Long term disability (LTD) claims based on back pain are perhaps the most common type of disability claim. Your back is essential to your day to day activities and any kind of disorder, discomfort, or injury can cause severe back pain. This affects your daily life, and also your ability to work.
Activities affected by back pain/disorders include walking, standing for long periods, bending, stooping, twisting, sitting, and lifting. If you have chronic back pain and your can't perform work-like duties, you may be eligible for LTD benefits.
Long Term Disability insurance benefits are often challenged by the insurance companies. They will usually argue there is not enough objective evidence to support your subjective complaints of pain.
Subjective complaints are your complaints to the doctor. If you go in complaining of back pain, that is a subjective complaint. It cannot be independently evaluated. Contrast that with you coming in complaining of blood oozing out of your leg. That's not a subjective complaint, anyone with at least one working eye, can independently verify that there is indeed blood gushing from your leg.
Objective evidence is evidence that can be independently verified. So, let's say you go to your doctor, complaining of pain in your back. You have an MRI (magnetic resonance imaging) exam, which reveals severe disorders along your spine in your back. Your complaints to the doctor are subjective complaints. The MRI results are objective evidence because anyone qualified can look at the image and evaluate it.
Many people who suffer from back pain do not know the cause of the pain. Some estimates put the number as high as 75%. That means up to 75% of people suffering from back pain cannot find the cause of their back pain through exams, X-Rays and MRI's.
As you can guess the insurance company doesn't like it when you can't find the cause of a disability. So they use that opportunity to deny your claim. They're arguing you are faking your pain and disability.
The key is to flood your claim file with objective medical findings. If you cannot pinpoint the cause of your pain, it's really hard to get an LTD insurance company to issue benefits. It's already hard enough with objective findings, but with only subjective complaints it's that much harder.
As mentioned above, back pain and disorders are likely the most common types of disabilities seen on disability applications. Insurance companies see a lot of these applications and they are extremely skeptical of the claims. In order to convince a claims examiner you must show:
Your credibility is a significant factor in getting your application or appeal of benefits approved. Your credibility will be determined by: