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ERISA Law

Chronic Back Pain Symptoms and How They Can Impact Your Ability to Work

J. Scott Kilpatrick

April 2, 2017

Updated: June 20, 2024

Chronic Back Pain Symptoms and How They Can Impact Your Ability to Work

Chronic back pain is a common disability.  Experts estimate that 80 percent of Americans will suffer from it at some point in their lives.  Moreover, employees across the country cite it as a primary reason for missing work.  According to one study, employees lose more than 264 million days of work because of back pain.  A person may have mechanical back pain or inflammatory back pain.  However, mechanical back pain accounts for most cases.

Chronic back pain symptoms directly impact a person’s ability to work.  The pain is often intense, and rest is necessary to relieve symptoms.  Moreover, even sedentary jobs—such as administrative work in an office—can be difficult since sitting for extended periods can trigger symptoms.

Despite chronic back pain being a leading cause of missing work, insurance companies deny many claims pertaining to such conditions.  Receiving an approval is difficult, but if you cannot work due to a chronic back pain condition, you must consider filing for long-term disability (LTD) benefits.   These benefits can help protect your income when you cannot work due to your condition.

Conditions That Can Cause Chronic Back Pain

Many conditions and injuries can lead to chronic back pain.  It is important to be cognizant of these conditions.  Insurance companies routinely deny long-term disability claims for back pain because claimants self-report their conditions.

Chronic Pain in Long Term Disability Claims

Nevertheless, conditions that can cause chronic back pain include:

  • Degenerative disc disease (DDD): This condition affects the discs in a person’s vertebrae and causes pain, though DDD is a normal part of aging.
  • Spinal stenosis: This condition puts pressure on your spinal cord nerves due to a narrowing of the spaces within the spine.
  • Herniated discs: Also known as a “bulged,” “ruptured,” or “slipped” disc, is an issue concerning the discs between the vertebrae of a person and most commonly affects the lower back.
  • Osteoarthritis: This form of arthritis is degenerative and is common as people age.
  • Sacroiliitis: This condition affects a person’s sacroiliac joints, and the inflammation can cause pain in the lower back.
  • Spondylosis: Several forms of spondylosis exist, and they all relate to the age-related degeneration of the spine.
  • Scoliosis: This condition refers to when the spine curves sideways.
  • Osteoporosis: This condition refers to the weakening of a person’s bones, which, since the bones become very brittle, can fracture easily.
  • Cervical radiculopathy: This condition refers to a “pinched nerve” (i.e., a compressed nerve) in the neck region of the spine.

Of course, this list is not exhaustive, but it represents a good overview of the conditions that may cause a person’s chronic back pain.  Each condition is treated differently, so it is important to consult with your physician to understand what is causing your symptoms.

Receiving a Diagnosis Helps When Filing LTD Claims

As mentioned, a major part of why insurance companies deny chronic back pain claims is because claimants self-report the symptoms of the condition.  Insurance companies also cite the “lack of objective evidence” as a common reason to deny such claims.

Therefore, it is vital to receive an official diagnosis of your condition to submit as objective evidence when you file your claim.  For example, if you receive a diagnosis of spondylosis, you will also have X-rays to submit as evidence.  Moreover, an official diagnosis will be reflected in your medical records.

Of course, regardless of the diagnosis, it is important to maintain an open dialogue with your doctor.  This ensures that your symptoms are continuously recorded, showing how debilitating your condition is.

Symptoms

The symptoms associated with back conditions can be debilitating.  Back pain is considered “chronic” when pain-related symptoms last for longer than six months.  It can take various forms, such as:

  • Pain that aches, stabs, burns, or shoots throughout the back;
  • Pain that radiates down into the legs;
  • Pain that may get worse with certain movements, such as bending and twisting;
  • Pain that persists and does not improve with rest; and
  • Pain that causes weakness, numbness, or tingling in the legs.

Yet this is not the only symptom.  Oftentimes, chronic back pain can cause other symptoms, such as:

  • Fatigue;
  • Sleeplessness;
  • Depression;
  • Anxiety;
  • Difficulty concentrating; and
  • Irritability.

Not every person will experience every symptom, but regardless of the symptoms a person does experience, it can make working difficult or impossible.  Additionally, symptoms can affect every facet of a person’s life, including enjoying leisure activities; maintaining healthy relationships; and more.

