Does A Pectoralis Major Injury Qualify For Disability?

The pectoralis major, one of the major muscles in the chest, allows the arms to move inwards towards the body, forwards, and backward. The muscle attaches to the collarbone, sternum, and humerus bone in the upper bone by the pectoralis major tendon.  

What is a Pectoralis Major Injury?

Pectoralis major injuries usually occur in athletes or other active people, such as heavy laborers. Injuries happen when a greater external force is put on the muscle than the muscle can put out while the arm is extended or rotated. Injuries can have a sudden, violent trauma or occur from chronic overuse. A familiar source of injury is lifting heavy weights during bench-press exercises. Strains generally happen with overuse over an extended length of time, while sudden trauma typically results in tears.

The severity of the injury can range from bruising and swelling on the mild end of the spectrum to rips, tears, and even severing of the muscle and tendons. Symptoms include swelling, pain, loss of motion, decreased muscle strength, and decreased muscle mass on the affected side. Severe injuries can leave one side of the body significantly weaker, forcing the other side to overcompensate and leaving the person prone to developing other injuries.

Diagnosing Pectoralis Major Injuries

Diagnosing these injuries can be done through a clinical exam, though swelling from a recent injury can make it challenging to examine the muscle thoroughly. Once the swelling goes down, any deformities in the muscle are usually visible. Clinical exams include range-of-motion and strength testing. The doctor will ask about the source of the injury, the location and the severity of the pain, and any other symptoms the patient may experience. A medical history can indicate if the patient has different conditions that can cause similar symptoms, such as neuropathies and muscle wasting.

Diagnostic testing may be done to determine the extent of the injuries and to see if any other condition may be causing symptoms. Testing includes:

• X-rays- to look for bone fragments, fractures, and breaks
• Computed Tomography (CT) scans- to further look for and evaluate fractures
• Ultrasound- to look for tears or ruptures of the tendons
• Magnetic Resonance Imaging (MRI)- to thoroughly examine the location and severity of the injury

Treating Pectoralis Major Injuries

Treatment for elderly or sedentary patients may be limited to rest, ice, and stretching techniques. People who have more severe injuries or who have physically demanding lifestyles will need to undergo surgery to recover.

Surgery is usually required to recover from pectoralis major injuries fully, and recovery from surgery usually takes at least six months. While many fully recover, others may suffer lasting effects from the injury. This can include lasting pain or weakness or reoccurring injuries.

Medication, both over-the-counter and prescription, helps reduce pain and swelling. Non-steroid anti-inflammatory drugs (NSAIDs) can help with both pain and inflammation. Severe injuries may be treated with prescription painkillers, such as opioids. Topical pain relief creams and ice therapy can provide relief.

Physical therapy is crucial to recover from these injuries. Physical therapy is usually ordered in combination with other types of treatment, such as after surgeries or with medications. Alternative pain-management therapies have proven to be beneficial when used in conjunction with more traditional methods of treatment. These include meditation, acupuncture, massage, cognitive behavioral therapy, and mindfulness techniques.

Disability Evaluation for Pectoralis Major Injuries

Some people cannot work because of an injury to the pectoralis major. Individuals unable to work due to their medical conditions should consider applying for long-term disability benefits. Insurance providers will assess these claims to determine eligibility based on the stipulations of the respective plan.

Most LTD plans stipulate that claimants must be unable to perform duties specific to their occupation. Beyond this period, to remain eligible for benefits, the individual must be unable to engage in nearly any form of employment. Given that each LTD plan possesses unique criteria, it’s crucial to examine your policy to understand its specific provisions thoroughly.

Evaluating Disability for People with Pectoralis Major Injuries

The evaluation of disability claims is based on how much an individual’s daily functions are impeded. Adjusters determine eligibility by assessing both the capabilities retained by the claimant and the limitations imposed by their condition.

Since the pectoralis major is a major muscle group and the full use of the arms is necessary for most work, lasting damage to the pectoralis major can easily prevent someone from working. Strenuous jobs could be unsafe, and athletes may not be able to return to their pre-injury performances. An injury to the dominant arm could prevent someone from performing even light-duty positions such as office work, as typing and writing may be troublesome. Chronic pain can prevent a person from sleeping, leading to trouble focusing and making sound decisions or excessive daytime drowsiness.

What Your Insurance Company Requires from You and Your Medical Professionals

The insurance company needs evidence from all the medical professionals who have overseen your care post-injury. This ensures they have access to pertinent medical records that can aid in assessing your claim. These records should detail any treatments or surgeries you have undergone and your symptoms and limitations.

Even if someone does not meet the requirements for disability for this injury alone, they may still qualify when other medical conditions and the combined restrictions are considered. Claimants should list all their conditions and how they can impact their ability to work when filing a claim; those medical records are equally important.

You need to provide:

1. Proof of Diagnosis: Concrete evidence of your diagnosis.
2. Ongoing Symptoms: Detailed records of persistent symptoms.
3. Life Impact: Tangible evidence showcasing how these symptoms impede your day-to-day life.
4. Residual Functional Capacity (RFC) Assessments: RFC evaluations identify how your condition affects you and pinpoint any limitations, which is used to determine what occupations you may still be able to perform despite your limitations.

Working with a Disability Attorney

You do not have to take on your insurance company alone. An experienced disability attorney can simplify the long-term disability claim process and help ensure you receive your rightful benefits. We represent long-term disability claimants located anywhere in the United States. Call Ortiz Law Firm at (888) 321-8131 to discuss your case.