Spinal Stenosis and Long-Term Disability: A Claimant’s Guide
If you’re a surgeon, dentist, or nurse, you probably spend a lot of your day bending, stooping, twisting, pushing, and reaching. This daily wear and tear can add up over time, causing spinal stenosis and other degenerative issues in your back. However, when these conditions make it impossible to work, you might face challenges in your disability insurance claims.
Insurance companies often minimize the impact of spinal stenosis, noting that some people with the condition report few or no symptoms. They might even suggest that you are exaggerating your limitations for purposes of financial gain.
At Bryant Legal Group, we help people with severe back pain fight back. We understand that no two back-related claims are the same, giving every one of our clients the attention and care they deserve. Keep reading to learn more about this misunderstood condition.
What Is Spinal Stenosis?
Spinal stenosis is the narrowing of your spinal canal, often due to age-related changes and the wear and tear of daily activities. However, a smaller number of people are born with conditions that narrow their spinal canal, like scoliosis.
To understand why stenosis can cause profound limitations, let’s examine the spine’s anatomy. Your back is made up of multiple, interrelated parts:
- Vertebrae: the bones that stack together and make up your spinal column
- Discs: doughnut-shaped shock absorbers that sit in between your vertebrae
- Spinal cord: a bundle of nerves and tissues that sends communications to and from your brain, and which runs through a series of hollow passages in the vertebrae called the spinal canal
- Spinal nerves: nerves that branch off the spinal cord and run to specific areas of your body
- Muscles and ligaments: soft tissues that help protect and support your spinal column
When the spinal canal becomes narrower, due to bone spurs, swelling, or collapsed or herniated discs, your spinal cord and nerves may become compressed, causing pain, numbness, tingling, and weakness. You might experience different symptoms depending on where the narrowing occurs in your back:
- Cervical spinal stenosis: You might notice neck pain, numbness and tingling that runs into your shoulders, arms, hands, and legs. In more severe cases, you might experience muscle weakness, balance problems, and even paralysis.
- Thoracic spinal stenosis: The rarest form of spinal stenosis, it is often associated with mid-back pain, numbness and tingling that runs into your legs, and balance problems.
- Lumbar spinal stenosis: Spinal canal narrowing in your low back can cause burning, shooting pain that runs down your leg (sometimes called sciatica), weakness in your legs, and foot drop. You might notice that standing and walking make your pain worse, while leaning forward or sitting alleviates it.
Typically, doctors diagnose spinal stenosis by performing a clinical examination and reviewing diagnostic studies, like X-rays, MRIs, and CT scans.
What Should I Expect if I Have Spinal Stenosis?
Spinal stenosis symptoms can vary from person to person. In fact, some people who have narrowing in their spinal canal are relatively symptom-free. When we talk about “spinal stenosis,” we’re really focusing on people who do suffer from severe pain, numbness, and weakness which limit their abilities to work and perform everyday tasks.
Depending on the severity of your symptoms and condition, your doctors may suggest a variety of treatment options:
- Medications, including anti-inflammatories and pain relievers
- Physical therapy
- Steroid injections
- Chiropractic care
- Surgeries, like laminectomies and spinal fusions, which aim to decompress your nerves and stabilize your spine
However, there’s not a simple cure-all for spinal stenosis, and you might continue to experience back pain even with ongoing treatment and pain management.
RELATED: Pre-Existing Conditions and LTD: 4 Things You Need to Know
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Can I Get Long-Term Disability for Spinal Stenosis?
It depends. If you have severe spinal stenosis and you cannot work, you may be eligible for long-term disability (LTD) benefits. However, you’ll need to understand how your insurance policy defines “disability.” You should request a copy of your Summary Plan Description or Plan Document and look for one of two common definitions:
- Own occupation: you are eligible for benefits if you cannot perform your actual job.
- Any occupation: you’ll have to convince the insurance company that you cannot perform any type of work.
Once you understand your policy’s requirements, you can evaluate the strength of your LTD claim by assessing the severity of your spinal stenosis, your work history, and your doctor-assigned limitations. This information and supporting evidence, like your medical records, will be the foundation of your LTD claim.
Notably, some policies start with the “own occupation” standard and then convert to the more rigorous “any occupation” one after a period of time. If you need help understanding your policy’s terms and conditions, schedule a consultation with one of our disability insurance lawyers.
I’m Getting Short-Term Disability for Spinal Stenosis. Will My Long-Term Disability Claim Be as Easy?
Many short-term disability insurance policies use the more claimant-friendly “own occupation” definition of disability. However, don’t be surprised if your long-term disability policy uses the “any occupation” definition. Our disability insurance lawyers frequently meet with people whose LTD claims were denied because the insurance company believes that while they cannot perform their own profession, there is other less physically demanding work that they can do.
In these cases, our experienced lawyers often work alongside medical and vocational experts to highlight our clients’ limitations and inability to perform any type of work.
How Can I Strengthen My Disability Insurance Claim?
While you might have a hard time understanding your long-term disability plan’s hard-to-read terms and conditions, there are still some simple ways you can actively strengthen your claim for stenosis-related disability.
Follow Your Doctor’s Recommendations and Treatment Plan
In many spinal stenosis cases, the insurance company will imply that your symptoms aren’t as severe as you claim them to be. If you have a history of skipping doctor’s appointments, ignoring your restrictions, or refusing to try low-risk treatment options, the claims adjuster will focus on these issues and question your credibility.
It’s always in your best interest to consistently attend your medical appointments, give a good faith effort when your doctor prescribes physical therapy and other treatment options, and live within your restrictions. That way, the insurance company won’t be able to point to inconsistencies in your medical records or collect damaging surveillance footage.
Keep a Disability Journal
Spinal stenosis is often a progressive condition, and your symptoms will likely change over time. It can be difficult to articulate how your symptoms have developed and recall the precise time when you started noticing specific issues. A disability journal can help you track and document your limitations and monitor your medications’ side effects.
Plus, disability and symptom journals can help you explain your daily challenges to your doctors, improving the quality of your medical records and your physicians’ level of care. If you need help creating a disability journal, check out our blog, .
Consult With a Disability Insurance Lawyer
During a long-term disability insurance claim, you’ll need to navigate complex legal issues and strict procedures. Unlike the claims adjuster, who represents the interests of the insurance company, a disability insurance lawyer is on your side. They can provide you with the honest advice and legal information you need to make smart decisions in your case.
Bryant Legal Group: Helping People With Spinal Stenosis Get the Benefits They Deserve
At Bryant Legal Group, our practice focuses on disability insurance law. We’ve fought for disabled professionals across Chicago and Illinois and have earned a reputation for our practical approach, sophisticated tactics, and stellar client experience. We’ve recovered millions in benefits for our clients, and we’d love to learn more about your story.
To schedule your free consultation, call us at 312-561-3010 or complete our online form.
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