Risk Factors of Chronic Back Pain

The abovementioned symptoms can affect anyone who has chronic back pain.  Moreover, anyone of any age can experience it.  However, there are certain factors that raise the risk of developing such a condition.  These risk factors include:

  • Age: As you age, the probability of developing back pain increases.
  • Not exercising enough: When you do not exercise, your muscles become weak.  These weakened muscles in your back can lead to pain.
  • Smoking: Smoking can cause coughing, which in turn can cause herniated discs.  Moreover, when a person smokes, they decrease the blood flow to the spine, which can lead to osteoporosis.
  • Being overweight: When you are overweight, your back comes under extra stress.
  • Improperly lifting heavy objects: You must use your legs to properly lift heavy objects.  Over time, the improper lifting of such objects can cause chronic back pain.

Your doctor will take these risk factors into consideration, especially when creating certain treatment plans.

How Chronic Back Pain Symptoms Can Impact Your Ability to Work

Many people suffer from back pain in the United States.  While insurance companies deny a high number of these LTD claims, this does not mean these claims are not worth pursuing.  Chronic back pain can affect a wide variety of jobs, from surgeons to office workers.  Anyone with a back condition knows how even sitting can trigger bouts of intense pain.

Pain is distracting.  When you are working, concentration—regardless of industry—is paramount.  Even minor pain can cause your mind to focus solely on your condition, which can lead to mistakes.  These mistakes at work can be detrimental.

When you suffer from chronic back pain, you are more likely to slouch at your desk.  Bad posture is a common cause of back pain.  If you have a sedentary job, your back pain could cause you to slouch for hours on end.

Other ways your symptoms can affect you at work include:

  • Decision making: When you are focusing on your pain, or suffer from fatigue because you cannot sleep, your cognitive abilities suffer.
  • Motivation decrease: Back pain can lead to a decrease in motivation to complete certain tasks, thereby allowing more mistakes to occur and work left undone.
  • Certain tasks can make the pain worse: Many jobs require repetitive movements, and such repetitiveness can aggravate chronic back pain.

Working while suffering from pain is impossible for many and requires treatment and rest.  Long-term disability benefits may be the answer for those who need the time to manage their condition.

Filing a Claim for Long-Term Disability Benefits

If you have chronic back pain that is severe and prevents you from working, you must consider filing a claim for long-term disability benefits.  However, there are a few things of which to be aware before beginning the claim process.

How ERISA Impacts Long-Term Disability Claims

Insurance companies deny many LTD claims for back pain.  Further, such companies do not like paying claims and will work to find a reason to issue a denial.  For example, insurance companies routinely employ surveillance tactics on claimants to inject doubt into a claim.

Your insurer is likely to request a lot of information when you decide to file a long-term disability claim.  It is beneficial to consult an LTD lawyer who can help gather and submit this information on time.

Additionally, if you receive your long-term disability policy through your employer then you must be aware of ERISA, which governs such policies.  ERISA is a federal law and has its own set of deadlines and strict rules.  To ensure a fair review of your claim, it is important to follow ERISA closely.

Appealing a Denial of Benefits

If you receive a denial of your initial claim, you have the right to appeal your insurer’s decision.

How Long-Term Disability Administrative Appeals Work

Your long-term disability policy has information regarding the appeal process, including specific deadlines and the general procedures you must follow.  When your insurance company denies your claim, they will send you a denial letter.  You should use this denial letter to help prepare your appeal.

Your denial letter will include the reasons why the insurance company denied your claim.  It is best to address these reasons directly in your appeal.  When you have an ERISA-governed policy, you must be aware that this appeal stage is the last time you may submit new or updated evidence.  In other words, if you go to litigation, you cannot submit any evidence.

Chisholm Chisholm & Kilpatrick Can Help with Your Claim

Many claimants decide to handle their long-term disability claims on their own.  However, it is beneficial to consult with an attorney to help with the process.

Chisholm Chisholm & Kilpatrick can help with your LTD claim for chronic back pain.  We can thoroughly review your long-term disability policy.  Every policy contains a definition of disability, and we will use this definition to determine the best evidence to gather for your claim.

Insurance companies are challenging to communicate with, and CCK understands this.  Our team can act as a point of contact between you and your insurer so that you never have to deal directly with them during the process.  Additionally, we can help you manage the many deadlines and regulations associated with LTD claims and appeals, as well as gather evidence to prove your case.

When you have chronic back pain, it can be difficult to work.  Long-term disability benefits are vital to protect your income and allow you to manage your condition.  Regardless of where in the process you are, a long-term disability attorney from CCK may be able to help.  Call us today at (800) 544-9144 for a free consultation with a member of our team.  We will evaluate your case and see if we can assist you.

About the Author

Bio photo of J. Scott Kilpatrick

Mr. Kilpatrick (Scott) is an experienced trial attorney, having tried dozens of jury cases to verdicts, and hundreds of other bench trials, arbitrations, and mediations. He is a founding partner of the firm, serves as its Managing Partner, and directly oversees, the firm’s Bequest Management Practice.

See more about J. Scott