A fractured upper extremity (hand, wrist, arm, shoulder) can be very painful and require a lengthy recovery period. Surgery is sometimes necessary to properly treat breaks that are complicated, severe, or resistant to healing. Surgical treatments include fixating (keeping together) the broken parts of the bone using metal pins, screws, or plates. Patients with a fractured upper extremity may be unable to work because of their injury and its related complications. Patients who find themselves unable to work because of their fractured upper extremity may qualify for long term disability (LTD) benefits. The insurance company will review their claim to see if they qualify under the conditions of that plan.
In this article, we will discuss:
- Limitations From an Upper Extremity Fracture
- How to Apply for LTD benefits While You Recover
- Suggested Way To Stay Organized
Limitations From an Upper Extremity Fracture
Some bones heal quickly and others more slowly. The speed at which a bone heals depends on the size of the bone, the severity of the break, and the number of nutrients and blood supply around the bone. Other things that affect the body’s ability to heal a broken bone are age, general health, and nutrition. As a general rule, the larger the bone, the longer it takes to heal.
Limitations from an upper extremity fracture will include:
- Pushing;
- Pulling;
- Grasping;
- Lifting; and
- Dexterity.
Most jobs require some ability to do all of these things, but people that are in specific job fields like surgeons, dentists, and construction workers will find it impossible to work during their recovery period. In fact, they could be putting themselves or others at risk if they return to work too early.
Bones also have sharp edges. Depending on how severe trauma to the upper extremity is, the bone could have damaged nerve endings that may not ever heal. A considerable amount of physical and occupational therapy will be needed to help the body recover. Therapy is often excruciating and energy draining for patients. Rest and recovery are essential after therapy, which will limit your ability to work on days you have therapy, maybe even days after therapy, depending on how intense the treatment is.
Applying for Long Term Disability While You Recover
The first thing to do when applying for long term disability is to read your policy thoroughly. If you have a group policy through your employer, you can request a copy from your human resources department.
After you read your policy, you can decide if you think you have a case for LTD benefits. When you start gathering information for your claim, be sure to include all the necessary information that will “stack” your administrative file. Your administrative file is everything in your case. It includes all the correspondence between you and your insurance company, all your medical information, notes from your doctors, and even surveillance footage. Check out our article about harmful elements on your disability application for information about bad facts that could hurt your claim for benefits.
Suggested Way To Stay Organized
Since two-thirds of all claims are denied the first time, help yourself by staying organized from the beginning. You may need this documentation for court later.
Create a binder or filing system for the following documents:
- Copy of your LTD policy;
- Copies of all letters from your insurance company and you to the insurance company;
- Why you can not perform your job duties (this will require medical documentation);
- A list of all medical providers that you have seen for this condition and a letter from each provider stating that your condition prevents you from working;
- Letters that summarize all conversations (by phone or in-person) between you and the insurance company representatives, nurses, doctors, and your employer. Send copies to all parties involved in the communication via certified mail as proof it was received; and
- Keep everything chronological so that if your claim is denied you have a complete record of how your claim was handled.
Not sure where to start?
An experienced disability attorney can help you gather the necessary medical information needed for your claim. They can help you track your deadlines (which are very strict), gather evidence such as medical statements/opinions from your doctors, represent you during a field interview, and communicate with the insurance company for you.
Even if you have been denied benefits, that does not mean your fight is over. Many people are denied benefits the first time they apply. You have the right to file an appeal and try to get more information that may help your case. Getting expert help is often the difference between being denied and being approved for benefits.
While the process can be daunting, your experienced disability attorney will be able to guide you through the process. They do not get paid until you win your case. You can seek help without worrying about upfront costs or unexpected bills.
Although based in Florida, the Ortiz Law Firm represents claimants across the United States. If you’d like to speak to a long term disability insurance attorney contact us at (888) 321-8131 to schedule a consultation. We can help you evaluate your claim to determine if you will be able to access long term disability benefits and how to move forward with the process.
