Below, we鈥檒l discuss important factors to consider when filing a radiculopathy long term disability claim and how an attorney can help you through the process.
Yes, you can get long term disability for symptoms of radiculopathy. The impact of radiculopathy can be profound. If you experience lower extremity (lumbar) radiculopathy, your symptoms may radiate from the lower back down to the legs, affecting your mobility and ability to perform daily activities. In the case of upper extremity (cervical) radiculopathy, symptoms often involve the neck, shoulders, arms, and hands, which can hinder your physical functioning and ability to perform tasks requiring dexterity. If your radiculopathy significantly impairs you from performing the material duties of your occupation, you may qualify for long term disability benefits.
Radiculopathy, often referred to as a 鈥減inched nerve,鈥� is a condition that occurs when nerves in the spine become compressed or irritated. This compression can result from a number of conditions, not limited to but including:
Disabling symptoms of radiculopathy may vary depending on the location of the affected spinal nerve root and the underlying cause of your condition. However, there are several common and potentially debilitating symptoms associated with radiculopathy. These disabling symptoms may include:
Any of the above symptoms may prevent you from performing your job duties and cause long term disability. For example, if you experience lower extremity radiculopathy, pain may radiate from the lower back into the buttocks and down one or both legs. This can lead to difficulties with walking, standing, or sitting for extended periods. In contrast, upper extremity radiculopathy may cause pain in the neck and shoulders, often extending into the arms and hands. Gripping objects, performing fine motor tasks, or even typing on a keyboard can become challenging.
Securing long term disability benefits for radiculopathy requires meeting the definition of disability in your policy. A diagnosis of the condition causing your radiculopathy alone is not sufficient. You must also demonstrate the severity of your symptoms and their effect on your ability to perform your job duties. This involves submitting your insurer comprehensive documentation, including medical and vocational evidence.
Examples of medical evidence for radiculopathy may include:
To provide your insurer with more objective evidence of your radiculopathy鈥檚 impact on your functioning, consider undergoing a Functional Capacity Evaluation (鈥淔CE鈥�). Objective medical evidence will hold the most weight with your insurer when they assess your claim. Of course, doctors do not keep records for the purpose of establishing disability for insurers, and as a result they may not capture the full extent of your restrictions and limitations. The FCE is an opportunity to obtain additional objective evidence of your physical limitations.
During an FCE, a trained healthcare professional evaluates your strength, endurance, range of motion, and functional capabilities. The results of this assessment can offer insights into how radiculopathy impacts your ability to engage in various work-related activities, such as lifting, carrying, standing, and sitting.
Insurance providers often place significant weight on FCE results when evaluating disability claims. An FCE can help bridge the gap between subjective symptom descriptions and objective evidence, making it an invaluable tool in demonstrating the extent of your functional impairment caused by radiculopathy.
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Vocational evidence to support your radiculopathy disability claim may include:
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Vocational evidence holds great importance in supporting your long term disability claim for radiculopathy. This evidence links the specific demands of your occupation to the limitations imposed by your condition. By providing a clear connection between your job and your radiculopathy鈥檚 impact on your ability to perform your duties, vocational evidence can strengthen your claim significantly.
If you鈥檙e in the process of filing a long term disability insurance claim for radiculopathy or facing a claim denial or termination, the experienced ERISA disability attorneys at Riemer Hess can help. We鈥檝e helped secure long term disability benefits for countless clients, many involving symptoms of radiculopathy.
For example, our client 鈥淎lan鈥� was working as a partner attorney for a major law firm when he began developing cervical radiculopathy due to a progressive spinal condition. The cervical pain and numbness were worsened by sitting for extended periods as his role required. Eventually, Alan was forced to leave his work due to his condition. He had long term disability coverage through multiple insurance policies, both provided by his employer and purchased individually. When he filed his claims, one of his insurers denied his benefits. Alan retained Riemer Hess to handle his disability claims and the appeal.
Riemer Hess worked to obtain additional evidence, including a Functional Capacity Evaluation, narrative reports from Alan鈥檚 treating providers, and a vocational assessment. When this evidence was submitted with a detailed appeal letter, the insurer came back with their own non-examining medical paper reviewers鈥� reports rebutting the informed opinions of Alan鈥檚 treating providers. Riemer Hess quickly coordinated with Alan鈥檚 providers to refute these medical paper reviewers and submitted this along with additional treatment records and assessments. In turn, the insurer ultimately approved Alan鈥檚 claim going forward.
Separately, Alan had both a group and individual claim with another insurer, which were initially approved. However, after receiving benefits for two years, the insurer alleged that Alan could work part-time (though no such requirement was in either policy) and threatened to terminate his claims. Riemer Hess succeeded in getting the insurer to continue benefits under the group policy, but they terminated the claim under the individual policy. As a result, Riemer Hess helped Alan sue Unum for reinstatement of his benefits.
Riemer Hess successfully established to the court that Alan鈥檚 condition, including symptoms of radiculopathy, meant he could not even work part-time, let alone perform at full capacity. Ultimately the judge sided with Alan, determining that Unum owed him back payment of benefits, including interest and attorneys鈥� fees, in a total victory for our client.