Long-Term Disability For Knee Injuries

The gut-wrenching sound of a knee injury is a familiar sound for athletes. You may have witnessed a knee injury watching a professional basketball game. Knee injuries account for 50% of all injuries in athletes. But knee injuries don’t just happen under the lights in a large stadium. Knee injuries and pain are common in our everyday life and can result in a lifetime of pain and problems. Here are five things you need to know about knee injuries and long-term disability claims.

#1: Knee Pain Is the Most Common Type of Joint Pain In the United States

Knee pain can start with weakened joints as early as childhood. Although exercise can help, as you get older, the joint continues to get weaker. Eventually, you will need knee surgery that can limit the type of work you can do for the rest of your life.

#2: You Can Inherit Bad Knees

Just as you can inherit red hair or brown eyes from your parents, you can also inherit joint weakness called Familial Osteochondritis Dissecans. People with this condition develop lesions over their joints, causing weakness, and eventually, the joint gives away, leaving you in significant pain and needing surgery.  A similar condition, called Sporadic Osteochondritis Dissecans, is when a single lesion forms around only one joint – usually the knee.

#3: Knee Surgery Recovery Period Can Be Longer Than You Expect

Short-term disability benefits cover routine procedures like c-sections, hysterectomy, and other minor surgeries that have a normal recovery period of fewer than six months. Knee surgeries are different. Depending on the type of knee surgery, it could take four months or more to recover before starting intense therapy to work the knee normally again.

#4: LTD Insurance Companies Will Try To Stay You Can Still Work Even With Chronic Pain

Chronic knee pain can be caused by many types of arthritis and degenerative joint diseases. The insurance company will try to argue that you can still work a sedentary job like sitting at a desk all day. If you have chronic knee pain, this is a ridiculous argument. Although you may be sitting at your desk, you still move your knees, you always get up and down to interact with co-workers for work-related duties, use the restroom, check the mail, use the fax or copy machine, etc. Once your pain starts to intensify, you can no longer think clearly and do your job correctly.

#5: Be Sure To Include Everything The Insurance Company Needs To Prove Your Claim

The insurance company will work hard to disprove your claim. Providing the insurance company with your medical file, including x-rays, test results, doctor’s visit notes, and operative notes from your surgery. Include your physical therapy notes and schedule. The doctor needs to be documenting your pain levels at every visit, but this is not always done, so be sure they are writing it down.

Getting Long-Term Disability Benefits Following A Knee Injury

Before filing a claim for long-term disability benefits, it’s essential to thoroughly review your policy. This will help you assess whether you have a valid case for receiving LTD benefits.

As you begin compiling details for your claim, ensure that you provide a comprehensive set of information. This will improve the strength of your administrative file, which is the foundation of your case. Your administrative file encompasses:

• All correspondences between you and your insurance provider.
• Complete medical records relating to your injury.
• Doctor’s notes and recommendations.
• Any surveillance footage, if available.

For further guidance, please refer to our article on applying for long-term disability insurance benefits.

How We Help With Long-Term Disability Claims Involving Knee Injuries

At Ortiz Law Firm, we often hear from people whose long-term disability claims were denied—even for serious knee problems like meniscus tears, ACL/PCL injuries, osteoarthritis, or post-surgical complications. A denial isn’t the end of the road. Most ERISA plans allow an appeal, but the deadline is strict, and the appeal is usually your last chance to add evidence to the file.

That’s where we come in. We focus on LTD appeals and lawsuits. We build the medical and vocational proof your claim needs, such as: operative reports and imaging, orthopedic and PT notes, treating-physician restrictions (e.g., limits on standing, walking, kneeling, climbing), functional capacity or gait assessments, medication side-effects, and a clear link between your knee limitations and your job’s demands.

What we do for you

• Track every deadline and requirement in your policy.
• Gather and organize records, imaging, and therapy notes—so the insurer can’t say they “didn’t receive” key documents.
• Work with your doctors on targeted forms (RFCs) and letters that translate medical findings into concrete work limitations.
• Prepare you for field interviews and surveillance pitfalls.
• Address vocational issues: why accommodations or sedentary alternatives still aren’t feasible given your restrictions.

You don’t have to hire a lawyer in your state to handle an ERISA LTD appeal—we represent clients nationwide. And with our Zero Fee Guarantee, there’s no fee unless we recover benefits.

If your knee injury is keeping you from working and your LTD claim was denied, we’ll review your situation and explain your options. Call (888) 321-8131 or contact us for a free, no-obligation case evaluation.