“Normal Age-Related Findings” versus Spinal Herniation: A Common Disability Litigation Fight
Helping Claimants Recognize Disability Insurers’ Tricks
Can you guess what the most common disabling condition in the United States is? That’s right, musculoskeletal disabilities, including arthritis, back pain, and spinal degeneration.
Almost 40 percent of the population suffers from some type of musculoskeletal injury. While these injuries don’t always disable the people they strike, they tend to get worse with time. Whether we’re sitting, standing, walking, or lying down, spinal injuries can cause extreme discomfort.
Due to the prevalence and length of such disabilities, many long-term disability insurers limit your eligibility period for back pain. They typically assume it is part of aging, not a true disability, and may terminate your long-term individual or group disability benefits after the “limited” period stated in your policy. However, the way your long-term disability policy defines disability often gives individual or group disability insurers another way to wrongfully delay, deny, or terminate your benefits. If your disability insurer’s “independent medical examiners” find that your pain results from age as opposed to an injury or illness, it may try to wrongfully claim that you do not qualify for long-term individual or group disability benefits at all.
A disability insurer’s often improperly credentialed doctor will routinely make a bad faith claim that arthritis or back pain do not stem from injuries or are “self-reported sicknesses.” Instead, insurers will use language like “normal age-related degeneration” to help support a wrongful delay, denial, or termination of individual or group long-term disability benefits.
If you’re one of the thousands of disabled Americans who have received this type of delay or denial, don’t hesitate to contact our experienced individual and award winning group ERISA long-term disability attorneys at DarrasLaw. With more than 100 years of combined litigation and claim experience in the field of long-term disability law, we know the disability insurers’ tricks and how to avoid fatal claim ending mistakes. For your free disability policy analysis and free claim consultation, call us today at (800) 458-4577 or contact us online.
What Is Degenerative Disc Disease?
In the broadest sense, degenerative disc disease is a spinal condition that develops as you age. Due to normal age-related degeneration, the cushions or “discs” between your vertebrae begin to dry, crack, or thin, causing pain and discomfort as your vertebrae rub together.
If the following symptoms worsen with time, you may suffer from degenerative disc disease:
- Back pain
- Sharp, sudden pain
- Pinched nerves
- Bone spurs
- Difficulty walking, sitting, bending and stooping
If your treating doctors diagnose you with degenerative disc disease, this typically means your pain does not stem from a traumatic injury or illness. Many long-term individual or group disability policies won’t cover benefits for age-related conditions. For example, a major disability insurer may define a disability as when an “injury or illness,” prevents the employee from performing the important duties of his or her occupation at the onset of disability. Depending on the policy language, degenerative disc disease is neither an injury nor an illness and you may experience a wrongful delay, denial, or termination of benefits.
If you’re older than 40, considerably overweight, or worked in a physically demanding, difficult occupation, you’re at risk for degenerative disc disease. However, if your symptoms manifested after a car accident, came on suddenly, or have been documented since you were young, you may suffer from an underlying qualifying condition.
Traumatic Herniation and Spinal Injuries
When it comes to degenerative disc disease, your MRIs will typically show deteriorating or narrowed discs. If your MRI shows some of your spinal discs protruding from your vertebrae, you may have a bulging or herniated disc (slipped disc). A traumatic injury, age-related degeneration, or a combination of both can cause this.
A bulging disc protrudes from its place between your vertebrae, like peanut butter spilling from the sides of a sandwich. A “herniated disc” takes place when the outer layer of the cartilage protecting your disc ruptures, causing the softer inner layer of the disc to protrude from the disc itself.
For some, these injuries bring on extreme pain and may require surgery. Falls, car accidents, and lifting heavy objects are some of the most common causes of bulging and herniated discs.
Because your spine weakens as you age, disc herniations often occur due to degenerative weakness in combination with trauma. For example, if you’re 55 and in a car accident, you’re generally more likely to suffer from disc herniation than a 25-year-old. Even though in this scenario the crash caused your injury and pain, your disability insurer may try to spin the facts and blame your age, not the traumatic injury. This is where the experienced long-term disability lawyers and seasoned group ERISA attorneys at DarrasLaw can fight for people.
Independent Medical Examinations and Your Back Injury
If you’re suffering from severe back pain and discomfort, your treating doctor will typically recommend you go for X-rays and MRIs. A trained doctor may see the cause of the discomfort, such as a herniated disc putting pressure on a nerve or a bone spur. The problem, however, is that doctors cannot always clinically determine the cause of the injury. Furthermore, your MRI may present evidence of both a traumatic injury and disc degeneration.
Your treating doctor will then need to determine the cause of your injury based on the facts you present. If you fell down the stairs last week and that’s the first time you experienced back pain, your treating doctor will likely conclude that the herniation came from the fall. The insurance company-paid doctors, however, are looking for ways to wrongfully delay, deny, or terminate your individual or group disability insurance benefits—and they often lack the proper training or specialization to diagnose you. So when they review your records during a “so called independent” medical exam, they may conclude that every injury resulted from age because you have one narrowed disc. In turn, those “independent medical exams” save your individual or group ERISA disability insurance company thousands of dollars.
You’re Not Alone. Call the Nationally Renowned Disability Lawyers and Expert ERISA Attorneys at DarrasLaw
Our top-rated individual and award-winning group ERISA long-term disability attorneys at DarrasLaw see bad-faith “age-related” delays, denials, and terminations of benefits almost every day. We know how to work with medical experts to determine the true cause of your back injury, and we may protect you from a wrongful delay, denial, or termination of individual or group disability benefits.
Even if an age-related condition causes your back and neck pain, the associated bone spurs and nerve damage can lead to serious disabling conditions for which your individual or group disability insurance policy may entitle you to benefits. America’s Top Disability Litigator, Frank N. Darras’s firms have recovered nearly $1 billion in wrongfully delayed, denied, or terminated individual and group insurance benefits. To schedule your free disability policy analysis or free claim consultation, call us today at (800) 458-4577 or contact us online.