Neck pain and cervical spine problems can have a number of different medical causes, such as nerve compression or damage (a “pinched nerve”), a bulging or herniated disc, muscle tears or strains, joints that become worn, injuries, disease, and other chronic and degenerative changes. Individuals who are unable to work due to neck pain may qualify to receive long-term disability insurance and/or Social Security Disability benefits (also known as Social Security Disability Insurance or SSDI) for a cervical spine disorder.
The most common conditions that may appear on applications for disability benefits due to chronic neck pain are a herniated disc, degenerative disc disease, infections such as meningitis, inflammatory disorders such as arthritis, certain types of cancer, pinched nerves, and whiplash, though there are many other conditions that can cause neck pain. Symptoms of a cervical spine problem may include pain, numbness, tingling, headaches, nausea, dizziness, problems swallowing and chewing, and sharp, shooting pain.
If you have a disability insurance policy, you must meet the requirements of your specific policy. To qualify for Social Security benefits you must meet the requirements of the Social Security Administration’s disability listing or demonstrate that you are unable to return to work as a result of your severe symptoms and resulting limitations.
Applying for Benefits with Neck Pain and Cervical Disorders
The focus of any disability claim based on neck pain is on the underlying condition that is causing the neck pain and/or neck problems. Establishing proof of the root causes of neck pain should be the focus of the medical information section of an application for benefits. This is done via the medical records, as one’s neck pain is but a symptom of the underlying causes of neck problems.
Reports of severe pain are not enough to meet the requirements for benefits. You need objective evidence such as a physical evaluation of your range of motion and ability to perform work activities. The results of imaging tests used in your diagnoses, such as a CT or MRI scan, may also help you qualify for benefits. If you are using an assistive device or have made changes to your daily activities you may consider using a sworn statement to support your case.
Disability Insurance, ERISA, and Long Term Disability Claims
To be approved for long-term disability benefits, you will need to show that your neck pain or cervical problems are so severe that they keep you from being able to perform the material duties of your job (if you are operating under an “own occupation” definition of disability under your LTD policy) or any position for which you might otherwise be qualified (if you are operating under the “any occupation” definition of disability under your LTD policy). Many policies use an “own occupation” definition for a certain period of time (typically a two-year period), then change to an “any occupation” definition for the remaining benefit period. It is common for the insurance company to determine that you no longer meet the requirements of the policy when this change in definition occurs.
However, if your “residual functional capacity” is such that your limitations are severe enough to prevent you from performing any occupation, then you will be approved to receive disability insurance benefits. If your claim is terminated after a two-year period, whether it be due to an “any occupation” provision or based on some other time-based policy provision, you should contact an attorney for a free consultation.
Social Security Disability Insurance (SSDI) Claims
To be approved for Social Security Disability benefits, you will need to show that you meet the requirements of one of Social Security’s official disability listings or prove that you do not have the capacity to return to work because your neck pain or cervical conditions are so severe. In addition, your condition must last, or be expected to last, 12 months or more.
SSA Disability Listing
The Social Security Administration’s listing for spinal disorders specifically addresses many of the causes of neck pain. If you meet the requirements found in the listing because of your severe neck pain and problems in your cervical spine, the Social Security Administration will approve your claim for Social Security Disability benefits based on that listing.
In order to meet the requirements of this listing you must show that the nerve root or spinal cord are affected and that you have either:
- spinal nerve root compression pain, limited movement of your spine, and muscle weakness with loss of feeling or reflexes in those muscles, or
- spinal arachnoiditis, a painful disorder caused by inflammation in the spine that requires you to change positions more than once every two hours.
The medical evidence required to meet this listing and qualify for Social Security benefits includes an evaluation of your spine and documentation of the range of motion of your neck. Laboratory findings and imaging tests may also be needed to show that you have a specific impairment. (Since pain is subjective and is not easily measured, there must be specific objective evidence to show the possible source of your chronic pain.) It is also helpful to submit a history of treatment you have received and your response to the treatment. There may be other related Social Security disability listings that may apply to some individuals who suffer from neck pain and problems, such as:
- joint dysfunction, or
- rheumatoid arthritis.
