Chiari Malformation and Long-Term Disability Insurance Claims

Chiari malformation is a neurological condition in which part of the brain extends into the spinal canal. This structural abnormality can disrupt the flow of cerebrospinal fluid (CSF) and place pressure on the brainstem or spinal cord. The result may be severe headaches, dizziness, balance problems, and debilitating fatigue — symptoms that make consistent work performance difficult or impossible.

If Chiari malformation prevents you from performing your job duties on a reliable, full-time basis, you may qualify for long-term disability (LTD) insurance benefits. Unfortunately, insurers frequently downplay the condition — especially when imaging appears “stable” or surgery has been performed. A well-documented claim or appeal is essential to showing how Chiari affects your ability to work.

Understanding Chiari Malformation

There are several types of Chiari malformation, but Type I and Type II are most commonly associated with disability claims.

• Type I Chiari Malformation occurs when the cerebellar tonsils extend slightly into the spinal canal. Symptoms often develop in late adolescence or adulthood and may include headaches, neck pain, dizziness, numbness or tingling in the extremities, and coordination problems.
• Type II Chiari Malformation involves a more extensive displacement of brain tissue and is frequently associated with spina bifida or other spinal abnormalities. Symptoms may include muscle weakness, difficulty swallowing, and significant balance or coordination challenges.

Both types can interfere with normal CSF flow and cause pressure that affects sensory, motor, and autonomic function. Some individuals also develop related complications such as syringomyelia (a fluid-filled cyst in the spinal cord), tethered cord syndrome, or hydrocephalus. Even after decompression surgery, many people continue to experience neurological symptoms that limit work performance.

Symptoms and Functional Limitations

Symptoms vary from person to person, but Chiari malformation commonly causes a combination of neurological pain, sensory disruption, and fatigue that interferes with sustained activity and concentration. Common symptoms include:

• Severe headaches (often at the back of the head or neck)
• Neck and shoulder pain
• Dizziness or vertigo
• Balance or coordination problems
• Numbness or tingling in the hands, arms, or legs
• Muscle weakness or fatigue
• Difficulty swallowing or speaking
• Tinnitus (ringing in the ears)
• Blurred or double vision

Many claimants also report cognitive fog, slowed processing speed, and difficulty multitasking — symptoms that directly affect productivity in sedentary, desk-based jobs.

Even with treatment or surgery, symptoms can flare unpredictably. Some days you may function relatively well; other days pain, dizziness, or vision changes make even basic tasks impossible.

Long-term disability insurance companies focus heavily on reliability: if you cannot maintain consistent attendance and productivity, you cannot perform full-time work — even if you can sometimes perform short bursts of activity.

Medical Evidence to Support Your LTD Claim

A strong LTD claim for Chiari malformation requires clear, detailed medical evidence demonstrating how your condition limits your ability to work. Helpful documentation includes:

• MRI or CT scans confirming brain tissue herniation or related abnormalities
• Neurological and neurosurgical evaluations describing diagnosis and treatment history
• Records of headaches, dizziness, and fatigue that persist despite medical management
• Pain or symptom diaries showing the frequency and severity of flare-ups
• Physical therapy or rehabilitation records documenting postural or balance issues
• Residual Functional Capacity (RFC) forms completed by your treating neurologist or neurosurgeon describing specific physical and cognitive restrictions

If you have undergone decompression surgery, ensure your records specifically document ongoing limitations. Insurers commonly assume surgery = recovery. In reality, many patients continue to struggle with pain, dizziness, or cognitive fatigue long after surgery.

Why Insurance Companies Deny Chiari Malformation Claims

Insurance companies frequently deny or terminate benefits by misunderstanding Chiari malformation and its long-term effects. Common tactics include:

• Treating surgical improvement as proof of full recovery
• Ignoring ongoing headaches, fatigue, and balance issues
• Relying on file reviews without conducting an in-person exam
• Misinterpreting “stable” or “normal” imaging results as evidence of work capability
• Using surveillance footage to argue that you can perform more activity than reported

The most common mistake I see claimants make is assuming that MRI results alone will prove disability. Insurers focus on functional capacity — whether you can sit, stand, concentrate, and maintain attendance on a predictable schedule. Without clear statements from your neurologist describing real-world limitations, even a strong medical file may fall short.

A successful appeal directly addresses each insurer assumption with updated medical evidence and vocational proof linking symptoms to job requirements.

Hypothetical Case: Lingering Symptoms After Surgery

A 38-year-old software developer undergoes decompression surgery for Type I Chiari malformation. Post-surgical imaging shows improvement, but she continues to experience daily headaches, dizziness, and cognitive fatigue. The insurer terminates her LTD benefits, claiming that surgery resolved her condition and her imaging is now “stable.”

We built the administrative record with updated neurological evaluations, an RFC form from her neurosurgeon, and vocational evidence showing how her symptoms impact computer-based work. The insurer reversed its decision and reinstated benefits.

How Ortiz Law Firm Helps with LTD Appeals

Chiari malformation claims are denied not because claimants aren’t sick — but because the evidence is not presented in the way insurance companies require.

Our team:

• Reviews the insurer’s claim file to identify what evidence is missing
• Works with your neurologist or neurosurgeon to obtain detailed functional opinions
• Collects imaging, surgical, and rehabilitation records showing persistent symptoms
• Challenges flawed peer reviews or biased independent medical examinations
• Refutes surveillance footage used to misinterpret isolated moments of activity
• Builds a comprehensive appeal record that links medical evidence to work limitations

In my experience representing disability claimants since 2005, the most successful appeals force insurers to confront the full reality of Chiari malformation — the pain, fatigue, cognitive limitations, and unpredictability that cannot be captured in a single MRI report.

Request a Free Case Evaluation

If Chiari malformation prevents you from working or your long-term disability benefits have been denied, Ortiz Law Firm can help. We will evaluate your claim, review the insurer’s denial, and outline a strategy for moving forward.

Call (888) 321-8131 today for a free consultation. We’ll take it from here — so you can focus on your health.