanation. The report must explain why the doctor arrived at the diagnosis and why the medical signs and findings caused the doctor to conclude the claimant cannot work.

Our New York disability attorneys are experienced at obtaining this type of report from treating doctors. We provide the doctor with guidelines for preparing the report or with a form that the doctor can complete that asks for the information the insurer wants.

New York disability attorneys advise doctors of other evidence that could corroborate claims of pain and disability from back and neck injuries. This evidence includes:

      • The doctor’s treatment notes, especially if the doctor asked the claimant to quantify the pain on a scale of 1-10 and the notes consistently report complaints of pain.
      • A functional capacity evaluation conducted by a physiatrist or physical therapist which can be used to prove the claimant is unable to stand, sit, or walk for an extended period of time, or to perform other physical functions to the extent that his or her job requires.
      • An evaluation by a vocational expert which can be used to show that the claimant cannot perform the duties of his regular occupation and/or any occupation he is qualified for.
      • A daily diary in which the claimant keeps a record of their pain and other troublesome symptoms.
      • Statements from co-workers describing the claimant’s struggles at work and declining productivity.

 

Conclusion

To maximize your chances of qualifying for benefits, work with New York disability attorneys who have a proven track record handling ERISA long term disability insurance claims.

Do not wait to hire New York disability attorneys until after your claim or appeal has been denied. When your long term disability insurance is employer-provided, you are bound by the evidence you provide the insurance company during your initial claim and subsequent appeal. You will not be able to present any new evidence in court.

Avoid fatal mistakes and get it right the first time by calling Riemer Hess LLC, Attorneys at Law, to arrange a consultation: 212-297-0700.

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