Securing Long-Term Disability For Radiculopathy: A Comprehensive Guide

Have you been diagnosed with radiculopathy and are struggling to navigate the complexities of filing a long-term disability claim? The process can be overwhelming, but you don’t have to go through it alone. Below, we’ll explore the key points surrounding long-term disability, such as the eligibility criteria and how an experienced attorney can provide the guidance and support you need to pursue your claim effectively.

Can I Get Long-Term Disability for Radiculopathy?

Radiculopathy is when a nerve root in the spine is compressed or inflamed, resulting in pain, numbness, tingling, or weakness along the course of the nerve. When the nerve roots are compressed or irritated, it can lead to symptoms that significantly impact an individual’s quality of life and ability to work.

Causes of Radiculopathy

Common causes of radiculopathy include herniated discs, bone spurs, degenerative disc disease, spondylolisthesis, diabetes, inflammatory conditions like rheumatoid arthritis or ankylosing spondylitis, and sudden injury. You can also develop radiculopathy simply due to the regular degenerative changes that come with age or conditions like osteoarthritis.

Types of Radiculopathy

• Cervical Radiculopathy: This type of radiculopathy occurs when a nerve in the neck is compressed or irritated. It can cause pain, weakness, or numbness that radiates from the neck into the shoulder, arm, and hand.
• Lumbar Radiculopathy (Sciatica): This condition is characterized by pain that radiates along the sciatic nerve, which runs down one or both legs from the lower back. It is often caused by a herniated disc or bone spur in the spine pressing on the nerve.
• Thoracic Radiculopathy: Less common than cervical or lumbar radiculopathy; this condition involves compression of the nerve roots in the upper or mid-back. It can cause pain and discomfort in the chest, abdomen, and areas surrounding the ribs.

Disabling Symptoms and Impact on Daily Life

The symptoms of radiculopathy include radiating pain, numbness, tingling, and muscle weakness in the affected area. These symptoms can limit mobility, affect one’s ability to perform daily activities and lead to difficulty maintaining employment. Individuals may find sitting or standing for prolonged periods, lifting heavy objects, or engaging in physically demanding tasks challenging.

The impact of radiculopathy on daily life can be significant, causing disruptions in sleep patterns, decreased productivity, and emotional distress. Work performance may also be compromised, leading to absenteeism or reduced efficiency in completing tasks. Seeking long-term disability support may be vital for individuals struggling with the effects of radiculopathy, given its potential to impair their ability to work and engage in daily activities.

How to Get Your Radiculopathy Long-Term Disability Claim Approved

When filing for long-term disability due to radiculopathy, it’s crucial to gather comprehensive and compelling medical evidence and documentation to support your claim. This includes diagnostic tests, treatment history, and physician statements. Additionally, functional capacity evaluations and vocational evidence play critical roles in establishing the impact of radiculopathy on your ability to work. Understanding the legal and procedural aspects of the claims process is essential, as it involves nuances such as the role of disability attorneys, the appeals process, and potential challenges.

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Medical Evidence and Documentation

In filing for long-term disability due to radiculopathy, the significance of medical evidence and documentation cannot be overstated. Diagnostic tests, such as MRI scans and nerve conduction studies, provide objective evidence of the condition. A detailed treatment history, including medications, physical therapy, and surgical interventions, demonstrates the ongoing efforts to manage the symptoms. Moreover, physician statements outlining the severity of symptoms, functional limitations, and the prognosis for improvement are pivotal in substantiating the claim.

Functional Capacity Evaluations

Functional capacity evaluations assess an individual’s physical and functional abilities in the context of their radiculopathy. These assessments provide valuable insight into the condition’s impact on activities such as walking, lifting, and sitting. By undergoing a comprehensive functional capacity evaluation, individuals can effectively illustrate the functional limitations imposed by radiculopathy, thereby strengthening their disability claim.

Vocational Evidence

Vocational evidence encompasses the impact of radiculopathy on an individual’s ability to perform work-related tasks. It involves assessing how the condition affects factors like sitting, standing, reaching, and handling objects, particularly in the context of one’s prior occupation. Vocational experts may examine the individual’s skills, educational background, and work experience to determine the feasibility of returning to their previous job or transitioning to alternative employment.

By addressing the critical components of medical evidence, functional capacity evaluations, and vocational evidence, individuals can enhance their prospects of securing approval for their long-term disability claim due to radiculopathy.

