Occipital Neuralgia and Long-Term Disability Claims

Living with chronic pain can interfere with your ability to work and enjoy daily life. For individuals with occipital neuralgia, the challenges are often compounded by the invisible nature of their symptoms. This article explores how occipital neuralgia can affect your ability to work, the medical evidence needed for a long-term disability (LTD) claim, and the role of legal support when a claim is denied.

Understanding Occipital Neuralgia

Occipital neuralgia is a neurological condition caused by irritation or injury to the occipital nerves, which run from the top of the spinal cord through the scalp. It can result from trauma, repetitive neck movements, tight neck muscles, or underlying conditions such as diabetes, osteoarthritis, or tumors. In many cases, however, the cause remains unknown.

Common symptoms include piercing, throbbing, or electric shock-like pain – similar to trigeminal neuralgia, except the pain is in the upper neck, the back of the head, and behind the ears (rather than the face). Patients often experience scalp tenderness, light sensitivity, and pain with neck movement. These symptoms can be debilitating and persistent, significantly impacting daily functioning.

Functional Limitations from Occipital Neuralgia

The chronic pain and sensitivity associated with occipital neuralgia can severely limit an individual’s ability to work. For example:

• An office worker may struggle to sit at a desk for extended periods due to neck pain and stiffness, especially if they must constantly look at a computer screen.
• A construction worker might be unable to perform physical labor involving lifting, bending, or working overhead.
• A teacher may have difficulty focusing or maintaining a calm demeanor due to ongoing head pain and sensitivity to light or noise.

These symptoms not only reduce productivity and may make it unsafe or impractical for individuals to fulfill their job responsibilities.

Medical Evidence to Support a Disability Claim

To establish a long-term disability claim for occipital neuralgia, claimants should present the following strong medical documentation:

• A formal diagnosis from a neurologist or pain specialist.
• Imaging studies, such as MRIs or CT scans, to rule out structural causes.
• Clinical notes documenting symptom history, treatments attempted, and functional impairments.
• Records of nerve blocks, physical therapy, medications, or surgical interventions.
• Statements from treating physicians regarding the patient’s inability to perform work activities.

Keeping a symptom diary can also help demonstrate the frequency and severity of episodes.

Common Challenges in LTD Claims for Occipital Neuralgia

Claimants with occipital neuralgia often face skepticism from insurers because:

• Pain is subjective and difficult to quantify.
• Imaging may not reveal any structural damage.
• Insurers may rely on surveillance or independent medical exams (IMEs) that downplay the severity of symptoms.
• There may also be pressure to prove that the symptoms are not exaggerated or psychosomatic.

These challenges can result in denied or terminated claims, even when the individual is genuinely disabled.

Consider Jane, a 44-year-old graphic designer who started having sharp, radiating headaches after a minor car accident. Despite taking medication, undergoing nerve blocks, and doing physical therapy, her pain persists, especially when she sits at her desk for more than an hour.

Jane struggles to concentrate and often misses deadlines due to migraines and light sensitivity. Although her employer provided accommodations, Jane eventually had to stop working. Initially, her long-term disability insurer initially approved her claim, but later terminated benefits, citing “insufficient objective evidence.”

Legal Support for LTD Appeals and Lawsuits

Navigating an LTD denial for occipital neuralgia can be overwhelming. An experienced long-term disability attorney can help by:

• Reviewing the denial letter and insurance policy.
• Gathering additional medical evidence and expert opinions.
• Preparing comprehensive appeal letters.
• Filing a lawsuit, particularly under ERISA guidelines, if necessary.

An attorney will also ensure that claimants meet all deadlines and procedural requirements, giving them the best chance of success.

Get Help from the Ortiz Law Firm

If your long-term disability claim for occipital neuralgia has been denied or cut off, don’t face the battle alone. The Ortiz Law Firm offers nationwide representation, personalized legal support, and a proven track record in LTD appeals and litigation. Contact us online or call (888) 321-8131 today to discuss your case and explore your legal options.