If you have or are planning on applying for disability benefits for back problems, you know that you will be running into a lot of hurdles.
Insurance companies have a huge number of requirements to qualify for disability benefits for back problems. Along with this, the long list of different back disorders tends to make diagnosis cloudy.
To make things worse, the process of having all the application requirements can be cumbersome and difficult.
Jumping through hoops and trying to overcome obstacles in the application process along with dealing with chronic back pain is the last thing you need.
This article will present an overview of the challenging process of applying for disability benefits for back problems in Canada. The information here will put you on the right track to successfully be granted the help you deserve. This article is part of our series looking at medical conditions and disability benefits.
Identifying your back disorder
Up to 80% of people who report a disability with back pain will recover within a few months. The remaining people have chronic back problems that prevent them from living a comfortable lifestyle.
One of the first things to do when evaluating your back issue is to get an idea of what the disorder might be. The most common culprits are as follows: degenerative disc disease; bulging discs; lumbar radiculopathy, sacroiliac joint disease, sciatica, fractures to the spine, osteoarthritis of the lower spine, ankylosing spondylitis, and spinal stenosis.
Degenerative disc disease refers to the symptoms of pain originating from a degenerated disc in the spine. This type of disorder actually has a decreasing amount of pain over time.
A bulging disc, commonly known as a slipped disc, is when an intervertebral disc expands beyond its normal bounds. Pain from this disorder comes when the affected disc compresses a nearby nerve root.
Lumbar radiculopathy is nerve irritation caused by damage to vertebrae discs. Pain from this disorder increases with hip movements, coughing and sneezing.
Sacroiliac joint disease is the inflammation of the sacroiliac joint, the firm joint between the spine and the pelvis. Sciatica is the pinching of the sciatic nerve, the largest nerve in the body. This disorder is characterized by back pain, numbness, weakness, and tingling feelings that radiate down the body.
Fractures of the spine are when the bones of the vertebrate break or collapse. If left untreated, this problem can lead to severe problems that can affect day-to-day life.
Osteoarthritis of the lower spine is when the cartilage in the joints and discs of the back break down.
Ankylosing spondylitis is a type of arthritis that affects the spine.
Spinal stenosis is the narrowing of the bone channel the spinal nerve goes through.
You can qualify for disability benefits with any of these back problems.
Which disability benefits for back pain do I qualify for?
When it comes to claiming long-term disability benefits, you might be eligible for one of two types of disability benefits if you are a worker. These are the Canada Pension Plan (CPP) disability benefits and the long-term disability insurance benefits.
The Canada Pension Plan:
The CPP, designed to support you after retirement, also covers disability benefits that start once you become disabled and last until you are 65. After that, these disability benefits are converted into regular pensions. In order to be eligible for the CPP disability benefits, you have to have worked for four out of the past six years and paid payroll taxes. The CPP requires you to prove that your disability is both prolonged and severe, leaving you unable to work.
Long-term disability benefits:
Group disability insurance policies are the most common type of disability insurances in Canada. If your employer has insured you as part of a group, you are receiving your disability insurance through your job. These group disability insurance policies provide both long-term ad short-term disability benefits. If you are suffering from a chronic form of Lyme disease, you can apply for the long-term disability benefits if eligible. If successful, these will provide you with monthly income payments during long absences from work to take the financial pressure off you.
Steps to position yourself to win disability benefits for back problems
1. Diagnostic Imaging helps, but maintaining your credibility is the key to winning disability benefits for back problems
The “lack of objective evidence of disability” is the most common reason insurance companies give for denying your claim for long-term disability benefits for back problems. One piece of evidence you need to prove your pain is legitimate is diagnostic imaging proving the disorder.
While this alone isn’t enough to win disability benefits, it does provide valuable evidence to strengthen your case. The most common imaging techniques are X-rays, CT scans, and MRI scans. X-rays can check for instability in the structure of the bones to find issues such as spinal fractures. CT scans are more detailed x-rays that can image specific conditions such as spinal stenosis or a bulging disc.
MRI scans are used to assess details of the disc and nerve root, allowing a doctor to identify disorders such as degenerative disc disease, a bulging disc, and spinal stenosis. Make sure to let the doctor know of your problems and pain in detail to allow them to best choose an imaging technique and analyze the resulting image for diagnosis.
An important note to make regarding MRI results is the fact that there is no accepted correlation between what can be seen on an MRI to back pain. This is where credibility becomes very important.
One of the best ways to build this credibility is going through a variety of different types of treatment for your back pain. By working with professionals who can back up your claims, you will have a much better chance of receiving disability benefits for back problems.
2. Show that you’ve done all you can to get better
When trying to be accepted for disability benefits for back problems, you have to prove that you have done absolutely everything you can to eliminate your problem. There are a variety of treatments for chronic back pain including drug treatment, various therapies, surgery, psychological counselling and physical rehabilitation.
Initially, many sufferers of back pain turn to drug treatment to alleviate their discomfort. Issues that arise from drug use that can limit effectiveness are experiencing major side-effects, having a susceptibility to addiction, and having the means to afford the drug.
There are also a variety of therapies such as exercise, electrotherapy, and superficial heating and cooling of the skin. Many of these therapies prove to be ineffective for many patients, but they are all worth trying before receiving disability benefits for back problems.
If available for your particular disorder, surgery is another option that can treat back disorders. The high price of surgery is usually the main problem with this form of treatment.There is always a chance complications to occur and other health conditions can prevent a safe procedure.
Psychology also plays a role in your back pain. It is important to seek out psychological counseling to make sure there isn’t a way you can cope with your pain. Disability benefits are often denied if applicants fail to do this, so attempting this form of therapy is crucial.
Lastly, attempting physical therapy is a must to qualify for benefits. Physical therapy is known to be a very difficult and painful process before results are realized, which is why you must give it your full effort before applying for disability benefits. If your physical therapist says you didn’t put yourself in a position to succeed, you will not be able to receive benefits.
3. Accurately document instances of pain from sustained sitting or standing
The best evidence of disability from work are limitations in sitting and standing for long periods of time. Many types of jobs require extended periods of time being sedentary behind a desk. If your back pain seriously prevents you from performing this type of labor, you have a strong argument to be granted disability benefits.
You must document instances of movements throughout the day to present as evidence. You have to be able to prove you are unable to sit or stand for a long period of time without experiencing severe pain that prevents you from performing at work. If you are able to sit for more than two hours, you should reevaluate the severity of your back problem, but if you are unable to do this, you have a strong case for receiving benefits.
What to do if your claim is denied?
You have done all the paperwork and have gathered all the evidence you could, but when you receive the decision a few weeks later, you are denied your rights to disability benefits, placing you in a very difficult situation.
This is a tough pill to swallow, and I know that - I have seen it many times before with clients of mine. If you don’t get the right type of evidence for your disability claim, the insurance companies will deny your disability claim for these technical reasons, even if they know you are actually disabled.
Still Feeling Unsure About Your Disability Claim? Sometimes a quick call with us can answer your concerns and help you move forward with confidence. Call us now at 888-732-0470 for a free consultation or click here to book online. All consultations are by phone.