Spondylolisthesis and Long-Term Disability Insurance Claims

Spondylolisthesis often causes chronic back pain, numbness, and leg weakness that can make it impossible to keep working. Yet long-term disability (LTD) insurance carriers question whether this spinal condition truly prevents full-time employment. The most common mistake I see claimants make is assuming that a diagnosis alone will be enough to win benefits. To succeed in an LTD claim, you must clearly document how your symptoms limit your ability to work and back it up with strong medical evidence.

What Is Spondylolisthesis?

Spondylolisthesis occurs when one vertebra slips out of its normal position and onto the vertebra below it. It most often affects the lower spine and can compress spinal nerves, leading to back pain, leg pain (sciatica), and limited mobility. Some cases are mild, while higher-grade slips may interfere with daily functioning and work capacity.

Types of spondylolisthesis include:

• Degenerative: Caused by age-related spinal joint or disc deterioration.
• Isthmic: Often the result of a small stress fracture in the pars interarticularis.
• Congenital: Present at birth due to abnormal spinal development.
• Traumatic: Caused by a fracture or direct injury to the spine.
• Pathological: Related to an underlying disease, such as infection or cancer.
• Postsurgical: A complication following spinal surgery.

Moderate to severe cases can worsen over time and may lead to chronic nerve compression, weakness, or pain that limits daily activity. Understanding how your condition is likely to progress is an important part of documenting its impact on your ability to work.

RELATED POST: Degenerative Disc Disease and LTD Claims

Functional Limitations Caused by Spondylolisthesis

With moderate to severe spondylolisthesis, symptoms can interfere with nearly every aspect of physical functioning. Pain may worsen with standing, walking, bending, or lifting—activities necessary for many occupations.

Common work-related limitations include:

• Inability to stand or walk for long periods due to back or leg pain.
• Difficulty sitting for extended durations without frequent position changes.
• Reduced flexibility or mobility from stiffness or nerve compression.
• Limited ability to lift or carry even moderately heavy items.
• Decreased concentration or stamina due to chronic pain or medication side effects.

These impairments affect not only physically demanding jobs like construction, delivery, and warehouse work, but also more sedentary positions that require prolonged sitting or concentration.

Medical Evidence to Support an LTD Claim for Spondylolisthesis

To prove disability, you need more than a diagnosis. You must demonstrate how spondylolisthesis prevents you from performing your occupational duties. The strongest LTD claims combine objective medical evidence with clear documentation of functional limitations.

Key supporting documentation includes:

• Imaging Results: X-rays, MRIs, or CT scans confirming vertebral slippage or nerve compression.
• Clinical Exam Findings: Records noting reduced range of motion, reflex changes, or sensory loss.
• Treatment History: Evidence of ongoing physical therapy, pain management, bracing, injections, or surgery.
• Physician Statements: Opinions linking your symptoms to specific job limitations.
• Functional Capacity Evaluation (FCE): Objective testing of your ability to sit, stand, lift, and perform job-related activities.
• First or Third-Party Statements: Pain journals, daily activity logs, or witness letters that document how your condition affects daily life.

Insurers often argue that imaging results don’t match the reported pain level. It’s important that your doctor connects those imaging findings to real-world functional restrictions in the medical record.

Key Medical Providers

Evaluations from orthopedic surgeons, neurosurgeons, and pain management specialists carry significant weight in LTD claims. Their notes often provide the clearest link between imaging results, physical findings, and work limitations.

Medication Side Effects and Pain Management

Insurers also evaluate how your treatment affects job performance. Records showing frequent medication adjustments, pain management visits, or side effects like fatigue, drowsiness, or cognitive slowing can further support your claim. Consistency across your medical records, symptom descriptions, and any activity data (including social media) is crucial.

Common Challenges in Spondylolisthesis Disability Claims

Even when symptoms are severe, insurers often deny LTD claims for reasons such as:

• Lack of Objective Evidence: Minimal imaging findings or stable alignment may be used to argue your condition isn’t disabling.
• Subjective Complaints: Pain, numbness, and fatigue may be discounted without supporting diagnostic proof.
• Gaps In Treatment: Missed appointments or inconsistent follow-up can weaken credibility.
• Return-to-work Assumptions: Improvement after treatment or lack of surgery may be misinterpreted as full recovery.
• Inaccurate Job Comparisons: Insurers may rely on outdated or overly broad job descriptions when evaluating whether you’re “disabled.”

