Can I Get Disability for My Back Surgery? A Claimant’s Guide

An estimated 60 to 80 percent of us will experience back pain during our lifetime. When conservative treatment options like injections and physical therapy do not control your chronic back pain, surgery might be your next option.

If you are facing a spinal surgery, you are not alone. Between 1998 and 2008, the number of back surgeries performed in the U.S. increased by more than 250%. More than a million people each year undergo these invasive operations.

Most people are unable to work while recovering from a back surgery. During this period, you may qualify for monthly disability insurance benefits if you have a short-term or long-term disability policy.

Please note that Bryant Legal Group focuses its practice on employer-sponsored and private disability insurance policies and plans. This article does not address eligibility for Social Security Disability Insurance (SSDI) benefits.

What to Expect After a Back Surgery

Here are some basics about the most common forms of spinal surgeries.

Discectomy

Discs are spongy shock absorbers that sit in between your spine’s bones (called vertebral bodies). When they are damaged, they can herniate or rupture—causing pressure on your spine’s nerve roots or the spinal cord. A discectomy involves removing part of a damaged or herniated disc.

Doctors perform minimally invasive discectomies (sometimes called microdiscectomies or laser discectomies) and open discectomies (where a large incision is made). The operations have different recovery times, with open surgeries taking longer to heal.

If you have an office job, you might return to work within a month. However, if your work is more physically demanding, you might be unable to work for four months or more.

Laminectomy

Laminectomies aim to relieve pain by relieving pressure in the spine. A lamina is an arch-shaped part of your vertebral body which surrounds the spinal canal along the back side of the spine. If the spinal canal has become narrowed (spinal stenosis), removing part of a lamina can give your nerves more space and relieve radiculopathy, a type of nerve pain that radiates down a limb. It is sometimes combined with another operation, like a discectomy or fusion.

If you are simply undergoing a laminectomy, you might return to work in a few weeks—especially if you have a light office job. If you must stand, stoop, lift as part of your job, you might be unable to work for two months or more.

Spinal Fusion

During a spinal fusion, your orthopedic or neurosurgeon will fuse two of your vertebral bodies (the bones that make up your spine) together, using a bone graft and hardware. The operation aims to stabilize your spine and reduce pressure on your nerve roots and spinal cord.

It is one of the more invasive forms of back surgery and it can take more than a year to fully recover from a fusion. However, your doctor may allow you to gradually return to activities within three to six months.

Disc Replacement

Sometimes, disc replacement is an option. This newer form of back surgery involves removing a damaged disc and inserting metal or plastic artificial disc in its place. It is an alternative to a spinal fusion surgery.

Some patients need three months or more to recover from a disc replacement.

Your Recovery Time Will Depend on Many Factors

While no two recoveries are the same, there are some common factors that will affect the speed and effectiveness of the healing process. Here are some of the primary factors that might affect your recovery times.

Tobacco Use and Vaping

Smoking and tobacco use slow your recovery by reducing your blood flow and the amount of oxygen in your blood. It also makes you more prone to infections.

Most orthopedic physicians will not operate on people who are actively smoking or vaping. However, if you return to the habit post-operatively, you might be putting your recovery in danger. It might also complicate your disability insurance claim, since the adjuster might argue that your inability to work is due to noncompliance, rather than your medical conditions.

Pre-Existing Depression and Anxiety

People with a history of depression, anxiety, or other mental health issues tend to report slower and more difficult recoveries after back surgery. Research suggests that mental health issues can amplify pain and reduce your quality of life. Over time, these conditions can snowball, resulting in debilitating chronic pain, depression, and anxiety.

If you are struggling with your mental health, speak with your doctor right away. They can offer therapies and medications that can help you regain control. And if you are experiencing thoughts of self-harm, please call 911 or seek immediate medical care.

Post-Surgical Complications and Failed Back Syndrome

Non-unions, infections, and other complications can add weeks, months, or even years to your recovery—especially if you need a revision surgery. Unfortunately, even if your surgery is relatively unremarkable, it does not guarantee that your back pain will resolve.

According to one study, at least 50% of spine surgery patients reported ongoing back problems post-operatively. Depending on your circumstances, you might need treatment from a pain specialist, physical therapist, or surgeon.

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When Is a Back Surgery Disabling?

Most people cannot work immediately after a spinal surgery. Your doctor will likely tell you that you should not work until after your first post-surgical checkup, and then they will tailor your restrictions based on your outcome and job duties.

However, “disability” is a legal term, and you need to understand your short-term or long-term disability insurance policy’s definition before you apply for benefits. Most plans define disability in one of two ways:

  • Own occupation: You are eligible for a monthly benefit payment if you cannot perform your current job.
  • Any occupation: You are disabled if you cannot perform any type of full-time work, including the simplest, lightest jobs.

This analysis requires a careful consideration of your medical records, work restrictions, training and qualifications, and other information. Before you apply for disability insurance benefits, you should review your policy and identify which definition applies to your disability claim. While most short-term disability plans follow an “own occupation” standard, long-term disability policies are more variable.

You should also look out for elimination or waiting periods in your policy. These periods act as a sort of deductible.

For example, suppose you cannot work for three months while you heal from a discectomy, and your short-term disability policy has a two-week elimination period. So, instead of receiving three months of benefits, you will only get about two-and-a-half months of compensation. (12 weeks of disability – 2 weeks = 10 weeks of benefits.) If your elimination period exceeds your time off work, you will not receive disability insurance benefits at all.

If you need help understanding your policy’s precise terms and conditions, schedule a consultation with one of our disability insurance lawyers.

How to File for Short-Term or Long-Term Disability Insurance After a Back Surgery

Once you have assessed your eligibility for disability insurance benefits, you and your lawyer can start the application process. This typically involves completing a series of forms and requesting information from your doctors.

Next, the insurance company will investigate your claim. Its adjuster will review your medical records, statements from both you and your medical team, and decide whether they think you have the functional capacity to work. Once they have made a decision, you will get a written notice that your claim was either approved or denied.

However, do not assume that the insurance company got it right. These for-profit businesses frequently deny legitimate claims to save money. If the insurer denies your claim, it is best to consult with a respected disability insurance lawyer who can give you an honest assessment of your case.

RELATED: How Do You Prove You Are Disabled Under a Disability Insurance Policy?

Bryant Legal Group: Chicago’s Disability Insurance Firm

The disability attorneys at Bryant Legal Group guide professionals through their complex legal claims. We take a practical, client-centered approach that focuses on you and your family’s unique needs—and we have recovered millions in compensation for our clients.

If you have questions about whether you are entitled to disability benefits due to a back condition or surgery, schedule your free consultation today. You can reach us by calling 312-667-2536 or completing this brief online form.

References
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.

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