Spinal Cord Stimulators and Disability: Do I Qualify for LTD?

When you’re living with chronic back pain or a spinal cord injury, you may be willing to try anything to alleviate your symptoms. From physical therapy and surgeries to chronic pain management, doctors have a wide variety of treatment options that may improve your quality of life. Sometimes, they suggest a spinal cord stimulator.

These devices can reduce pain and improve function, but they are not a cure-all. If you’re considering a spinal cord stimulator, here are the essentials that you need to know. We’ll also explain how a stimulator may impact your long-term disability claim.

What Is a Spinal Cord Stimulator?

A spinal cord stimulator is a medical device that doctors can implant into your body, helping reduce your chronic pain. They treat severe, chronic back pain that runs into your arm or leg. While many medical conditions can cause back pain and sciatica, spinal cord stimulators are often associated with the following conditions:

  • Degenerative disc disease: arthritis, narrowing in your spine (stenosis), and other degenerative changes can cause pain that runs into your legs or arms
  • Arachnoiditis: a condition that causes swelling and scarring in your spinal nerve’s protective lining
  • Failed back surgery syndrome: when you continue to experience severe arm or leg pain, even though your surgery was technically “successful”
  • Complex regional pain syndrome: an often-misunderstood condition where you experience excess and prolonged pain and inflammation after an injury
  • Spinal cord injuries: studies suggest that electrical stimulation can help people with spinal cord injuries regain some motion and other functions like bladder and bowel control

How Do Spinal Cord Stimulators Work?

An SCS typically consists of several parts:

  • Stimulator: a battery-powered device surgically implanted in your spine to generate electrical pulses
  • Leads: thin wires connected to the stimulator that run through your spinal canal, delivering pulses to the spinal cord
  • Remote control: a handheld device that helps you control the spinal cord stimulator and adjust its settings

Your doctors and other professionals will program your SCS to target your specific condition and symptoms, using specific patterns of electrical pulses of varying frequency and strength to address your pain.

Spinal cord stimulators have become increasingly sophisticated. Today, some devices are rechargeable and can even sense when you’re sitting or lying down and will change your program based on your position and other factors.

A spinal cord stimulator, however, will not stop or cure your chronic back pain. Instead, it changes how your brain perceives the pain. So instead of feeling an excruciating pain that shoots down your leg, you might feel milder pain combined with numbness and tingling (sometimes called “paresthesia”). Doctors consider a spinal cord stimulator successful if it reduces your back pain by 50–70%. However, SCS does not work for everyone—and some people decide to remove their stimulators due to negative side effects or poor pain control.

When Do Doctors Recommend Spinal Cord Stimulators?

Your medical team might recommend an SCS if other pain management treatment (like injections, medication, and physical therapy) have failed and you are either out of surgical options or another back surgery is inadvisable. Your doctors may also ask you to undergo a mental health assessment, since conditions like depression, anxiety, and addiction can impact your spinal cord stimulator’s likelihood of success.

If your doctors believe a stimulator is in your best interests, they will have you undergo a trial, where they surgically place leads in your spinal canal, but you wear the stimulator on a belt.  After a few weeks, they will evaluate your pain levels. If the temporary stimulator improves your quality of life, you can decide to have a more permanent device surgically implanted in your back.

How Will a Spinal Cord Stimulator Change My Daily Life?

It typically takes a month or two to heal from a spinal cord stimulator surgery. After that, your doctor will fine-tune your stimulator’s programming. You may need to visit your doctor on several occasions to make sure that your incision is healing properly and that your stimulator is working well.

If your stimulator dramatically reduces your pain and symptoms, you might be able to increase your activity levels significantly. An Australian study found that nearly 74% of the people surveyed could perform more activities of daily living (like making meals and performing chores). However, only 24% of this population could return to work.

Do I Qualify for Long-Term Disability if I Have a Spinal Cord Stimulator?

There’s no simple answer to this question. To understand your eligibility for disability insurance benefits, you’ll need to assess your policy’s terms and conditions and the severity of your symptoms.

First, you’ll need to understand how your disability insurance policy defines “disability.” Look for one of the following definitions in your Summary Plan Description or Plan Document:

  • Own occupation: to be eligible for benefits, you must be unable to perform your actual job duties
  • Any occupation: you must show that you cannot perform any work

Because spinal cord stimulators’ results vary dramatically, you and your doctor will need to carefully assess your symptoms and abilities. Suppose you experience a dramatic reduction in your symptoms with a spinal cord and have an “any occupation” plan. In that case, you might have difficulty proving that you’re incapable of doing low-impact work.

Similarly, even under an “own occupation” plan, your claim may become complicated if your spinal cord stimulator is effective and your job is not physically intensive. For example, suppose you are an attorney with a chronic low back condition. You can sit and stand as needed during a typical day, and you only need to lift or carry an occasional file. If your spinal cord stimulator reduces your back pain by 70% and your doctors think you can lift 10 pounds on occasion, the insurance company will likely deny your claim or terminate your benefits.

To fight back, you’ll need evidence that documents your other limitations. For example, if you still experience negative side effects from your pain medications or need to take frequent, unscheduled breaks even with a spinal cord stimulator, you may still be eligible for long-term disability benefits.

You’ll likely need help from a disability insurance lawyer when building these sophisticated arguments. At Bryant Legal Group, our attorneys use medical evidence, expert testimony, and careful legal analysis to strengthen and support their clients’ claims. We’ve helped people throughout Illinois recover millions in insurance benefits, earning us a reputation as one of the state’s premier disability insurance law firms.

RELATED: Chronic Pain and Disability Insurance: A Claimant’s Guide

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

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