Long Term Disability Claims Due to Back Pain
One of the most common causes for filing a short or long term disability insurance claim is due to “back pain.” Although this encompasses a wide range of conditions – from disc herniations and bulges to soft tissue disorders and fibromyalgia – insurance companies will evaluate entitlement to benefits as a result of back pain in the same manner regardless of the medical basis for the pain. Complicating the insurance company evaluation further is the fact that the overwhelming majority cases of back pain are due to an unknown etiology, or more simply put – the doctors are not quite sure what the root cause of the pain actually is. In light of this conundrum, insurance companies will often view a claim based on back pain as simply one of “self-report” with no objective evidence to support a level of impairment that would result in disability.
What objective evidence supports a claim due to back pain?
When filing a claim for disability benefits it is imperative to try to provide as much “objective” evidence to support your complaints of pain. The most common forms of objective medical evidence used to diagnosis a person’s complaints of back pain include MRI’s, CT Scans, X-Rays and in instances of radiating pain, EMG and Nerve Conduction Studies. Although having positive test results is not a requirement to receiving disability benefits, positive findings on these tests will greatly assist in the presentation of your claim to an insurance company. This is becoming increasingly true in light of disability insurance policy trends that see the addition to policies of more language that limits claims due to pain to a maximum 24 months of benefits. Many insurance companies now write limitations in policies for “self-reported symptoms” or “neuromuscular, musculoskeletal, soft tissue disorder conditions” that are meant to limit the amount of disability benefits you will receive in the absence of requisite objective medical evidence to support your complaints.
Will my claim be approved if I have positive findings on objective medical tests?
Unfortunately, no. Even with positive findings on objective medical testing, that, in and of itself, will not guarantee that a disability insurance claim will be approved. Insurance company doctors will certainly look to minimize the level of impairment a person experiences regardless of test results. As the experience of pain is completely unique to the individual and there is no way to objectively measure pain, a person’s report of pain will always be based on their subjective complaints. Due to this fact, the insurance company and its doctors will acknowledge findings on MRIs but will often argue that the findings would not support the level of the claimant’s subjective complaints of pain, and in turn would not result in restrictions and limitations that would prevent work.
Objective medical evidence does provide a firm foundation with which to argue why restrictions and limitations relating to work ability are appropriate; however, there still has to be a nexus drawn between the objective medical evidence and establishing and proving functional restrictions and limitations that would prevent you from performing your occupational duties.
What can I do if I don’t have strong objective medical evidence to support my claim?
Regardless of objective medical evidence in your file, one of the most important aspects of establishing a claim for disability due to back pain is the contents and detail in your medical records. Your doctor needs to be accurately and comprehensively documenting your medical records as it relates to your condition. Doctors are not trained to write medical records to satisfy a disability insurance carrier and we often see instances where despite medical evidence and history, a doctor does not document items such as range of motion, bending, the site of the pain, side effects of medication, etc. In the absence of this information in your records an insurance company will assume that you are not having issues related to same.
Another issue that often arises in medical records stems from the automation of many of the records maintained by doctor’s offices. Quite often when entering a record for a patient the record system will have a series of boxes to be checked by the doctor as part of their exam. It is not uncommon for these “checked boxes” to contradict the written notes in the medical record relating to the patient’s complaints. In turn, the insurance companies will often use these contradictions as a basis to undermine a disability claim.
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As disability claims due to back pain are so prominent, disability insurance carriers have many tactics with which to deny a claim for benefits. Knowing what will be needed to put your claim in the best position for success can help nullify these tactics. Proper presentation of your disability insurance claim for back pain or conditions that cause back pain is crucial to your success in having your disability benefits approved. Please feel free to contact our office to discuss how we may be able to assist you.
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Lincoln Financial
Uses every dirty trick in the book
It’s next to impossible to get $ out of them without a lawyer. They use plenty of intimidation and unfair tactics. They don’t want to pay. And yet, their CEO made 13 m... read more >
Unum
Unum is evil
On 11/3/2021 I got shot by my boyfriend and my spinalcord got hit, paralyzing me from the neck down and accepting Unum benefits was the worst decision I ever made. I sued ... read more >
Lincoln Financial
Every month I get paid on a different date
I will start by saying that my experience is not as horrible as others, like the folks who have valid claims but get nothing from Lincoln. I feel for you and hope to god y... read more >
MetLife
They will do anything to not approve your claim
MetLife’s handling of my short-term disability claim has been incredibly frustrating and stressful. I followed all the necessary steps prior to my surgery, providing the... read more >
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Sedgwick
Don't trust them, they like to play games
They suck the life out of people that need help. They falsely advertise for helping people that they care. Sorry to tell you it's all about money, they do not care for any... read more >
New York Life
Lyme Disease Disability Claim Denial
I have had repeat claims for genuine medical leave and they have repeatedly been denied by NY Life. I have even been diagnosed with Lyme and going through treatments and t... read more >
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I am beyond disappointed with NY Life Disability Insurance’s handling of my father’s claim. My father, a 66-year-old man who has suffered two strokes and continues to ... read more >
New York Life
New York Life is a joke!
This company sucks when it comes to disability claims. They are slow at processing stuff, then they always say they didn't recieve the doctors information. You spend your ... read more >
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Who are Dell Disability Lawyers?
We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.
Our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement in more than 98% of our cases. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.
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Our disability insurance attorneys help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.
Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.
A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.
Do you work in my state?
Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability insurance lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.
What are your fees?
Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.
The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.
In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.
Do I have to come to your office to work with your law firm?
No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via phone, email, fax, or video conferencing sessions. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.
How can I contact you?
When you call us during normal business hours you will immediately speak with a disability insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.