Hi everyone, I’m Nick Ortiz. I’m a board certified, disability insurance attorney and owner of the Ortiz Law Firm. Today I’m here to talk to you about Long-term disability claims and neck pain or cervical spine problems.
The biggest issue is what type of evidence is key for a neck pain problem case? Well, perhaps the most important thing is the medical evidence to support your case. In a C-spine case, you really want to make sure that you have good, objective documentation of the extent and severity of your problem. Specifically, if you have an MRI, that is the Gold Standard Test to determine the full extent of the problems going on in your spine. An MRI might show, for example if you have an annular tear, or if you have a herniated disc, or a bulging disc, perhaps you’ve had a burst of the disc. That’s because this is the type of evidence that will show impact on your spinal cord which is your nerve root endings. Hold on just a minute, I have an idea.
So I grabbed a sample vertebrae from a lumbar spine. This is from a lumbar spine of the lower back but it basically looks very similar in the cervical spine so we’ll use it just for reference purposes. But in essence, this is one of your discs. This central part is also called the nucleus of the disc. You can see here, this is the disc between two of the vertebrae. And again this red part is the nucleus. When you have a herniation, the nucleus starts to push out of the disc and this is the nerve root or spinal cord and these are nerve root endings. So when you’ve heard the term “pinched nerve,” this nucleus that’s herniated is actually pinching into this nerve and this is what causes significant pain. So if you have an MRI that shows evidence of a herniated disc, that’s impacting the nerve, then you have objective evidence to support a finding of a condition that’s expected to produce significant pain. So this is really good evidence to use in a case.
Next, one of the important things that you could use in your case is a statement from your doctor. It could be in the form of a letter, or more importantly, what we use in our office is a medical source statement, or Residual Functional Capacity Evaluation Report, that the doctor fills out that identifies your functional limitations you have as a result of these conditions. And that’s really what the insurance company needs to know is, not just what your condition is, having a herniated disc is a diagnosis, but what the insurance company needs to know is what are your resulting limitations in terms of what you can and cannot do. Because once they identify what your limitations are, then they have a greater understanding of why it is you cannot perform eight hours of work activity. Just as a simple example, if you cannot sit for more than an hour a day due to your condition, stand for more than an hour, or walk more than an hour, in fact, most of the time your either laying down or sitting in a recliner with your feet propped up there’s not a whole lot of jobs that’ll let you do that.
So this is the kind of evidence that’s important for a neck pain problem case. Our office helps develop this kind of evidence. Not only getting the medical records, but developing the opinion and evidence from your doctors, your treating doctors. And that is significantly important evidence for your case. So if you’d like more assistance, then I encourage you to contact our office at 850-898-9904; or if you want to get more information in a written form, there’s a free book that I’m offering called “The Top 10 Mistakes That Will Destroy Your Long-Term Disability Claim” You an go to www.freeltdbook.comtoday to download your free copy. We look forward to hearing from you.