Degenerative disc disease is one of the most common reasons for filing a disability claim. But disability insurance companies don’t always make it easy for policyholders who have degenerative disc disease to get the disability benefits they deserve.
Back or neck pain can be caused by degenerative disc disease or an aggravation from an accident or injury. A claim you are disabled because of back or neck pain is not enough. Disability carriers are notorious for denying and terminating back and neck claims, even in the face of fusion surgery.
The Common Reasons Disability Carriers Deny Degenerative Disc Disease Disability Claims
Many claims are denied because the disability insurance company says:
(1) There is no objective basis of the degenerative disc disease,
(2) There is no objective basis for the restrictions and limitations assigned by your physician because of your degenerative disc disease,
(3) There is no causal relationship between your degenerative disc disease and/or restrictions and limitations, and your inability to do your own or any occupation, and
(4) If you are in the any occupation stage of a claim, the carrier will say you can perform any sedentary occupation and deny your benefits.
Nancy Cavey, who has 35 years experience handling disability cases, has successfully represented many policyholders with degenerative disc disease. Ms. Cavey overcomes a claims denial by working closely with you and your physician. She has had back surgery herself and understands what you are going through!
Nancy Cavey offers a free initial consultation and welcomes the opportunity to speak with you about your disability claim.
What Are The Causes and Symptoms of Degenerative Disc Disease?
Your spine is a beautiful piece of architecture. The principal building block is bone, which can have structural problems like degenerative disc disease.
Between the bones of your spine are discs that allow the spine to move. The disc is a pad of cartilage that has a tough outer layer, the annulus, and a soft inner layer, the nucleus. It is like a jelly-filled lifesaver.
Degenerative means the actual process of the disc degenerating over time. Not all degenerative discs progress or are painful.
When a degenerative disc occurs, the thickness of a disc decreases, which can cause rubbing between discs. It’s like the jelly donut has lost its shape and size.
The common symptoms of a degenerative disc in your low back can include:
- Pain centered in the low back that can radiate to your hips and legs,
- Continuous low back pain of more than six weeks.
- Pain that is aching in nature and made worse when sitting or doing prolonged standing,
- Pain that is made worse by bending, twisting or lifting, and
- Numbness and tingling of the legs.
Cervical disc degeneration is not as common because your neck is generally not subjected to torque or force like your low back. But it is not uncommon in occupations that involve repetitive neck motions, including dentistry and dental hygiene.
A cervical degenerative disc can lead to spinal stenosis and even a herniated disc.
The common symptoms of a cervical degenerative disc can include:
- Low grade neck pain,
- Stiff or inflexible neck pain, and
- Numbness, tingling and weakness of the neck, arms, and shoulders.
How Do I Get The Disability Insurance Benefits I Deserve?
Regardless of your diagnosis, neck and back pain and radiculopathy can interfere with your daily activities and your ability to work. If you no longer can work or your doctor has told you to apply for disability, before you apply for benefits, you should:
- Obtain a copy of your disability policy. See how it defines “disability,” “occupation” and “self-reported conditions.” You’ll need to understand what you have to prove and whether there are limitations in your coverage. Some policies consider degenerative disc disease a subjective condition and limit benefits to two years. Find out about applicable limits in your policy before you apply for benefits.
- Obtain a copy of your medical records. Review them to see if there is an objective basis for your diagnosis, what your records say about your report of symptoms and your restrictions and limitations.
When claims are denied, a common reason given is that the claim includes “no objective evidence to support your subjective complaints of pain.’’ But even objective testing can’t prove how severe and disabling someone’s pain is. Often there are no objective findings on x-rays, CT scans or MRIs to explain someone’s pain, and EMG/NCV electrical testing can be normal. People have excruciating neck pain with minimal findings.
The disability carrier often makes a leap of logic and concludes that the policyholder either is exaggerating or is faking their pain. Nancy Cavey, who has had spine surgery herself, knows what proof is necessary to meet the policy’s definition of disability.
- Obtain a copy of your personnel file to see whether your degenerative disc disease pain has affected your work performance.
- Obtain a copy of your job description. Create your own description of your physical duties with an explanation of how your symptoms impact your ability to do your occupation.
- Provide your doctor with the occupational description. Ask your doctor to prepare a report that explains the objective basis for your diagnosis, the objective basis of your restrictions and limitations, and the objective reasons you can’t perform some or all of the material and substantial duties of your occupation.
- If necessary, undergo a Functional Capacity Evaluation. Use a policyholder-friendly physical therapist who can objectively determine your ability to sit, stand, walk and lift, and why you can’t perform your occupational duties. Don’t rely on your physician to recommend the right FCE provider; many physicians are beholden to the insurance companies that send them work.
- Prepare a pain diary that explains your pain and the side effects of medication you are taking. Be sure to give examples of how your pain and symptoms interfere with your ability to do things on a daily basis. Your pain may even have caused problems with your concentration.
- Hire Nancy Cavey to help you file your initial application. The application process is confusing and designed so you and your physician make mistakes that can result in a delay or even a denial of your benefits. Ms. Cavey knows how to prepare and file a winning shock and awe disability application that leaves the carrier little reason to question your claim.
- Hire Nancy Cavey to help you appeal a wrongful denial or termination of your disability benefits. Disability carriers are in the business of collecting premiums and not paying disability benefits. They’ll use any reason to deny your claim. The odds of getting your benefits on appeal are greater when you are represented by an experienced ERISA/private ID policy disability attorney.
Contact Disability Attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live
Degenerative disc disease can make it difficult, if not impossible, to work. You owe it to yourself and your family to get help today! Nancy Cavey can review your policy and your medical records, and explain to you what your policy says and how to get your disability benefits. Call today for a free consultation at 727-894-3188.
