Long-Term Disability for Arthralgia

Arthralgia, the clinical term for joint pain, is a common symptom in numerous health conditions. Chronic arthralgia can significantly limit an individual’s ability to perform daily activities and maintain gainful employment, leading to a claim for long-term disability benefits.

Symptoms of Arthralgia

Arthralgia manifests itself in a variety of symptoms that can significantly affect your ability to work. Individuals experiencing arthralgia often report pain in one or more joints, which may be accompanied by stiffness, especially after periods of inactivity or in the morning. Swelling, redness, and a warm sensation in the affected area are also common, indicating inflammation. Your eyes, lungs, and heart valves could also become inflamed. The severity of pain can range from a mild ache to a severe, disabling discomfort that restricts mobility and interferes with daily activities. In some cases, the sufferer might notice a decreased range of motion in the affected joint, making it challenging to perform tasks that were once routine.

Arthralgia v. Arthritis

The two terms, arthritis and arthralgia, often get mixed up. However, they’re not the same. It’s important to note that while arthritis, a condition that inflames the joints, can cause arthralgia, joint pain doesn’t always mean you have arthritis.

Causes of Arthralgia

Arthralgia can result from a variety of conditions including:

Diagnosing Arthralgia

Your doctor will conduct a physical exam to look for swelling, tenderness, warmth, and abnormal motion. There is no specific test to diagnose arthralgia, but your doctor may order tests to identify the underlying condition:

• Complete blood count (CBC) or blood differential
• C-reactive protein
• Joint x-ray
• Sedimentation rate
• Blood tests specific to certain autoimmune disorders
• Joint aspiration to obtain joint fluid for culture, white cell count, and examination for crystals

Treatment for Arthralgia

The treatment needed varies based on the severity and the underlying cause of your pain. Since joint pain can be caused by mild conditions like a joint sprain or a side effect of medication, you may not need immediate medical treatment. Rest, massage, stretching exercises, and warm baths may help. However, you should talk to your doctor if you feel a sharp pain that will not go away or have been experiencing joint pain for an extended time. A physician may recommend medication or physical therapy to relieve pain and swelling.

How Long-Term Disability Claims for Arthralgia Are Evaluated

Navigating a long-term disability claim can be complex and daunting. We will provide insight into the different stages of the LTD claim process.

The Initial Claim Evaluation

When a long-term disability claim is submitted for arthralgia, the insurance company conducts the initial assessment. It typically consists of three main stages:

1. Medical Assessment: The evaluating body will first scrutinize the claimant’s medical records to confirm the diagnosis of arthralgia and understand its severity. Critical evidence may include physician’s notes, imaging results, blood test reports, physical therapy records, and other related documentation.
2. Functional Capacity Evaluation: This assesses the claimant’s physical and mental abilities concerning their occupational requirements. For instance, if an individual’s job involves manual labor, their joint pain might substantially limit their ability to work, qualifying them for long-term disability benefits.
3. Consistency of Evidence: The evaluator will ensure the claimant’s reports of pain and disability are consistent across medical records, their own reports, and observable behavior. Insurance companies might sometimes use surveillance or unannounced visits to check for discrepancies.

Appeal and Review

If a claim is denied, claimants typically have the right to appeal. At this stage, further evaluation occurs, sometimes involving additional peer review reports, independent medical exams, and vocational assessments conducted by the insurance company’s hired experts.

The administrative appeal also provides an opportunity to present additional evidence. This could include new test results, reports from specialists, or testimony from vocational experts who can further elaborate on how the claimant’s ability to work is impaired due to arthralgia. If your appeal is unsuccessful, you can file a lawsuit.

Ongoing Monitoring

The evaluation does not end for approved claims. Insurance companies periodically review claims to ensure the claimant remains eligible for benefits. These reviews may involve medical re-examinations, interviews, and routine checks of the claimant’s medical records.

RELATED POST: 10 Tips to Maintain Approval of Your LTD Benefits

A Disability Attorney at Ortiz Law Firm Can Help You Get Long-Term Disability for Arthralgia

Arthralgia can seriously limit a person’s ability to work, leading to a need to file a long-term disability claim. Evaluating long-term disability claims for arthralgia involves a thorough assessment of medical evidence, and many claims are initially denied. If your claim is denied, a long-term disability attorney like Nick Ortiz can help you recover the benefits you deserve.

Seeking professional help can make the appeal process less overwhelming and increase the chances of a successful appeal. The Ortiz Law Firm is based in Florida, but represents long-term disability claimants nationwide. We can help you evaluate your claim and prepare a strategy for the appeal process. Call (888) 321-8131 or contact us online to request a free case evaluation today.