Symphysis Pubis Dysfunction and Long-Term Disability Claims

Symphysis Pubis Dysfunction (SPD) is a painful and often debilitating condition that affects the joint at the front of the pelvis. While commonly associated with pregnancy, SPD can also occur due to trauma, surgery, arthritis, or chronic instability in the pelvic region. This article explores how SPD may lead to long-term disability, the evidence necessary for a successful claim, and how to overcome common challenges in the claims process.

What Is Symphysis Pubis Dysfunction?

The symphysis pubis is a joint that connects the left and right sides of the pelvis. SPD occurs when there is excessive movement or instability in this joint. This results in inflammation, pain, and altered gait. The condition is common during pregnancy, but it typically resolves postpartum.

Non-pregnancy-related SPD, however, is often caused by:

• Pelvic trauma (e.g., from an accident or fall)
• Pelvic or hip surgery
• Osteitis pubis (inflammation of the symphysis pubis)
• Osteoarthritis
• Chronic overuse or sports-related injuries

Symptoms include pain in the pelvic area, difficulty walking or climbing stairs, pain when standing on one leg, and instability or clicking in the pelvis. In severe cases, the pain can radiate into the lower back, hips, and thighs, making even basic daily tasks challenging. Limitations due to SPD may lead to depression.

How SPD Limits Functional Capacity

Chronic SPD can severely affect a person’s ability to work, particularly in positions that require physical exertion. Key limitations may include:

• Mobility Issues: Walking, standing, or climbing stairs may trigger severe pelvic pain.
• Postural Limitations: Sitting or standing for extended periods can exacerbate discomfort.
• Reduced Strength and Stability: Difficulty lifting, carrying, or bending due to lack of pelvic control.

Even sedentary workers, like office professionals, may find prolonged sitting intolerable. Documenting these symptoms and resulting limitations is key to a successful claim.

Medical Evidence to Support a SPD Disability Claim

Insurance companies need substantial documentation to approve a long-term disability claim for SPD. Helpful medical evidence includes:

• Imaging studies showing inflammation, separation, or instability of the symphysis pubis
• Clinical examination notes documenting pain levels, mobility limitations, and gait abnormalities
• Reports from physical therapists, orthopedists, or pain specialists
• A record of attempted treatments, such as physical therapy and medications
• Functional capacity evaluations (FCEs) that show work-related limitations

It is also important for your treating providers to outline how your symptoms interfere with your ability to perform job duties. A list of your diagnoses is not enough to get your LTD claim approved.

Challenges in Getting a SPD Claim Approved

Claimants with SPD may encounter several obstacles in the LTD claim process, including:

• Subjective Symptoms: Pain and instability are often self-reported and difficult to measure objectively.
• Bias Toward Pregnancy-Related Cases: Some insurers may dismiss SPD as a temporary pregnancy-related issue, even when unrelated to childbirth.
• Lack of Awareness: SPD is not a well-known condition, which can lead to skepticism from claim reviewers unfamiliar with its severity.
• Surveillance: The insurer may use activities like walking short distances or carrying light items to argue against your limitations, even if your symptoms fluctuate.

These challenges highlight the importance of strong medical documentation and consistent statements about your limitations.

RELATED POST: Surveillance In Long-Term Disability Claims

Hypothetical Case Example

Imagine a 45-year-old former firefighter who suffered a pelvic fracture during a fall. He continues to experience chronic pain, instability, and limited mobility months after surgery. Despite physical therapy and following his doctor’s orders, he cannot return to work without pain. He applies for LTD benefits, but is denied due to “insufficient evidence.”

With support from his medical team, he obtains an updated MRI and a functional capacity evaluation showing significant postural and exertional limitations. With this evidence and legal support, he successfully appeals the denial.

How a Long-Term Disability Attorney Can Help

An experienced long-term disability attorney can be key to getting an SPD claim approved or reinstated. Legal support may include:

• Reviewing the insurance policy and claim file
• Helping gather and organize strong medical evidence
• Coordinating expert opinions or functional assessments
• Responding to denials with detailed appeal letters
• Filing a lawsuit if the insurer refuses to pay

SPD is often misunderstood or minimized. Having a knowledgeable advocate can make a significant difference in the outcome of your claim.

Get Help from the Ortiz Law Firm

If your long-term disability claim for symphysis pubis dysfunction has been denied or terminated, don’t give up. The Ortiz Law Firm offers nationwide representation for LTD claimants and has a strong track record of success in complex disability cases. We provide personalized support and aggressive advocacy to help you get the benefits you deserve. Call (888) 321-8131 today to schedule your free consultation.