Qualifying for Long Term Disability Insurance Benefits with Spondylolisthesis

Spondylolisthesis is a condition where a vertebra in the spine slips out of its proper position and onto the vertebra below it. This can occur in any part of the spine, but it most commonly affects the lower back (lumbar spine).

While some individuals may not experience any immediate symptoms, they may develop low back pain years later. This condition has the potential to compress the spinal cord or nerve roots exiting the spine, resulting in back pain, numbness, weakness in one or both legs, or no symptoms at all.

However, not all individuals with spondylolisthesis are automatically entitled to long term disability benefits. Disability insurance companies may make it difficult for policyholders disabled by spondylolisthesis to receive the disability benefits they deserve.

There are several different causes of spondylolisthesis, and symptoms can vary depending on the severity of the condition.

Causes of Spondylolisthesis:

1. Congenital Spondylolisthesis: This is a rare type of spondylolisthesis that is present at birth. It is caused by a defect in the formation of the spine.
2. Isthmic Spondylolisthesis: This is the most common type of spondylolisthesis, and it is caused by a defect in the pars interarticularis, a small bony arch that connects the upper and lower facets of a vertebra.
3. Degenerative Spondylolisthesis: This type of spondylolisthesis is caused by the normal wear and tear of the spine that occurs with aging.
4. Traumatic Spondylolisthesis: This type of spondylolisthesis is caused by a traumatic injury to the spine.

Symptoms of Spondylolisthesis:

1. Lower Back Pain: The most common symptom of spondylolisthesis is lower back pain. The pain may be mild or severe and may be felt in the lower back, buttocks, or legs.
2. Muscle Weakness: Spondylolisthesis can cause muscle weakness in the legs. This can make it difficult to stand, walk, or climb stairs.
3. Numbness or Tingling: Spondylolisthesis can compress the nerves in the spine, causing numbness or tingling in the legs or feet.
4. Stiffness: Spondylolisthesis can cause stiffness in the lower back, making it difficult to move or bend.
5. Loss of Bladder or Bowel Control: In severe cases, spondylolisthesis can compress the nerves that control the bladder and bowel, leading to incontinence.

It’s important to note that not all individuals with spondylolisthesis will experience symptoms. If you suspect that you have spondylolisthesis or are experiencing any of the symptoms listed above, it’s important to consult with a medical professional for an accurate diagnosis and appropriate treatment.

Treatment for Spondylolisthesis and The Impact on a Long Term Disability Claim

The treatment for spondylolisthesis can vary depending on the severity of the condition and the symptoms that are present. Here are some common treatments:

1. Physical Therapy: Physical therapy can help strengthen the muscles around the spine and improve flexibility, which can help alleviate symptoms.
2. Medications: Pain medications and anti-inflammatory drugs can help relieve pain and reduce inflammation.
3. Bracing: A brace or back support can help provide stability to the spine and reduce the risk of further slippage.
4. Steroid Injections: Steroid injections can help reduce inflammation and provide pain relief.
5. Surgery: In severe cases, surgery may be necessary to realign the spine and stabilize it.

The impact of spondylolisthesis on a long-term disability claim can vary depending on the severity of the condition and the individual’s ability to perform their job duties. If the condition is severe enough to prevent the individual from working, they may be eligible for long-term disability benefits.

In order to qualify for long-term disability benefits, the individual will need to provide medical evidence of their condition, including the diagnosis, the severity of the condition, and the impact it has on their ability to work. This may include medical records, imaging studies, and statements from treating physicians.

Additionally, the individual will need to show that they have been compliant with their treatment plan and have followed their doctor’s orders. If an individual refuses or fails to follow through with recommended treatment, it could potentially hurt their chances of being approved for long-term disability benefits.

A Doctor’s Documentation of the Claimant’s Symptoms and Their Ability To Work

Documenting symptoms and ability to work is crucial in establishing a claim for disability benefits related to spondylolisthesis or any other medical condition. Here are some things that doctors may consider when documenting these issues:

Symptoms:

• Description of the symptoms experienced by the patient, including pain, stiffness, numbness, tingling, or weakness in the legs, feet, or back.
• The severity of the symptoms, including how often they occur and how long they last.
• Any aggravating or alleviating factors, such as movement or rest.
• How the symptoms impact the patient’s daily activities, including their ability to work.

Ability to Work:

• The patient’s job duties and physical demands of their work.
• Limitations or restrictions on the patient’s ability to perform their job duties, such as lifting, standing, walking, or sitting for extended periods of time.
• Any accommodations that could be made to allow the patient to continue working, such as reduced hours or modified job duties.
• The patient’s history of absenteeism or work-related injuries.

In addition to documenting these issues, doctors may also be asked to provide an opinion on the patient’s ability to work or their limitations and restrictions. This can be an important factor in establishing a claim for disability benefits.

If you are experiencing symptoms related to spondylolisthesis or any other medical condition, it’s important to seek medical treatment and document your symptoms and their impact on your ability to work. This can help establish a claim for disability benefits and ensure that you receive the benefits you need to support yourself and your family.

