Dealing with back or spinal injuries can mean unpredictable pain levels and major limitations on movement and daily activities. These conditions often interfere with your ability to do your job and keep up with regular tasks. Unfortunately, claim denials are common for people with these injuries, with insurance companies labeling injuries as minor or disputing doctors’ findings.
Why Are Back and Spinal Injury Disability Claims Denied?
Insurance companies often carefully review back and spinal injury claims because these conditions can vary widely from person to person. Denials are commonly a result of lack of objective evidence (like MRIs or X-rays), inconsistencies in medical records, statements suggesting improvement, or claims that do not neatly fit insurer definitions for “total disability.” Too often, insurers downplay pain and mobility loss or interpret any improvement as evidence that you could return to work.
What Evidence Can Strengthen a Back Injury Disability Appeal?
Certain evidence can make your chance of appeal more likely to be successful:
Medical Imaging and Diagnostics
Submit all relevant imaging studies, such as X-rays, MRIs, or CT scans, and written reports explaining your injuries and how they impact your life. Anything you may have left out in your original case must be included. If you’ve had further medical treatment and tests, submit those.
Specialist and Treating Physician Support
Include records, progress notes, and clearly written statements from treating physicians, especially specialists (such as orthopedists or neurologists), who can outline your prognosis and work restrictions. Letters that clarify physical limitations in daily and workplace activities can be particularly helpful.
Detailed Treatment History
Show a history of following recommended treatments (physical therapy, injections, surgeries, and activities within your restrictions). This tells insurers that your limitations are real and you have made sincere efforts to get better.
Functional Capacity Evaluations (FCE)
Providing the results from a formal FCE quantifies what physical actions, lifting, standing, and bending, you truly can or can’t do at work. This should help explain why you truly aren’t able to go back to work yet.
Personal Descriptions and Third-Party Statements
Describe in detail the challenges you face at home and at work. You can also incorporate letters from family, colleagues, or others who’ve seen changes in your abilities.
When you’re filing an appeal, it’s important to include as much evidence as possible, which your lawyer can help you with.
Why a Lawyer is Needed For Back and Spinal Long-Term Disability Denials
Even devastating back or spinal injuries can be ignored by insurance companies. Getting an attorney brings important advantages for your appeal:
- Ensuring deadlines aren’t missed, so technicalities don’t ruin your chances for appeal.
- Gathering records and letters from medical and therapy providers that clear up any doubts about your diagnosis or limitations.
- Preparing you for what to expect as the case moves forward.
Working with legal representation means a complex, difficult claim becomes easier to manage.
Schedule a Free Consultation About Your Disability Denial
Facing a disability claim denial due to a back or spinal injury affects so many aspects of your life. Chronic pain, limited mobility, and the inability to work can create significant financial and emotional stress, especially when the benefits you were counting on are suddenly denied. Julie Rice Law can help you understand your options, gather the evidence needed to support your claim, and pursue the strongest appeal possible.