How a Long-Term Disability Attorney Can Help with Your Radiculopathy Claim

Dealing with a long-term disability claim due to radiculopathy can be overwhelming. Navigating the legal aspects, especially while coping with health challenges, may be daunting. Engaging the services of experienced disability attorneys can provide invaluable support throughout the claims process.

Assessing Eligibility and Building a Strong Case

First and foremost, a long-term disability attorney can help assess your eligibility for benefits. They will evaluate your medical records, work history, and the specific impact of radiculopathy on your ability to work. With their expertise, they can suggest the best course of action and guide you through building a solid case to support your claim.

Navigating Complex Legal Procedures

Long-term disability claims involve complex legal procedures and paperwork. An attorney specializing in this area can help you navigate the intricate process. From filling out forms to understanding legal jargon, having a legal expert by your side can alleviate stress and ensure all procedures are followed correctly.

Maximizing Entitlements

It’s common for individuals to undervalue their entitlements or settle for less than they deserve. A proficient long-term disability attorney can help you maximize the benefits you are entitled to. They can ensure that all aspects of your claim are thoroughly evaluated and that you receive the compensation you deserve, considering the limitations of radiculopathy.

Representing You in Appeals and Litigation

If your long-term disability insurance claim for radiculopathy has been denied or terminated, an experienced ERISA disability attorney at Ortiz Law Firm can assist you. We have successfully obtained long-term disability benefits for numerous clients, many of whom couldn’t work due to symptoms of radiculopathy.

For example, our client “Anna” was a respiratory therapist when she was injured in a motor vehicle accident. As a result, she developed cervical disc disorder with radiculopathy and post-traumatic fibromyalgia. Her cervical pain radiates down his bilateral arms to his hands, and she experiences weakness in her hands and fingers. Eventually, Anna had no choice but to stop working due to her condition. 

She had long-term disability insurance with Reliance Standard through an employer-provided group disability insurance plan, and her claim was initially approved. However, after receiving benefits for two years, the definition of Totally Disabled changed. Reliance reviewed the claim to determine if Anna was still eligible for benefits under the “any occupation” definition of disability.

The insurer’s medical department alleged that the medical documentation in the claim file supported sedentary work capacity, meaning she can perform a sedentary occupation full-time. Vocational staff also reviewed the claim file and determined Anna could perform and would qualify for several sedentary occupations in the medical field. As a result, Reliance determined that she no longer satisfied the definition of Total Disability and terminated her claim.

FREE RESOURCE: Appeal a Long-Term Disability Denial with our Disability Insurance Appeal Guide

We collected evidence, such as a functional capacity evaluation, statements from Anna’s doctors and coworkers, and a vocational assessment to support her claim. We then submitted this evidence with a detailed appeal letter. In response, Reliance issued peer review reports that questioned the informed opinions of Anna’s treating providers despite the peer review physician never examining our client.

We worked with Anna’s doctors to counter these peer-review reports and submitted our rebuttal and additional medical evidence. This successfully convinced Reliance that Anna’s conditions, including symptoms of radiculopathy, meant she could not even perform the duties of a sedentary occupation at full capacity. The insurer ultimately reinstated Anna’s claim, and she received the disability benefits she deserved.

Providing Peace of Mind

Perhaps most importantly, a long-term disability attorney can provide peace of mind during a challenging time. Knowing that you have a dedicated legal advocate handling your claim can alleviate stress and allow you to focus on your health and well-being. Their expertise in navigating the legal complexities, maximizing entitlements, and providing representation can make a substantial difference in the outcome of your claim, ensuring that you receive the support you need during a challenging period in your life.

Remember, the most important thing is to prioritize your health and well-being, and seeking the appropriate support can help alleviate the stress and uncertainty often associated with long-term disability claims. By being informed and seeking assistance from a long-term disability attorney, you can increase your chances of a successful claim and focus on your journey to recovery.

Disability insurance attorney Nick Ortiz is the founder of the Ortiz Law Firm. Since 2005, he has dedicated his practice to helping individuals denied the disability benefits they deserve. He offers a free case review for claimants facing a disability claim denial and a zero-fee guarantee to each client. You only pay a fee if there is a recovery. Call the Ortiz Law Firm at (888) 321-8131 for a free disability case review.