How do Disability Insurance Companies Handle Spondylolisthesis Claims?

Disability insurance companies handle spondylolisthesis claims like any other disability claim, by reviewing the evidence and determining whether the individual meets the requirements for disability benefits. However, spondylolisthesis claims can be more complicated than other claims because the symptoms and limitations can vary widely depending on the severity of the condition.

Here are some things that disability insurance companies may consider when handling a spondylolisthesis claim:

1. Medical Evidence: Disability insurance companies will review the medical evidence provided by the claimant’s doctors, including medical records, imaging studies, and statements from treating physicians. The insurance company may also require an independent medical examination to confirm the diagnosis and evaluate the severity of the condition.
2. Work History: Disability insurance companies will review the claimant’s work history to determine whether the individual is able to perform their job duties. They will also consider the physical demands of the individual’s job and whether any accommodations can be made to allow the individual to continue working.
3. Treatment History: Disability insurance companies will review the claimant’s treatment history to determine whether the individual has been compliant with their doctor’s orders and has followed through with recommended treatment.
4. Limitations and Restrictions: Disability insurance companies will evaluate the limitations and restrictions imposed by the claimant’s condition and determine whether these limitations prevent the individual from performing their job duties or any other work.
5. Vocational Expert Review: Disability insurance companies may hire a vocational expert to review the claimant’s work history, education, and transferable skills to determine whether the individual can perform any other work.

It’s important to note that disability insurance companies have a financial incentive to deny claims, and they may use tactics to delay or deny claims. For this reason, it’s important to have strong medical evidence and to work with an experienced disability attorney who can help navigate the claims process and ensure that the claim is presented in the best possible light.

Why are Spondylolisthesis Long Term Disability Claims Denied by Insurance Companies?

Long-term disability claims related to spondylolisthesis can be denied by insurance companies for a variety of reasons, some of which may be legitimate and others that may be unfair or even unlawful. Here are some common reasons why spondylolisthesis long-term disability claims are denied:

1. Lack of Medical Evidence: Disability claims require strong medical evidence to support the diagnosis and severity of the condition. If the claimant’s medical records are incomplete or do not support the diagnosis of spondylolisthesis, or if there is insufficient evidence of the severity of the condition, the claim may be denied.
2. Failure to Follow Treatment: Insurance companies expect claimants to follow through with recommended treatment and to comply with their doctor’s orders. If the claimant refuses or fails to follow through with treatment for spondylolisthesis, the claim may be denied.
3. Dispute Over the Severity of the Disability: Insurance companies may dispute the severity of the claimant’s spondylolisthesis, arguing that the individual is able to perform some type of work, or that the limitations and restrictions imposed by the condition do not prevent the individual from working.
4. Pre-Existing Condition: Insurance companies may deny a claim if the claimant had spondylolisthesis before purchasing the disability insurance policy, or if the condition was not disclosed during the application process.
5. Policy Limitations: Disability insurance policies may have limitations on coverage for certain conditions, including spondylolisthesis. If the policy does not cover spondylolisthesis or if there are limitations on coverage, the claim may be denied.

It’s important to note that disability insurance companies have a financial incentive to deny claims, and they may use tactics to delay or deny claims related to spondylolisthesis.

Steps to Take in a Long Term Disability Insurance Claim

In a long term disability insurance claim, it’s important to take the following steps:

1. Obtain a copy of your disability policy and review it carefully to understand what you need to prove and if there are any limitations in your coverage, such as limitations on conditions based on subjective complaints.
2. Obtain a copy of your medical records and review them to see if there is an objective basis for your diagnosis, as well as what your records say about your report of symptoms, restrictions, and limitations.
3. Obtain a copy of your personnel file to see if your condition has affected your work performance, and create your own description of your physical duties with an explanation of how your symptoms impact your ability to do your job.
4. To better support your disability claim, it’s important to obtain a copy of your job description and create a detailed description of your physical duties, including an explanation of how your symptoms affect your ability to perform your job.
5. Provide your doctor with the occupational description and ask them to prepare a report that explains the objective basis for your diagnosis, the objective basis of your restrictions and limitations, and the objective reasons you can’t perform some or all of the material and substantial duties of your job.
6. Prepare a pain diary that explains your pain and the side effects of your medication, and give examples of how your condition interferes with your ability to perform daily activities.
7. Consider hiring an experienced ERISA/private policy disability attorney, such as Nick Ortiz, to help you appeal a wrongful denial or termination of your disability benefits. Disability carriers may use any reason to deny your claim. Having a qualified attorney on your side can increase your chances of a successful appeal.

By taking these steps, you can be better prepared to file fan appeal or disability benefits and increase your chances of success.

Overall, the impact of spondylolisthesis on a long-term disability claim will depend on the individual’s specific circumstances and the severity of the condition. It’s important to consult with a disability attorney to ensure that all necessary evidence is submitted and the claim is presented in the best possible light. If you would like to talk to one of our experienced disability lawyers about your spondylolisthesis and its impact on your ability to work, call us at (888) 321-8131.