Shoulder Disorders and Long-Term Disability Claims

Shoulder disorders can be painful, limiting, and long-lasting. Whether caused by injury, overuse, or degenerative disease, these conditions can significantly impair your ability to lift, carry, reach, or perform repetitive tasks. If you’re struggling to work due to a shoulder disorder, you may be eligible for long-term disability (LTD) benefits. However, these claims are often denied without strong medical evidence and legal support.

Understanding Shoulder Disorders

The shoulder is a complex joint. It has a wide range of motion, but that flexibility makes it vulnerable to injury and degeneration. Common shoulder disorders include:

• Rotator Cuff Injuries: Tears or inflammation in the muscles and tendons that stabilize the shoulder.
• Adhesive Capsulitis (Frozen Shoulder): Stiffness and pain that limit range of motion.
• Shoulder Impingement Syndrome: Pain and inflammation when tendons are pinched during arm movements.
• Shoulder Arthritis: Degeneration of the joint, leading to stiffness, swelling, and chronic pain.
• Bursitis or Tendinitis: Inflammation of the shoulder bursa or tendons due to overuse or trauma.

Symptoms may include sharp or aching pain, limited range of motion, weakness, swelling, and a grinding or popping sensation. In severe cases, the condition may require surgery and months of rehabilitation.

Functional Limitations That May Affect Work

Shoulder disorders can severely limit a person’s ability to perform physical tasks required in many jobs. Functional limitations may include:

• Inability to lift or carry objects over a few pounds
• Limited ability to reach overhead or behind
• Difficulty with repetitive arm movements (typing, driving, etc.)
• Inability to push, pull, or grasp with force

For example, a warehouse worker may be unable to lift inventory. An office worker might find typing or using a mouse for extended periods intolerable. Even sedentary jobs may become unmanageable if shoulder pain interferes with concentration or arm positioning.

Medical Evidence to Support an LTD Claim

A successful long-term disability claim requires detailed, objective medical documentation. Important types of evidence include:

• Imaging tests (MRI, X-rays) showing structural damage
• Physical examination findings (e.g., limited range of motion, tenderness)
• Operative reports and physical therapy notes
• Treatment history and response (medications, injections, surgery)
• Statements from treating physicians outlining work restrictions

Functional capacity evaluations (FCEs) and medical opinion letters can also help prove how the condition limits your ability to work.

Common Challenges in Shoulder Disorder Disability Claims

Insurers often deny LTD claims for shoulder disorders due to:

• Lack of “objective” evidence, especially in soft tissue injuries
• Claims of improvement despite ongoing symptoms
• Surveillance footage showing the claimant performing certain activities
• Opinions from insurance-hired doctors who never examine the patient

Confused by your LTD denial letter? We’ll explain what it means, what went wrong, and what you can do next. Get your free denial letter review now — no strings attached.

RELATED POST: Benefit Limitations in LTD Claims for Soft Tissue Disorders

Hypothetical Case Example

Imagine a 54-year-old plumber with severe shoulder arthritis and a torn rotator cuff. He undergoes surgery but continues to experience pain and limited mobility. This prevents him from lifting tools or raising his arm overhead. Although his doctor provides medical records and restrictions, his LTD insurer denies the claim. The denial letter states he could do “lighter work.”

Appealing a Denied Shoulder Disorder Claim: Strategy and Steps

In a case like this, the best strategy for appealing the denial involves a comprehensive and well-documented approach. Key steps may include:

• Collecting updated medical records that show ongoing pain, limited range of motion, and treatment outcomes.
• Requesting a functional capacity evaluation (FCE) to objectively assess the claimant’s physical capabilities and limitations.
• Obtaining detailed statements from treating physicians outlining why the claimant is unable to work in any occupation.
• Securing a vocational expert’s report that explains why the claimant’s restrictions eliminate even sedentary job options.
• Writing a compelling appeal letter that addresses the insurer’s reasons for denial and presents all supportive evidence in a clear, organized manner.

A well-prepared appeal often makes the difference between a continued denial and the approval of LTD benefits.

How a Long-Term Disability Attorney Can Help

Shoulder disorder claims often require aggressive advocacy to overcome insurer skepticism. A long-term disability attorney can:

• Gather and present strong medical evidence
• Address policy-specific definitions of disability
• Challenge unfair denials with expert opinions and vocational analysis
• Represent clients in appeals or lawsuits if needed

The Ortiz Law Firm offers personalized support and experienced legal representation in LTD appeals and litigation nationwide.

Get Help with Your Denied Shoulder Disorder Disability Claim

If your long-term disability claim for a shoulder disorder has been denied or terminated, you don’t have to face the insurance company alone. Call (888) 321-8131 today to schedule your free case evaluation and take the next step toward securing the benefits you deserve.