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Spine disorders are among the most common reasons people file long-term disability (LTD) claims. Chronic neck or back pain, nerve compression, and mobility problems can make it impossible to sit, stand, or concentrate long enough to perform reliable work. Unfortunately, disability insurance companies often minimize or deny these claims—especially when imaging or test results don’t appear “severe enough.”
If your long-term disability claim for a spine condition has been denied or terminated, you still have options to fight back.
Common Spine Disorders That May Qualify for Long-Term Disability
Many spinal conditions can interfere with your ability to work full-time. Some of the diagnoses we frequently see in LTD claims include:
- Degenerative disc disease
- Herniated or bulging discs
- Arachnoiditis
- Spinal stenosis (cervical, thoracic, or lumbar)
- Spondylosis and spondylolisthesis
- Sciatica and nerve root compression
- Radiculopathy
- Osteoarthritis of the spine
- Ankylosing spondylitis
- Syringomyelia
- Post-surgical complications or failed back surgery syndrome
- Scoliosis
- Kyphosis
Each of these conditions can cause pain, numbness, weakness, and limited range of motion that reduce your capacity to perform the essential duties of your occupation.
When Mild Imaging Findings Still Prevent Work
Even when MRI or X-ray findings seem mild, functional limitations may still prevent consistent work performance.
Common work-related restrictions include:
- Difficulty sitting or standing longer than 20–30 minutes
- Needing frequent position changes or unscheduled breaks
- Using a cane or walker
- Inability to lift, reach, or twist safely
- Loss of focus or productivity due to pain or medication side effects
Insurance companies often argue that claimants can do sedentary work, but they rarely consider how chronic pain and positional restrictions make full-time work unreliable.
Understanding Key LTD Policy Definitions
Before filing or appealing a claim, it’s crucial to understand your policy language:
- Own Occupation vs. Any Occupation: During the “own occupation” period (usually the first 24 months), you must prove you can’t perform your specific job. Afterward, the standard often shifts to “any occupation,” meaning you must show you can’t perform any job for which you are reasonably qualified.
- Elimination Period: The waiting period before LTD benefits begin—commonly 90 or 180 days after your last day of work.
- Benefit Duration: Some spine-related LTD policies have a 24-month limit for “musculoskeletal” conditions unless there is objective nerve damage.
Understanding these terms can help you plan your claim strategy and avoid unexpected terminations.
Evidence to Support Your Spine Disorder Claim
A successful LTD claim for a spine disorder depends on detailed medical and vocational evidence. Strong documentation may include:
- Office visit notes from treating specialists
- MRI or CT imaging
- EMG or nerve conduction studies
- Physical therapy and pain-management records
- Functional Capacity Evaluation (FCE)
- Residual Functional Capacity (RFC) form completed by your doctor
These records help prove that your symptoms are consistent, persistent, and severe enough to prevent sustained employment.
Common Reasons LTD Claims for Spine Disorders Are Denied
Disability insurance carriers frequently deny or terminate claims for spine disorders. Common reasons include:
- Alleging “insufficient objective evidence”
- Selectively interpreting imaging results
- Relying on “paper review” doctors who never examine you
- Claiming you can perform sedentary or “light duty” work
- Conducting surveillance or monitoring social media activity
The appeal process allows you to challenge these tactics—but the quality of your appeal determines whether you win.
How Ortiz Law Firm Builds Strong LTD Appeals
At Ortiz Law Firm, we focus exclusively on long-term disability appeals and lawsuits involving spine and neurological conditions. Our process includes:
- Gathering and organizing all medical and vocational evidence
- Coordinating with treating doctors to complete custom RFC forms
- Obtaining targeted testing or FCEs
- Addressing vocational reliability issues such as absenteeism and productivity
- Building a strong administrative record in anticipation of potential litigation
Nick Ortiz has represented disability claimants since 2005. Our team understands how insurers evaluate spine-related LTD claims—and how to counter their denials effectively.
How We Turn a Denied Claim Into a Win
To show how a strong appeal can make a difference, consider this hypothetical example based on real client experiences:
A 48-year-old registered nurse with lumbar degenerative disc disease and nerve root compression stopped working after years of worsening back and leg pain. Her LTD insurer denied the claim, arguing that her MRI showed only “mild” findings and that she could perform sedentary work.
We obtained a Functional Capacity Evaluation (FCE) showing that she could not sit or stand longer than 15 minutes and required unscheduled rest breaks throughout the day. Her spine surgeon completed a customized RFC form confirming these limitations, and a vocational expert provided a report showing that no employer would tolerate her absenteeism and productivity restrictions.
Result: The insurer overturned the denial and reinstated ongoing LTD benefits.
This type of outcome demonstrates that thorough documentation and strategic appeals can turn an insurer’s denial into a successful claim.
Request a Free Case Evaluation
If your disability insurance company denied or terminated your claim for a spine disorder, you don’t have to face them alone. Ortiz Law Firm represents clients nationwide in long-term disability appeals and lawsuits. Call (888) 321-8131 or request a free case evaluation today to learn how we can help you protect your rights and secure the benefits you deserve.
