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Tendinitis and Long Term Disability Insurance Claims


Patients with tendinitis may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their tendinitis 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.

What is Tendinitis?

Tendinitis is inflammation of the tendons, which connect muscles to bone. This inflammation causes pain at the site of the inflammation as well as the surrounding area. Stiffness at the affected joint can cause loss of motion. Sometimes swelling of the area can be seen or felt.

Tendinitis can be caused by repetitive movement over a long period of time or sudden injury, such as from a car accident. Repetitive movements, especially with poor posture, are the most common cause. Common tasks that include repetitious movements include:

  • Writing;
  • Yard work;
  • Sweeping and mopping; and
  • Computer tasks.

Workplaces can contribute to workers’ tendinitis by requiring repetitive movements or not designing the workplace to prevent injury. Other risk factors for tendinitis include:

  • Autoimmune disorders, which increase inflammation;
  • Poor joints, either from arthritis or injury; and
  • Overwork or doing a physical activity without proper conditioning.

Diagnosing Tendinitis

Often tendinitis is diagnosed with only clinical examinations. The doctor will examine the area and see the extent of pain and swelling. He or she will ask about the kinds of activities that cause pain as well as common tasks in the workplace or home.

A physician may order further testing to determine the extend and severity of the tendinitis. Imaging tests, such as MRIs or ultrasounds, can measure the thickness of the tendon and show any damage and inflammation.

Treating Tendinitis

Tendinitis usually responds well to self-care. RICE (rest, ice, compression, and elevation) can reduce symptoms and give the tendon time to heal. Anti-inflammatory drugs like aspirin or ibuprofen are also used to reduce pain and inflammation.

If tendinitis does not respond to home methods, further treatment may be needed. Injections of corticosteroids into the affected area can bring relief. Physical therapy can strengthen the surrounding muscles and prevent further injury. In extreme cases untreated tendinitis can cause the tendon to rupture, requiring surgery. Surgery is also used in severe cases of tendinitis to remove scar tissue.

It is just as important to figure out what is causing the tendinitis as it is to treat the symptoms. Reconfiguring the workspace to be more ergodynamic can relieve strain. Gradually conditioning the body to physical activity and properly warming up or cooling down can prevent future injury.

Disability Evaluation of Tendinitis

Definition of Disability

Most LTD plans consider a person disabled if the claimant has a medical condition that causes him or her to 1) be unable to perform their work duties for the first two years of the policy and 2) be unable to work in almost any job for the following years.

Each LTD plan defines disability as slightly different, so look over your plan policy to see how your plan determines “disabled.”

Evaluating Disability for People with Tendinitis

You must prove that your tendinitis keeps you from doing your old job (or, depending on how the term “disabled” is defined in your LTD policy, any job that you could be trained to do).

The insurance company adjuster reviewing the claim will also look at the Residual Functional Capacity (RFC) form to determine the extent of your symptoms and how they may keep you from working. If your tendinitis is caused by another condition, you may be awarded benefits based on the severity of the underlying condition.

Tendinitis may keep you from working, even with accommodations. Many workplaces require repetitive movements like writing or bending. Some people with tendinitis cannot use computer equipment without pain.

What the Insurance Company Needs From You and Your Medical Providers

You should tell the insurance company about any doctors you may have seen for your tendinitis. The insurance company will need to obtain all relevant medical records to get the full picture of your health. If for any reason they cannot get these records from your doctors, you should request them and provide them to the insurance company yourself. Important records to include are:

  • Physician notes;
  • Bloodwork;
  • Physical therapy notes; and
  • Diagnostic test results.

You will need to provide proof of your diagnosis and your ongoing symptoms, as well as proof of how you are affected by your symptoms. If your doctor diagnosed you by clinical assessment, you may want to get additional diagnostic testing to help your case. Providing detailed documentation is key to a successful claim. Residual Functional Capacity (RFC) assessments determine how you are affected by the condition and what you can do despite your limitations. It is used to determine what jobs you may still be qualified to perform.

Working with an Experienced Disability Attorney

An experienced disability attorney will give you the best chance of getting the disability benefits you deserve. Even if you have been denied disability benefits, that does not mean you are out of options. It is not unusual to be denied the first time you 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 intimidating, your disability attorney is an expert on the process. You can seek help without worrying about upfront costs or unexpected bills because they are paid out of any awarded funds.

The Ortiz Law Firm has successfully represented people in disability cases across the United States. If you would like to talk to one of our experienced disability lawyers about your tendinitis and its impact on your ability to work, call us at (888) 321-8131. We would be happy to evaluate your case and to discuss how to help you through the appeal process.

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