Filing an orthopedic disability claim can be a complex process with myriad hurdles. It can exacerbate an already stressful situation and intensify emotional and physical distress. However, assistance in securing success with your claim is available. The process is much more manageable when you engage the services of an experienced New York orthopedic disability claims attorney.
Our disability lawyers understand the intricacies of the disability benefits system and have years of experience. We can provide legal advice, guide you through the process, advocate for your rights, and see that your claim is effectively represented. Our involvement significantly reduces the physical and mental burden you suffer and allows you to shift your focus to your personal health and recovery.
Orthopedic issues are among the top five reasons that Americans file claims for long-term disability insurance benefits. Arthritis and back pain comprise a third of all disability claims. Severe arthritis can limit the ability to use fine motor skills (writing, typing, performing surgery, dentistry, using scientific or medical equipment). A painful back issue or hip disability can destroy a worker’s ability to perform any tasks that require movement or lifting, but they can also prevent a business person from traveling to meetings and interfere with their cognitive abilities.
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The claims process for short- or long-term disability benefits can be challenging, complex, confusing, and time-consuming. Our experienced New York disability attorneys are knowledgeable in processing these types of claims. We can guide you through the complexities and help make sure that your claim is completed properly, on time, and with the proper documentation to support your eligibility.
Orthopedic pain is extremely common because it covers your entire musculoskeletal system. That means it can happen anywhere on your body where the body moves. Damage to your bones or muscles can cause pain in every extremity of your body.
Arthritis is a rheumatic disease that affects the joints and connective tissues. It causes joints to swell and stiffen, limiting movement and causing pain ranging from mild aches to debilitating agony.
Bursitis is an inflammation of closed, fluid-filled sacs that serve to cushion the movement between body tissues, especially at your joints. It is usually a short-term condition but can be disabling on a permanent basis.
From hairline fractures that do not heal properly to bruises, sprains, and issues like plantar fasciitis, a variety of ailments can cause pain and problems in the feet.
Fractures come in many varieties. Hairline fractures can cause sharp pain but usually heal quickly. The most severe fractures can involve a complete break that punctures the skin. These breaks usually take between six and 12 weeks to heal but can require months of physical therapy.
Kyphosis is a condition that is similar to scoliosis but far more severe. It usually results in a humpback appearance where the spine has a curvature of greater than 50 degrees.
Millions of Americans suffer from lower back pain every year. Sometimes it is a simple muscle ache that can be resolved with rest and over-the-counter anti-inflammatories. Other times, it is a more severe injury that can result in an inability to stand or walk.
Much like other extremities, hand pain can result from a wide range of issues. These can include fractures, strains like tendonitis, or repetitive motion injuries like carpal tunnel syndrome.
Knee pain results from a variety of issues. It could be a serious impact injury that dislocates or otherwise damages the knee itself. It could be repetitive motion stress, a sprain or strain, or simply occur due to age or weight putting strain on the joint over the years.
Osteoporosis is a degenerative disease that results in the bones weakening and growing thin. They are then more prone to breakage and less able to support the body. The cause of osteoporosis is unknown, but it is degenerative and may result in permanent disability.
Paget’s disease is a chronic disorder that causes the bones in the body to become deformed and enlarged. Bones may become fragile yet dense. Paget’s disease ranks just behind osteoporosis among common bone disorders in adults over 50.
Scoliosis is a spinal disorder marked by an abnormal curvature of the spine. This causes severe pain and debilitating limitations on posture and movement.
Shoulder pain can result from poor posture, back and neck injuries, bruises, broken bones, stiff muscles, strains and sprains, or other problems. It can range from mild and temporary to severe pain that limits strength, flexibility, and range of movement.
Soft tissue is anything in your body that is not a bone, which means any injury you have that is not a bone injury is considered a soft tissue injury. These can involve mild bruises, muscle tears, straining or torn ligaments, damage to the cartilage at joints, or any of a wide range of other injuries.
A list of orthopedic conditions includes:
Our client, a 59-year-old Systems Services Representative/Field Engineer/Major Incident Manager, enjoyed a successful career working for a major international technology and business consulting firm. He suffered from numerous ailments due to degenerative disc disease, cervical (C6-C7) and lumbar disc herniation, spinal stenosis, cervical and lumbar radiculopathy, epidural fibrosis (L4-5, S1), lumbar spondylolisthesis, bilateral hip/pelvis osteoarthritis, degenerative synovial cyst (L4-L5), arthritis of the spine, lower back pain with right hip/buttock pain that radiates down anterior leg, para labral cyst on right hip, labral tear of right hip joint, atrophy of right arm, hypertension, peripheral neuropathy, chronic pain, sleep apnea, poor balance, gastroesophageal reflux, high cholesterol, essential tremor of upper extremities, grand mal and petit mal seizure disorder.
He lived for many years with a great deal of pain and had done his best to continue to work, but at a certain point, his conditions made it impossible to perform the duties of his position. In addition, he took a number of medications, and the side effects took a toll on his cognitive abilities.