Limitations Caused by Neck Pain Disorders
If you have a neck pain problem, you may be experiencing pain due to spinal nerve root compression, limited movement of your spine, and muscle weakness with loss of feeling or reflexes in those muscles. Your ability to use your arms may be impacted, especially if you have decreased feeling or sensation in your arms. Neck pain problems can also cause pain so severe that you are unable to concentrate on tasks. For example, spinal arachnoiditis is a painful disorder caused by inflammation in the spine that may require you to change positions more than once every two hours. A perineural cyst or neurofibroma at the bilateral exiting nerve roots may press on nerves causing severe pain and, in severe cases, loss of bladder control, constipation, or even sexual dysfunction. If there is a spinal cord injury in the cervical area, it may result in tetraplegia/quadriplegia, which means there is limited or absent feeling or movement below the neck.
Limitations like these are used to determine your “Residual Functional Capacity”, or RFC, which describes your ability to perform work activities (or lack thereof). It may help to use a Residual Functional Capacity form to show the relationship between your diagnoses and your inability to work. Your doctor should perform a physical evaluation of your limitations, then document your work-related limitations on the form. These forms are often more specific and may go into more detail about your limitations than your office visit notes. The insurance adjuster or Social Security Disability claim representative for your case will then look at your RFC form to see if you have the capacity to perform relevant work.
In short, your combination of impairments caused by your cervical spine disorder and any pain you may experience, as well as establishing the relationship between those impairments and your ability to work, is what qualifies you for long-term disability or Social Security Disability benefits.
Objective Evidence is Very Important in a Claim for Neck Pain
Disability insurance and Social Security Disability neck pain claims are often denied due to the reasoning that there is no objective evidence found to support the claimant’s alleged restrictions and limitations caused by his or her neck pain. As such, your application should include extensive medical documentation to support your claim for disability. Medical evidence for a neck pain problem may include:
- Imaging test results (such as an MRI, CT-Scan, X-ray, EMG, nerve conduction study, or discogram) and other medical tests documenting the organic causes of neck pain and spine problems, such as a herniated disc or degenerative disc disease;
- Evidence of epidurals, nerve blocks, nerve burning, trigger point injections, and/or injections performed under fluoroscopy;
- Notes from physical medical examinations and doctor visits;
- Treatment records, including notes from physical therapy, medications, and other remedies pursued;
- Statements from your treating physician(s) identifying the symptoms you experience and their severity and duration, as well as the overall prognosis for your health condition; and
- Records showing your health condition has not improved despite following physician-recommended treatments.
It is important to treat with a doctor that knows how to administer the proper diagnostic testing as objective testing is so essential in all neck disability claims. Positive findings on all test results may not be required to be approved for benefits, but a claim may be more challenging if the objective testing does not document any abnormalities. Some long-term disability policies may go so far as to specifically require positive findings of radiculopathy or myelopathy in order to receive benefits after the first 24 months of payments.
Work With an Experienced Disability Attorney
Mr. Ortiz is a Board Certified SSDI attorney who has handled hundreds of disability claims related to neck pain and has an in-depth understanding of cervical spine disorders. We know that there are a large number of claimants that may have relatively normal objective test findings, yet still have debilitating pain. Regardless of the specific disorder causing your pain, if you are unable to work due to cervical spine problems or chronic neck pain, we will fight to get you the disability benefits you deserve. Our firm has the experience needed to help you meet the definition of disability in your insurance policy or a Social Security Disability listing so that you are able to get the benefits you deserve.
How We Can Help with Your Neck Pain or Cervical Disorder Case
When you are receiving long-term disability benefits, you should work closely with your medical doctor to ensure your medical records are thorough and that they accurately reflect the limitations you experience as a result of your health problems. Because neck pain and neck problems can be caused by many different medical conditions, you should seriously consider working with an experienced disability attorney in your claim. An attorney can help you ensure your claim is thoroughly documented, will get copies of medical records related to your disabling condition, and will ensure that all your documentation is sufficient to qualify for disability benefits.
Contact Us to Get a Free Case Evaluation Scheduled Today
If you are unable to work as a result of neck pain, you should get help with your case from an experienced long-term disability attorney. Unfortunately, long-term disability carriers do not make it easy for disabled claimants to get the benefits that they deserve. If your neck pain makes it impossible for you to work and you have been denied your long-term disability benefits, contact the legal team at Ortiz Law Firm. Or, if your benefits were terminated and you still aren’t able to go back to work we will help you get your benefits back. We will help you cut through the red tape and will fight for your disability benefits no matter where you live in the United States. Contact us online or give us a call today at (888) 321-8131 to schedule your free case evaluation so we can discuss the many benefits of using our services.