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ERISA Law

Getting Long-Term Disability (LTD) Benefits for Thoracic Outlet Syndrome

Leah Small

June 19, 2020

Updated: January 19, 2024

Getting Long-Term Disability (LTD) Benefits for Thoracic Outlet Syndrome

Getting your long-term disability (LTD) benefits for thoracic outlet syndrome (TOS) can be difficult, time-consuming, and stressful.  You should be able to easily file your claim and start receiving the disability benefits to which you are rightfully entitled.  Unfortunately, wrongful denials by insurance companies are far too common and the process of appealing such a denial can be taxing.

At Chisholm Chisholm & Kilpatrick, our team of attorneys and professionals can take the burden off of you, which can allow you more time to focus on your health and your family.  We apply our knowledge and experience in handling LTD claims and can fight the insurance company on your behalf to get you the benefits you deserve.  Call us today at (800) 544-9144 for a free case evaluation.

Understanding Thoracic Outlet Syndrome

Thoracic outlet syndrome is a group of conditions that occur when the blood vessels or nerves between the collarbone and first rib are compressed.  This can cause pain and numbness in the neck, shoulders, arms, and fingers.  Thoracic outlet syndrome is often caused by a traumatic injury, such as a fall or a car accident.

Long-Term Disability (LTD) 101

It can also be the result of repetitive job or sports-related injuries; anatomical defects like having an extra rib; or pregnancy.  Unfortunately, doctors are not always able to determine the cause of thoracic outlet syndrome.

Types of TOS

There are three main types of Thoracic outlet syndrome.  The most common is neurogenic thoracic outlet syndrome, which is characterized by the compression of the brachial plexus, or the network of nerves that run from the spinal cord to the shoulders, arms, and hands and control their movement and sensation.

There is also vascular thoracic outlet syndrome, which occurs when one or more veins or arteries are compressed.  Finally, there is nonspecific-type thoracic outlet syndrome, which not all doctors believe exists.  This type is often characterized by chronic pain in the thoracic area, which typically worsens with activity, but does not have a specific cause.

Symptoms, Diagnosis, and Treatment

While symptoms can vary depending on the type of thoracic outlet syndrome you have, you will generally experience pain in the neck, shoulders, or hands; tingling in the hands or fingers; a weakened grip; arm fatigue, typically with activity; and discoloration in the hands or fingers.

Because the symptoms can vary from person to person, Thoracic outlet syndrome is often difficult to diagnose.  Your doctor will likely ask for your medical history and perform a physical exam, usually including provocation tests, or tests that are designed to reproduce the symptoms you experience.

During the exam, your doctor may ask you to perform various movements and examine you in different positions.  Your doctor will also likely order imaging or nerve study tests such as MRIs, CT scans, and EMGs before diagnosing you with thoracic outlet syndrome.

Treatment for thoracic outlet syndrome typically involves physical therapy and pain management.  Your doctor may also recommend changes in your daily activities, such as taking more breaks in order to stretch in between tasks; maintaining good posture and a healthy weight; avoiding carrying and lifting heavy objects; and avoiding or adapting activities that tend to exacerbate your pain.  In more serious cases of thoracic outlet syndrome, or for cases where symptoms are not treated early on, nerve damage could occur and surgery may be required.

How CCK Can Help You Obtain Long-Term Disability for Thoracic Outlet Syndrome

Whether you are filing an initial claim; appealing a denial or termination of your benefits; or litigating in court, we may be able to help.  Many clients reach out to us during the administrative appeal stage.  The appeal stage is very important.  Under ERISA, it is typically a claimant’s last opportunity to submit supportive evidence onto the record before heading to court.  We use our knowledge and expertise of ERISA; the U.S. Department of Labor Regulations; and various insurance policies to help us fight the insurance company for the benefits you deserve.

Why It's Important To Have a Lawyer Help With Your LTD Claim

One of the most important pieces of evidence in a disability claim is detailed medical records, and, when necessary, compelling reports from treating doctors.  It is important to speak with your doctors about your condition, symptoms, and the limitations and impairments you experience daily.

For example, you should typically ask your doctors to document their exam findings; any medication changes and side effects; your symptoms; and their observations within your medical treatment records.  Most doctors want to help; however, they are often busy with the high demands of their medical practice. CCK can work with your doctors in order to get strong medical evidence onto the record.

Gathering Supplemental Evidence to Reinforce Your LTD Claim

Once we gather your medical records, we will begin to analyze your insurer’s denial letter.  This denial letter contains the reasons for the insurance company’s decision.  Moreover, our team will also analyze your specific policy and your claim file to determine if any mistakes were made during the handling of your claim.

Vocational Evidence in Long-Term Disability Claims: Why It's Important

If your claim requires supplemental evidence, we can gather and submit this evidence on your behalf.  For example, we can obtain specialized reports from your treating physician(s); witness statements from family, friends, and co-workers; and additional medical and vocational evidence from third-party experts.

CCK will write a comprehensive appeal explaining to the insurance company the reasons why you meet your policy’s definition of disability and are entitled to benefits.  Our arguments are always based on and supported by the medical evidence in your claim file, as well as the evidence that was gathered during the investigation stage of the process.

Contact Chisholm Chisholm & Kilpatrick

Obtaining long-term disability benefits is often difficult, but it is not something must handle on your own.  CCK has over 30 years of experience helping clients go up against big-name insurance companies like Unum and Prudential.  We understand how these insurance companies operate and what they look for in a successful claim.  We may be able to help you.

Call CCK today at (800) 544-9144 for a free case evaluation.  A member of our team will analyze your claim and determine if we can assist you.

About the Author

Bio photo of Leah Small

Leah joined CCK in September of 2016 an Associate Attorney in the firm’s litigation practice and now serves as a Supervising Attorney. Leah’s practice focuses on representing individuals in the application, appeal, and litigation of life, health, short-term disability and long-term disability insurance benefits under the Employee Retirement Income Security Act (ERISA) and under private insurance contracts. Leah’s practice also includes litigation of personal injury, business, and contract disputes in both state and federal court.

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