Will My Disability Insurance Pay Benefits for Failed Back Surgery Syndrome?
Failed Back Surgery Syndrome (FBSS) refers to persistent or worsening lumbar spinal pain despite undergoing spinal surgery. In some cases, the surgery may be deemed medically successful but fails to relieve the pain, or even causes new pain in the same or nearby areas. This condition can significantly impair a person’s ability to work and maintain daily life activities, often leading to the need for long-term disability insurance benefits.
FBSS is a complex condition that disability insurance companies frequently challenge. According to the National Centers for Biotechnology Medicine, patients with FBSS often experience co-morbid conditions such as anxiety, depression, obesity, smoking, spinal stenosis, fibrosis, and disc herniation. Additionally, individuals with multiple back surgeries face a higher risk of FBSS.
For most patients, treatments like nerve blocks, injections, or physical therapy may provide some relief, but many find themselves unable to work and must file for disability.
What Does This Mean for Your Disability Claim for Failed Back Surgery Syndrome?
Disability insurance companies often scrutinize FBSS claims closely, looking for reasons to deny benefits. Understanding their tactics can help you better prepare.
Common Tactics Used by Insurance Companies:
- Shifting the claim to a mental/nervous condition: Chronic pain often leads to emotional challenges like anxiety or depression. Insurance companies may exploit these conditions to reclassify the claim under mental/nervous disability, which is often limited to 24 months of coverage.
- Inadequate medical review: Claims are often reviewed by nurses or physicians with little to no expertise in FBSS. These reviewers may misinterpret diagnostic reports or rely on incomplete medical records cherry-picked by the insurance company.
Persistent Spinal Pain Syndrome and Your Claim
Persistent Spinal Pain Syndrome is an alternative term proposed for FBSS, reflecting the ongoing nature of pain after spinal surgery. Regardless of terminology, the impact on your ability to work remains central to your claim.
Can I Still Perform Activities Without Surveillance Undermining My Claim?
Disability insurance companies frequently use surveillance to gather evidence against claimants. Engaging in daily activities is normal, but claimants should ensure that their actions align with their medical records. Surveillance footage showing activities inconsistent with your documented limitations can harm your claim.
Do I Need to Hire an Attorney for a Failed Back Surgery Syndrome Claim?
Filing a long-term disability claim for FBSS is often a complex and adversarial process. It involves gathering comprehensive medical records, diagnostic tests, and filling out extensive paperwork. Additionally, insurance companies often employ tactics to minimize or deny claims, making professional legal guidance invaluable.
Key Considerations:
- Always send documents via trackable methods such as express mail, registered return receipt, fax, or email to ensure proof of delivery.
- An experienced disability attorney can help navigate the process, ensure your claim is thoroughly documented, and counteract the insurance company’s tactics.
For assistance with your FBSS disability claim, contact Newfield Law Group today. Our experienced attorneys can guide you through the process and help you secure the benefits you deserve.