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ERISA Law

Long-Term Disability (LTD) Benefits for Degenerative Disc Disease (DDD)

May 14, 2020
man holding back in pain due to degenerative disc disease

Coping with back conditions including degenerative disc disease can be difficult enough without the added stress of filing a long-term disability (LTD) claim.  Unfortunately, the process is often difficult, time-consuming, and wrongful denials by the insurance companies are all too common.

The team of attorneys and professionals at Chisholm Chisholm & Kilpatrick help clients fight for the ERISA and non-ERISA LTD benefits to which they are rightfully entitled.  We remove the burden of dealing with the insurance company so that our clients can focus on their health and recovery.  Contact us now at 401-331-6300 for a FREE consultation.

Understanding Degenerative Disc Disease (DDD)

Many older adults experience some level of disc degeneration, but not all cases cause pain.  If you are experiencing pain in your back and your doctors are unable to identify a cause, you may have degenerative disc disease. Degenerative disc disease occurs when the cartilage discs between your vertebrae begin to shrink and deteriorate.  In addition to general wear and tear that comes with aging, injuries, accidents, and repetitive movements of the discs can also lead to degenerative disc disease.  Unfortunately, once the discs become damaged, they cannot repair themselves.

The most common symptoms of degenerative disc disease are pain in the neck or back, depending on which discs are deteriorating.  Additionally, this pain can also radiate into the outer extremities.  For example, disc degeneration that occurs in the neck and upper back will often cause radiating pain into the shoulder, arms, and hands, while degeneration in the lower back will often lead to radiating pain in the buttocks, thighs, and legs.

In order to diagnose you with degenerative disc disease, your doctor will likely send you for diagnostic testing including x-rays, MRIs, and CT scans.  Additionally, they will likely observe your functional abilities and determine your range of motion.  Accordingly, you may be asked to bend, twist, or rotate your neck and back so your doctor can determine if certain limitations exist or if different movements cause increased pain.

Treatment of degenerative disc disease typically starts conservatively with physical therapy to increase strength and mobility, along with pain management. Your doctor might also prescribe you pain mediation, administer steroid injections into the problem area, and/or advise you to avoid certain activities that could exacerbate your symptoms or lead to further degeneration.  In certain cases, surgical intervention may be recommended in order to relieve severe pain resulting from degenerative disc disease.  Typically, spinal fusions or the insertion of artificial discs are the two surgical options available to those with severe degenerative disc disease.

CCK Understands Disability Claims for Back Conditions Such as DDD

We know that back conditions including degenerative disc disease can progress and symptoms can worsen over time.  If your back pain becomes severe enough that it prevents you from working, in your own occupation or any occupation, you should consider filing a claim for long-term disability benefits. Back pain is one of the most common claims that insurance companies receive, and they often deny these claims due to a lack of objective evidence.

If your LTD claim has been denied, CCK can help you fight the insurance company for the benefits you are rightfully owed.  First, we analyze the insurance company’s denial letter, claim file, your long-term disability policy, and any other plan governing documents, to determine if mistakes were made by the insurance company.  There are many rules and regulations that insurance companies must follow under ERISA.  We use our knowledge and experience to identify any errors that the insurance company made in the handling and review of your LTD claim.

Next, we will reach out to your treating doctors and gather your medical records and potentially subsequent reports in further support of your claim.  It is important to have treating doctors who thoughtfully complete forms and provide reports documenting your disability.  Additionally, it is important to have your doctor document examinations findings, medications changes and side effects, your reported symptoms and limitations, and how they would impact your ability to work. We can help facilitate the flow of this information and often ease the burden on both you and your doctor.

In preparation for writing your long-term disability appeal, we would gather all information in support of your disability.  This information often includes:

  • Medical records
  • Test results
  • Reports from your treating doctors
  • Expert opinions
  • Witness and video statements from you, your family, your friends, and even former co-workers.

Preparing a strong and complete record of evidence is particularly important with ERISA governed long-term disability claims because typically the administrative appeal is your last chance to get supportive evidence into the record.  Once an appeal decision is made, new evidence is seldom allowed to be added to the record at the court level.  Once we have strong evidence, we write the appeal, thoroughly and strategically explaining why your condition interferes with your ability to work.

Call Chisholm Chisholm & Kilpatrick today at 401-331-6300 for a FREE consultation.