Arthralgia, the clinical term for joint pain, is a common symptom in numerous health conditions. It can be a result of various diseases, from arthritis to Lyme disease to systemic lupus. Chronic arthralgia can significantly limit an individual’s ability to perform daily activities and maintain gainful employment, leading to a need for long-term disability benefits. In this article, we will discuss the symptoms, causes, diagnosis, and treatment of arthralgia. We will also delve into how long-term disability claims for arthralgia are evaluated.
Symptoms of Arthralgia
Symptoms of arthralgia can include:
- Back pain
- Loss of spine flexibility
- Inflammation of the eyes, lungs and heart valves
- Swelling and stiffness of the spine and sacroiliac joints
You may notice your symptoms getting worse when you are active like during a workout or swimming.
Causes of Arthralgia
Arthralgia can result from a variety of conditions including:
- Strain and joint sprains
- Joint dislocation
- Autoimmune diseases
- Bone disease or cancer
- Lyme disease
There is no specific test to diagnose arthralgia, but your doctor may order tests to identify the underlying condition. Lab work like blood tests, urine analysis, and joint fluid tests. A joint fluid test is when they numb the area and then draw fluid out from the area you are experiencing pain. They may need to biopsy the affected joint as well. C-reactive protein levels and Anti-CCP antibody tests will also help doctors diagnose your condition. X-rays (using small amounts of radiation to make it easier to see the bone and bone loss and cartilage damage), CT Scans, MRI’s, and ultrasounds are ways that the doctor can take a look at your joints without surgery to find out what is the best treatment option for you.
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, if you feel a sharp pain that will not go away, or have been experiencing joint pain for an extended amount of time, you should talk to your doctor about it. 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, particularly when dealing with chronic joint pain. 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:
Medical Assessment: The evaluating body will first scrutinize the claimant’s medical records to confirm the diagnosis of arthralgia and understand its severity. Key evidence may include physician’s notes, imaging results, blood test reports, physical therapy records, and any other related documentation.
Functional Capacity Evaluation: This assesses the claimant’s physical and mental abilities in relation to 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.
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. In some cases, insurance companies might 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 takes place, sometimes involving additional peer review reports or independent medical examinations.
The 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.
For approved claims, the evaluation does not end. 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.
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, functional capacity, and ongoing review of the claimant’s condition. The process is designed to ensure that only those truly in need receive the benefits.
Nevertheless, understanding the steps involved, gathering comprehensive medical documentation, and seeking professional help when needed can make this process less overwhelming and increase the chances of a successful claim. The Ortiz Law Firm is based in Florida, but represents long term disability claimants across the country. We can help you evaluate your claim and prepare a strategy to navigate the appeals process. Request a free case evaluation today by calling (888) 321-8131.