In my experience reviewing spinal disorder cases, insurers often minimize the impact of pain and nerve compression unless the medical documentation explicitly ties those symptoms to workplace limitations.

Common Mistakes That Lead to Denials

The most common mistakes I see claimants make are failing to keep up with medical treatment, not obtaining written functional assessments from their doctors, and assuming imaging alone will prove disability. Lack of consistent care or physician support can make it easier for insurers to dismiss a legitimate claim.

Surveillance and Social Media Monitoring

Insurance companies may monitor your activities through private investigators or social media. Even brief clips or photos of lifting groceries, attending social events, or doing light chores can be taken out of context. Always be consistent in describing your limitations to doctors, insurers, and online.

Case Example: Winning an LTD Appeal for Spondylolisthesis

“James,” a 54-year-old cable technician, was diagnosed with grade II isthmic spondylolisthesis after months of back pain and leg weakness. His work required climbing, lifting, and crouching—activities that became intolerable.

He applied for LTD benefits with an MRI report and diagnosis, but the insurer denied his claim, arguing he could transition to a desk job. With help from a disability attorney, James appealed the denial by submitting:

• A detailed FCE confirming he couldn’t sit, stand, or walk for more than 30 minutes at a time
• Updated imaging showing worsening degeneration
• A statement from his orthopedic surgeon explaining that surgery might not restore function

The insurer reversed its decision on appeal, and James began receiving monthly LTD benefits.
(Based on real case patterns, not a specific client.)

How Legal Representation Can Strengthen Your Claim

Filing an LTD claim for spondylolisthesis isn’t just about proving the diagnosis—it’s about showing how the condition prevents you from working.

Your LTD policy may define “disability” differently depending on duration:

• Own Occupation: You’re considered disabled if you can’t perform the specific duties of your job.
• Any Occupation: After 24 months (or a similar timeframe), you must show that you can’t perform any job for which you’re reasonably qualified.

An experienced attorney can help you:

• Collect and organize medical records, imaging, and specialist reports
• Obtain functional and vocational assessments
• Address the insurer’s reasoning for denial directly in your appeal
• Counter biased medical reviews or vocational opinions
• Navigate ERISA deadlines and, if needed, file suit in federal court

At Ortiz Law Firm, I represent clients nationwide in both ERISA-governed group disability plans and private individual policies.

RELATED POST: Own Occupation vs. Any Occupation In LTD Claims

How Long the LTD Process Takes

Initial LTD claims often take several months to review, while appeals can extend six to twelve months depending on policy deadlines and documentation needs. Having an attorney ensures that every deadline is met and every piece of evidence is submitted correctly the first time.

ERISA vs. Individual Disability Policies

Most employer-sponsored disability plans are governed by ERISA, which imposes strict timelines and limits on new evidence after denial. Individual or private policies fall under state law, which allows broader discovery and, in some cases, jury trials. Because new evidence usually cannot be added after an ERISA appeal, early legal representation can make or break your case.

RELATED POST: What Are the Differences Between Group and Individual Disability Insurance?

Post-Approval Reviews and Ongoing Eligibility

Even after approval, insurance companies periodically review claims—especially after surgery or major treatment. Many claimants lose benefits not because they’ve improved, but because insurers reinterpret medical records. Continuing consistent treatment and documentation helps protect ongoing eligibility.

Talk to the Ortiz Law Firm About Your Spondylolisthesis Claim

If your long-term disability benefits were denied or terminated due to spondylolisthesis, don’t face the insurance company alone. Call the Ortiz Law Firm at (888) 321-8131 for a free case review. I’ll explain your options, outline the strongest evidence for your appeal, and fight to get you the benefits you deserve.

We represent clients nationwide and have a proven record of success in spinal disorder claims. When insurers question your pain or downplay your limitations, we step in with a clear strategy and strong evidence to protect your claim.