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Hip replacement (hip arthroplasty) is a very common surgical procedure in the United States, and the number of hip replacements for people over the age of 40 continues to grow. Reasons vary from the growing number of people with obesity to confidence in the procedure through word of mouth to treat arthritis.
Although success rates for hip replacements are good, not all hip replacements end well. The residual effects and symptoms of a hip replacement failure can leave you out of work. If so, you may be eligible to receive long-term disability (LTD) benefits.
In this article, we explain:
- What a hip replacement is;
- Symptoms of an unsuccessful hip replacement;
- Reasons why long-term disability claims for failed hip replacements are denied; and
- How we can help if your claim is denied.
What Is a Hip Replacement?
A hip replacement is a surgical procedure that removes the affected part of the hip joint and is replaced with an artificial joint. The most common reason for hip replacement is chronic arthritis and decreased mobility. Most patients are still experiencing pain after exhausting all other remedies such as physical therapy, medications, and steroids, so they receive a hip replacement in the hopes of easing their pain.
Recovery Period
While most hip replacement surgeries are successful, about 10% are not. If you are unfortunately among that 10%, you can experience long-term problems. The recovery period for a hip replacement is long. It could take a year to bear weight on that leg. If you are in a profession that requires that you spend a large portion of your day walking, you may not be able to return to work until you are completely cleared for duty. This could extend well beyond one year. Your inability to stand or walk may entitle you to long-term disability benefits.
Possible Complications
If you experience any of these symptoms after your surgery, they could be related to your hip replacement:
- Pulmonary embolism;
- Blood Clots;
- Infection;
- Nerve damage;
- Fractures;
- Dislocation; and
- Metal poisoning.
Because the majority of hip replacements are metal on metal, there is a risk of pieces of metal coming loose and being absorbed by your body. Symptoms of metal toxicity are thyroid problems, kidney failure, popping or grinding sounds in the hip joint, and swollen hip joint.
What You Need to Support Your Long-Term Disability Claim
If you still need a walker or cane after one year, you should consult your doctor to find out why you are not healing. You should also consider filing for long-term disability. The documents that you will need to help prove your long-term disability case are:
- Your diagnosis and medical notes from your orthopedic surgeon;
- X-rays, CT scans, and MRI’s of your hip before and after surgery;
- Blood test results if you do have metal toxicity complications; and
- Physical examination notes from your doctors, including your primary physician up to your surgeon that notes how this problem has affected your daily life.
Common Reasons LTD Carriers Deny Hip Replacement Claims
Insufficient Medical Documentation
One of the most common reasons for claim denial is the absence or inadequacy of medical documentation. Omitting essential details like your doctor’s correct address can impede the insurance company’s ability to verify your information. Ensure that all your medical practitioners and prescribed medications are listed comprehensively.
Lack of Medical Treatment
Being ill and off work might make attending doctor’s visits challenging, especially if there’s a co-pay involved with each session. Nevertheless, skipping these appointments may lead insurance providers to assume that you don’t require medical care. It’s critical that you attend all of your appointments.
Insufficient Doctor’s Notes
Often, doctors note only the clinical symptoms, overlooking essential subjective experiences like pain or fatigue. Ensure that your physician records all these aspects in your medical file to provide a complete picture of your condition.
We Can Appeal Your Long-Term Disability Denial
While most hip replacements are successful, there still is a risk of complications that could leave you with a lifetime of problems. If you have experienced any of the complications we have listed, you may be entitled to long-term disability benefits. If your insurance company wrongfully denies your claim, we can help you appeal. We are headquartered in Florida, but we represent disability insurance claimants across the country. You can receive a free consultation by calling us at (888) 321-8131 or contacting us online.
