After cardiovascular disease, orthopedic and musculoskeletal issues are among the top most frequent disabilities afflicting Americans, including everything from debilitating lower back pain to herniated cervical (neck) discs.

Orthopedic Disability Claims Law Firm

After cardiovascular disease, orthopedic and musculoskeletal issues are among the top most frequent disabilities afflicting Americans, including everything from debilitating lower back pain to herniated cervical (neck) discs. As we age, we all develop some level of pain – and much of it is often from lower back issues – as bear large loads (our bodies) with each step. Back problems also impact the way we walk, and cause other orthopedic issues.
What differentiates musculoskeletal pain experienced by most adults at some point in their lives compared to the injury or illness that qualifies for disability coverage? How impairing is that back problem? This is at the core of many claim disputes between disability insurance companies and claimants with policies they thought would provide coverage when an injury or sickness caused them to be unable to do their job. An experienced orthopedic disability claims attorney can guide you from the outset of a claim, and help prepare a claim before it becomes problematic for the claim, or represent you when the insurance company denies your claim when you filed the claim on your own.

What Types of Orthopedic Disabilities Lead to Claims Being Denied:

Like any disability claim involving pain, disability insurance companies take the position that the orthopedic claim is based on subjective, patient-reported pain and treat the claimant as if they are malingering and trying to fraudulently access their disability benefits. Over the past two dozen years, Jason Newfield, Esq. has represented many people with musculoskeletal and orthopedic claims and is familiar with the tactics used by disability insurance companies to deny claims.
Here are the types of orthopedic claims frequently denied:
Arthritis
Back pain (lower and cervical)
Carpal Tunnel Syndrome (CTS) –
Cubital Tunnel Syndrome
Hip pain – caused by bursitis, hamstring strain, iliotibial band syndrome, hip flexor strain.
Osteoarthritis – not always the result of aging, but of frequent overuse
Rheumatoid arthritis – an autoimmune disease of the joints
Traumatic arthritis – resulting from an injury or fracture.
Avascular necrosis – loss of bone due to injury or bone tumors resulting in the degeneration and breakdown of the hip joint.
Sports injuries – particularly among “weekend warriors”
ACL (Anterior Cruciate Ligament) Injury or Tear (knee)
For people who rely on their hands, like a surgeon, dentist, chiropractor, scientist, or anyone who works on a keyboard, the loss of fine motor skills can end their career. There are numerous adaptive technologies, but they cannot replace the dexterity of healthy, functioning hands. We have successfully represented scores of these professionals navigate the disability insurance process to ensure a smooth transition from working – and often finding a new career while securing total disability benefits.
Experiencing debilitating back or hip pain can make something as simple as a business trip an impossibility. Being unable to sit in a chair for an extended period of time because of an orthopedic illness or injury is a disability, but the disability insurance company may not see it the same way.  

Why Would Someone Need a Long Term Disability Insurance Lawyer?

Orthopedic claims raise red flags for claims adjusters tasked with weeding out troublesome claims – meaning they are costly to the insurance company and there are several issues the insurance company can easily rely on to delay or ultimately deny the claim. Many of these claims can be managed – but frequently insurance companies will target these claims, and pursue examinations of claimants with such claims.

Like any disability claim involving pain, each individual experiences different pain levels and has different tolerances for pain. One person could have a herniated disc, most frequently L-4-5, and feel completely fine, while another could have the same herniated disc (or even a bulging disc) and be unable to walk because of sciatica (pain from the sciatic nerve) and muscle spasms in the lower back. Disability insurance companies take advantage of this, challenging even the clearest MRI images that show the full extent of the claimant’s injury. Subjective complaints are often not properly considered and they are difficult to prove, so careful consideration to development of evidence is critical for these claims.

Pain medication is far from the only medication used to combat various orthopedic issues, although it may be the most common. Side effects from pain medication range from being dizzy, disoriented and fatigued to extreme nausea and constipation. Other medications used for orthopedic conditions, like steroids used to combat inflammation, can leave users with poor concentration, muscle tenderness, fever, a susceptibility to infections, bone fractures, fatigue, nausea, and muscle weakness.
The Newfield Law Group has represented many claimants suffering from the side effects of medications and has fought against denials when the insurance company claims the side effects should not be considered the cause of the claimant’s disability. We demonstrate that these impactful issues must be considered and that the entirety of one’s condition must be evaluated.

A diagnosis by an orthopedist of an illness or injury that prevents a claimant from working is not enough for a successful orthopedic disability claim. The medical record must also include information, test results and support specific to the disability providing as much objective evidence as possible, and often crediting the patients’ subjective complaints. The physician’s notes will be reviewed in depth and need to include not just a diagnosis, but a complete description of the material tasks and duties the person cannot do as a direct result of their disability. Doctors are not disability insurance attorneys, and New York disability attorney Jason Newfield, Esq. is highly skilled in working with medical professionals to ensure their records provide robust support of claimant’s disability.

What Tests Do I Need To Have to Prove My Orthopedic Disability?

X-rays used to be the gold standard for identifying breaks, fractures, or dislocations of bones. Today the MRI is used to detect micro-tears that may not be seen on a traditional x-ray, but these are not the only tests used in orthopedics. Electromyography is used to measure muscle response and electrical activity in response to a nerve’s simulation of the muscle. Nerve conduction studies, discography and bone scans are also used to examine bones. There is no lack of medical studies to objectively prove an orthopedic disability. A treating physician may not feel they are necessary for the care of the patient, but they are necessary for the success of a disability claim.  

The American College of Rheumatology reports that approximately 790,000 total knee replacements and more than 450,000 hip replacements are performed annually in the U.S. While the reported rates of success are high, not all are successful and some patients are disabled as a result. If you have had a knee or joint replacement that led to your becoming disabled, you are invited to call the office at (877) 406-7883 to learn how we can help with your disability claim.

Car accidents, sports injuries and falls are often the cause of an orthopedic disability. Someone whose life has been permanently altered as the result of an orthopedic injury may be busy with taking care of their health and managing a personal injury claim. They may feel too overwhelmed to consider their disability benefits, which is where the Newfield Law Group can help. Many of our clients who suffered injuries from an accident turn to Jason Newfield, Esq. to manage their disability claim so they can focus on self-care and any other legal matters.

Cervical and lumbar degenerative disc disease is a fairly common ailment impacting the ability of many professionals – including dentists, chiropractors, surgeons – to practice their specialty. They may suffer from neck or back pain (or both) for years and undergo various treatments including surgery before deciding they need to stop practicing. Jason Newfield recommends speaking before filing a claim (877) 406-7883 in order to prepare for the challenges a disability insurance company may present.
Continuing to practice in the face of pain is admirable, but not advised, as it can lead to further damage and impact the quality of patient care.
Musculoskeletal disability claims are often denied by disability insurance companies because of the nature of the disability – pain as a subjective condition—and the wide range of personal experiences with the same physical condition.
Jason Newfield, Esq. has more than two decades of experience with orthopedic disability claims. If you have questions about an orthopedic disability claim, contact him at (877) 406-7883 to get a free legal consultation about your claim.