When his physicians advised him to stop working and to apply for short-term disability, MetLife approved his short-term claim and agreed that he was disabled from performing his own occupation on a full-time, sustained basis. After his short-term disability claim was exhausted, his physicians did not release him to return to work and advised him to apply for long-term disability, which was subsequently denied by MetLife, despite no change in his medical condition.
MetLife based its determination on a faulty vocational analysis which miscategorized our client’s occupation and failed to appreciate his functional deficits. He had been reassigned to lighter duty as a Major Incident Manager but was not able to perform the necessary tasks of that position. MetLife erroneously misconstrued his duties as a Major Incident Manager by only acknowledging the sedentary duties of the occupation.
On appeal, we worked closely with our client in establishing evidence with his employer delineating his day-to-day occupational duties as a Major Incident Manager, reinforcing the fact that his own occupation by no means could possibly be considered “sedentary.” Even with the reassignment of his occupation as Major Incident Manager, MetLife refused to acknowledge his restrictions and limitations.
We attacked MetLife’s purported “independent” peer-reviewing consultants and the well-known pro-insurance company vendors MetLife typically retains to bolster its claim denials.
Additionally, we developed powerful arguments revealing MetLife’s bias and egregious conduct. These arguments included MetLife’s failure to consider our client’s:
Frankel & Newfield was proud to reverse MetLife’s decision through our aggressive representation, the use of supporting materials documenting the material and substantial duties of our client’s job, and our skillful highlighting of the biased nature of the medical reviews created by its vendor. By working harmoniously with our client for this collaborative effort, success was achieved.
The disability insurance law firm of Frankel & Newfield has represented many clients with orthopedic issues when the disability insurance companies have challenged their claim. There are certain strategies used to push back on a claim, even when all medical evidence clearly demonstrates that the claimant cannot perform the tasks and duties of their job. Call our office today at 877-583-2524 for a free consultation, and learn how we can protect your benefits.
Yes, an orthopedic injury can result in long-term disability or even permanent disability in certain instances. Orthopedic disability claims are among the top five most common reasons for people to file disability insurance claims, with arthritis and back pain comprising a third of all disability claims.
Like with many claims, evidence of symptoms, diagnostic tests documenting the severity of the disability, and evidence of the impact of these medical issues on the claimant’s ability to perform the material tasks and duties of their occupation are necessary for an orthopedic disability claim to succeed.
Orthopedic disabilities in adults are usually the result of injuries sustained in accidents, including car accidents, falls, and sports injuries. They range in severity from an inability to sit or stand for extended periods of time to spinal paralysis. Orthopedic disabilities can also include difficulty with large and fine motor skills. Others develop orthopedic disabilities through degenerative conditions, where over time, the body is less strong, and biomechanical issues cause functional problems.
A diagnosis of an orthopedic disability by a doctor is not enough for a claim to succeed. The treating physician will need to conduct the appropriate tests to establish the degree of the condition and provide objective medical evidence. The medical record will also need to include the specific tasks the claimant can no longer perform as a result of the disability. A vocational evaluation may be needed to accurately assess the physical ability required to perform the claimant’s occupation, as well as the functional impairments from the condition.
X-rays are most commonly used to look for fractures, dislocations, or broken bones, while CT scans or MRIs are used to detect small tears in the bone that are not visible on an X-ray. Other tests used to evaluate orthopedic claims include electromyography (EMG), which measures muscle response or electrical activity in response to a nerve’s stimulation of the muscle.
A nerve conduction study may be needed to evaluate the severity of numbness or tingling and/or weakness of the arms and legs. Skeletal scintigraphy, discography, bone densitometry, and myelography are also used to diagnose and evaluate orthopedic injuries or impairments. Often, these diagnostic results are critical to supporting a claim for own occupation disability.
The rise in the number of knee and hip replacement surgeries has led to a large number of people becoming disabled after undergoing surgery. Complications of knee replacement surgery include implant failure, knee stiffness, persistent knee pain, stiffness, swelling, and limited mobility. Hip replacements can also lead to complications that make it impossible for people to work after surgery.
When you go to a specialist for an orthopedic issue, they will perform tests to diagnose the problem. These tests will be an important part of your health care records that you must include with your disability claim.
If you or a loved one’s orthopedic disability claim is denied, you are not alone. The right disability lawyer can help you challenge the denial and fight back. A toll-free phone call to Frankel & Newfield could be one of the most important calls you make in your effort to get the benefits you need. We can communicate with insurance providers, help you put together the records you need, and build a strong case to challenge your denial and get the benefits you deserve.
It is never too soon to seek out representation for your orthopedic disability claim. At Frankel & Newfield, we have years of experience dealing with all manner of injury cases from traumatic brain injury to a variety of disability claims. We represent clients from across the nation, from Brooklyn to Los Angeles, and we are ready to hear your story. We have a strong history of positive prior results and client testimonials, and deeply value everyone who comes through our doors.
Do not go it alone if you are facing a difficult orthopedic disability case. Let us help. Our phone number is 877-583-2524. Reach out to us for a free consultation today. We serve claimants nationwide.
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