Tendinitis and Long-Term Disability Insurance Claims

Patients with tendinitis may be unable to work because of their disease and its related complications. If so, they may qualify for long-term disability (LTD) benefits if the insurance company determines that they meet the disability criteria as defined by the claimant’s policy.

Understanding Tendinitis

Tendinitis is inflammation of the tendons, which connect muscles to bone. This inflammation causes pain at the site of the inflammation and in the surrounding area. Stiffness and swelling at the affected joint can cause loss of motion. It is caused by repetitive movement over a long period or sudden injury, such as a car accident. Repetitive movements, especially with poor posture, are the most common cause.

Common tasks that include repetitive movements include:

• Writing.
• Yard work.
• Sweeping and mopping.
• 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:

• Diabetes.
• Autoimmune disorders, which increase inflammation.
• An injury.
• Overwork or doing a physical activity without proper conditioning.

Diagnosing Tendinitis

First, the doctor examines the area to see the extent of pain and swelling and asks about the activities that cause pain and common tasks in the workplace or home. They may also order further testing to determine the extent and severity of the tendinitis. Imaging tests like MRIs and X-rays can measure the tendon’s thickness 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 steroids 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 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 ergonomic can relieve strain. Gradually conditioning the body to physical activity and properly warming up or cooling down can prevent future injury.

How Disability Insurance Companies Evaluate Claims for Tendinitis

Tendinitis may prevent you from working, even with accommodations. Many workplaces require repetitive movements like writing or bending, and some people with tendinitis cannot use computer equipment without pain. However, you must meet specific requirements outlined in your disability insurance policy to get benefits.

The Definition of Disability

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). Each LTD plan defines disability slightly differently, so review your policy to see how your plan determines “disabled.”

What the Insurance Company Needs From You and Your Medical Providers

Providing detailed documentation is key to a successful claim. 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. You should request copies of the relevant medical evidence for your claim and provide it to the insurance company. Important records to include are:

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

If your doctor diagnosed you by clinical assessment, you may want to get additional diagnostic testing to help your case. For example, a residual functional capacity (RFC) assessment determines how you are affected by the condition and what you can do despite your limitations. The insurance company will review the completed residual functional capacity form to determine the extent of your symptoms and how they may keep you from working.

Appealing a Long-Term Disability Denial

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. If the denial is upheld on appeal, you can file a lawsuit.

Getting expert help is often the difference between being denied or approved on appeal. The process can be intimidating, but your disability attorney will help you through it. You can get help without worrying about upfront costs or unexpected bills because they are only paid out of benefits recovered or court-awarded funds.

Get a Free Case Review with a Long-Term Disability Attorney

The Ortiz Law Firm has successfully represented people nationwide in long-term disability appeals and lawsuits. If you would like to talk to long-term disability attorney Nick Ortiz about your long-term disability denial, call us at (888) 321-8131. We would be happy to evaluate your claim and discuss how we can help you through the appeal process.