Ossification of the Posterior Longitudinal Ligament and Long-Term Disability Claims

Ossification of the Posterior Longitudinal Ligament (OPLL) is an uncommon but serious spinal condition that can lead to chronic pain, neurological symptoms, and significant loss of function. But many long-term disability (LTD) claimants struggle to explain how fluctuating symptoms translate into real-world job limitations. The most common mistake I see claimants make is assuming that imaging alone will prove disability. Insurers focus on how your symptoms affect daily functioning, not just what appears on a scan.

Understanding OPLL

OPLL occurs when the posterior longitudinal ligament, which runs along the back of the vertebral bodies inside the spinal canal, begins to thicken and harden. This abnormal bone formation narrows the spinal canal and can compress the spinal cord or nerve roots. It is most common in the cervical spine but can also affect the thoracic or lumbar regions.

Causes are not fully understood, but risk factors include:

• Genetic predisposition
• Diabetes
• Diffuse idiopathic skeletal hyperostosis (DISH)
• Prior spinal trauma
• Age-related changes

Symptoms depend on the location and severity of the ossification but often include:

• Neck or back pain
• Stiffness and reduced range of motion
• Tingling, numbness, or burning sensations in the arms and hands
• Weakness or clumsiness in the hands
• Gait instability
• Bowel or bladder dysfunction in more advanced cases

Over time, OPLL may progress, increasing cord compression and leading to myelopathy.

How OPLL Limits a Person’s Ability to Work

The functional limitations of OPLL vary, but they often affect both physical and cognitive stamina. Many claimants struggle with:

• Pain and reduced mobility. Chronic neck stiffness, limited rotation, and muscle spasms make it difficult to drive, sit, or work at a computer.
• Neurological deficits. Numbness, weakness, or loss of dexterity in the hands can interfere with typing, writing, grasping, or fine-motor tasks.
• Balance and gait issues. Cord compression may impair walking or standing for extended periods.
• Fatigue and concentration problems. Persistent pain and neurological symptoms often reduce focus and productivity.

People in physically demanding jobs may be unable to lift, carry, or perform overhead work. But even sedentary workers may struggle with prolonged sitting, computer use, or maintaining reliable attendance.

Medical Evidence That Helps Support an OPLL LTD Claim

Because insurers rarely approve LTD claims based solely on imaging, it’s important to provide robust and well-organized medical documentation. Helpful evidence may include:

• MRI or CT scans showing the degree of ossification and cord/nerve compression
• Neurological examinations documenting strength, reflexes, sensation, and gait
• EMG/NCS testing if radiculopathy or neuropathy is suspected
• Physician treatment notes describing ongoing pain, functional limitations, and response to treatment
• Medication history and reported side effects
• Physical therapy or pain management records
• Surgical records, when applicable

The most common mistake I see claimants make is failing to include detailed statements from their treating doctors. Insurers want clear explanations of how symptoms translate into specific work-related restrictions: sitting limits, lifting limits, computer tolerance, fine-motor limitations, and whether symptoms would cause excessive absences.

Why LTD Insurers Deny OPLL Claims

OPLL claims are frequently denied because the condition can be slow-progressing and may not always produce dramatic exam findings early on. Common insurer arguments include:

• “Imaging doesn’t show significant compression.”
• “Symptoms are out of proportion to exam findings.”
• “You should be able to perform sedentary work.”
• “Your treatment has been conservative.”
• “Your activities suggest greater functioning than reported.”

Insurers may also rely heavily on paper-only reviews instead of in-person evaluations, which often leads to underestimating neurological deficits.

Strengthening Your Appeal After an OPLL Denial

If your LTD claim has been denied, the appeal is your one chance to present the strongest possible medical and vocational case. Effective appeals often include:

• Updated imaging studies
• Detailed treating physician statements and RFC-style assessments
• Functional capacity evaluations (where appropriate)
• Documentation of falls, gait disturbances, or hand dysfunction
• Pain diaries or symptom logs
• Clarification of how OPLL interacts with any coexisting spinal conditions (such as stenosis, disc protrusions, or DISH)

A well-supported appeal connects the medical findings to day-to-day limitations: sitting tolerance, need for breaks, difficulty with fine-motor tasks, and unreliability due to flare-ups or neurological symptoms.

How the Ortiz Law Firm Can Help

OPLL-related disability claims can be complex, especially when insurers argue that imaging is “not severe enough” or that you should still be able to work a desk job. Our team understands how to build a strong medical and vocational narrative that demonstrates why your symptoms prevent full-time work.

We handle long-term disability appeals and lawsuits nationwide. If your claim has been denied—or if your benefits were terminated—our firm can review your denial letter, gather the right evidence, and prepare a targeted appeal.

To discuss your situation, call Ortiz Law Firm at (888) 321-8131 or contact us online for a case evaluation.