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Do I Qualify For Disability Insurance Benefits If I Have Spinal Stenosis?

CaveyLaw.com > Practice Areas  > Long Term Disability & ERISA Lawyer  > Long Term Disability Disabling Conditions > Do I Qualify For Disability Insurance Benefits If I Have Spinal Stenosis?

Spinal stenosis is a narrowing of the spinal canal in which your spinal cord rests. It puts pressure on the spinal cord and the nerves that exit the cord. Called impingement, this pressure can cause pain, numbness, tingling, and weakness throughout your spine and extremities.

Not everyone with spinal stenosis is entitled to disability benefits. Disability insurance companies don’t always make it easy for policyholders who are disabled because of spinal stenosis to get the disability benefits they deserve.

What Are The Causes Spinal Stenosis And What Are The Symptoms?

There are many causes of spinal stenosis:

  1. Degenerative changes,
  2. Osteoarthritis or rheumatoid arthritis,
  3. Instability of the spine or spondylolisthesis,
  4. Tumors of the spine,
  5. Trauma, and
  6. Heredity

Other causes or aggravating conditions include:

  1. Bulging or herniated discs,
  2. Bone spurs,
  3. Scoliosis,
  4. Kyphosis, and
  5. Scar tissue.

Spinal stenosis can cause low back and leg pain. Because spinal stenosis pinches the nerves that control the muscle power and sensation in your lower legs, the disease can cause low back and leg pain. More than 75% of spinal stenosis is found in the low back.

Cervical stenosis in your neck can cause pain, weakness, tingling and numbness of your hands, causing you to drop things or have difficulty using your arms. It can cause headaches.

What Is The Treatment for Spinal Stenosis and How Does That Impact My Claim?

The treatment for spinal stenosis often includes nonsteroidal anti-inflammatory drugs, known as NSAIDs, pain relievers and injections. Treatment can have significant side effects, including gastrointestinal problems, anemia and fatigue.

It is important that your physician document any side effects and how they impact your ability to work.

You also may have physical therapy for relief or reduction of symptoms.

If medication or therapy doesn’t relieve your pain, you may have to undergo surgery:

  1. Spinal fusion to restore curvature and stability of the spine;
  2. Laminectomy to relieve pressure on the spinal roots; or
  3. Foraminotomy to expand the bone that allows the nerve roots to exit your spinal column.

Depending on the nature of the surgery and your health, the recovery can take six months to more than a year. These surgeries also can be the basis of a disability claim.

How Disability Carriers Handle Spinal Stenosis Claims

Disability carriers are notorious for denying and terminating many spinal stenosis claims. Carriers commonly argue:

  1. Coverage is excluded by the pre-existing condition clause of your disability policy.
  2. Benefits are limited under the subjective limitation clause. Pain and fatigue can be your most disabling symptoms, but carriers routinely dispute their impact.
  3. You’ve had spinal stenosis for years and have not been disabled before now. You will have to overcome the carrier’s argument that you have been working with these problems for years and nothing has changed. It is crucial that your medical records develop the progression of your symptoms.
  4. Your symptoms are in remission and just flare up temporarily, so you can work.
  5. Your complaints really are coming from your back, and there is no objective testing that supports the severity your back complaints.

Many disability claims are denied. Other reasons carriers say they deny claims:

(1) There is no objective basis of the spinal stenosis diagnosis,

(2) There is no objective basis for the restrictions and limitations assigned by your physician, or

(3) There is no causal relationship between your spinal stenosis diagnosis and/or your restrictions and limitations, and your inability to do your own or any occupation,

(4) There is no reason you can’t work in a sedentary capacity, or

(5) There is no reason you can’t work with accommodation.

Why You Need Nancy Cavey

Nancy Cavey, who has 35 years experience handling disability cases, has successfully represented many spinal stenosis policyholders. She overcomes a claims denial by working closely with you and your physician.

She obtains, as needed, a Functional Capacity Evaluation to objectively document your physical limitations, including difficulty walking, standing and sitting. She even hires a Vocational Evaluator to explain why your symptoms prevent you from doing your occupation or any occupation.

Nancy Cavey offers a free initial consultation and welcomes the opportunity to speak with you about your disability claim.

How Do I Get The Disability Insurance Benefits I Deserve?

Spinal stenosis can interfere not only with your daily activities but with your ability to work. If you no longer can work or your doctor has told you to apply for disability benefits, you should take steps before you apply:

  1. 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 if there are limitations in your coverage. Your policy might limit conditions that are based on subjective complaints without objective evidence of a diagnosis.
  1. 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.
  1. Obtain a copy of your personnel file to see if your spinal stenosis has affected your work performance. Your productivity may have suffered because you may have limited ability to use your hands, walk, stand or sit for any length of time.
  1. 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.
  1. 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.
  2. Prepare a pain diary that explains your pain and the side effects of medication. Don’t forget to give examples of how your spinal stenosis symptoms interfere with your ability to do things on a daily basis.
  1. 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.
  1. 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

Spinal stenosis 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.