The vast majority of disabilities arise from medical disorders rather than from an accident or injury.
Musculoskeletal disorders – such as back problems, arthritis, and carpal tunnel syndrome — are the biggest category of long-term disability claims. These claims are also frequently denied. Unlike cancer or a broken bone, it is not always easy to quantify or document the pain and limitations of these conditions.
Spinal disorders and problems with joints
According to the Council for Disability Awareness and insurance industry statistics, musculoskeletal disorders account for roughly 25 percent of all long-term disability claims. This category includes disorders of the spine, muscles, bones, and joints, such as:
- Arthritis, gout, and fibromyalgia
- Tendonitis (tennis elbow, carpal tunnel, rotator cuff)
- Herniated or bulging disc
- Degenerative disc disease
- Lower back pain
If you count bone fractures, muscle sprains and ligament strains, musculoskeletal conditions account for more than one-third of all long-term disability (LTD) claims.
Disability claims for musculoskeletal disorders
The majority of these disorders are not work-related, which means people must turn to sick days, vacation days and short-term disability benefits to pay the bills. When those safety nets are exhausted, a long-term disability insurance policy kicks in if the person has been or will be off the job for at least 90 days.
Insurers are notorious for delaying or denying such LTD claims, on the basis of technicalities or endless requests for “additional information.” An attorney who has specific experience with ERISA (employer-sponsored) policies for long-term disability can help with submitting and appealing disability claims.
It may be as simple as supplementing the medical records to convince the insurance company to authorize benefits. Or it may be necessary to submit to an independent medical exam, and/or to go to court to force the insurer to live up to its obligations.