Claims for disability benefits for neck and cervical disorders are some of the most common disability claims in Canada.
This is because a majority of workers experience neck pain either due to their occupation or from everyday movements like bending and lifting. Since it is so prevalent, claimants find that their applications for benefits are often denied. This article will discuss how you can make your claim stand out and increase your chances of approval. This article is part of our series looking at medical conditions and disability benefits.
Disability from neck and cervical disorders: You are not alone
Neck and cervical disorders are not ordinary neck pains. They are usually attributed to cervical disc degeneration. The cervical vertebrae in the spine are made up of discs that act as shock absorbers for the body. These deteriorate over time leading to compressed nerve roots between the discs. Because these nerves run through the spinal cord, you will feel weakness or numbness from your shoulders down to your arms and hands. This radiating pain is the main symptom of cervical radiculopathy, which is a condition that occurs when there is a pinched nerve in the neck or near the spine. Such disorders can also be linked to whiplash injuries, arthritis, meningitis, and some forms of cancer.
Most employers and benefits providers misunderstand the impact of neck and cervical disease on a person’s ability to work. This is especially true if you are engaged in sedentary work or a job where you are just sitting down at a desk. Anyone who suffers from the condition will find that it becomes painful to sit for a long time. There is also a loss of control over arm movements making it difficult to write or type on a computer.
If your condition has progressed to this level, then it is sensible to apply for disability benefits as your ability to perform work has become restricted. Continuing to work might also aggravate your disorder and cause further damage. It is important to present evidence that you are unable to perform tasks that are crucial to your occupation and that it would be impossible for you to find any other type of work in the long-term.
Over-the-counter pain medicines can be used to treat neck and cervical disease. Your doctor can also prescribe painkillers that contain steroids or narcotics. A physical therapist will be able to relieve your pain and restore mobility through exercises and the manipulation of muscles. Surgery is an option if your disc disease has already become serious. The main procedure is a discectomy in which a deteriorated disc is replaced with a new metal one.
Types of disability benefits for neck and cervical disorders
There are two sources of disability benefits for Canadian workers with neck and cervical disorders: the Canada Pension Plan and Long-Term Disability Insurance Benefits.
CPP disability benefits for neck and cervical disorders
The Canada Pension Plan (CPP) is a mandatory pension program run by the Federal Government of Canada. It is mandatory for you to pay to be included in the program, so your employer is required by law to deduct contributions from your salary. It is widely-known as a retirement pension, but you can also get survivor benefits, post-retirement benefits and disability benefits under the CPP.
For disability benefits, your benefits begin once you become disabled at any age under 65 years old. These are paid to the disabled worker and to the disabled worker’s children who are minors or 18 to 25 years old and attending school full time. If you were approved for disability benefits, you would receive monthly payments as a cheque in the mail or through deposits to your bank account.
You can receive CPP disability payments if you meet the contribution requirements and have a “severe and prolonged disability.” Under the rules of the CPP Administration, a severe disability means that you are “incapable of pursuing any substantially gainful occupation,” while a prolonged disability means that “your disability must be long-lasting, indefinite or will result in death.” You must be able to provide evidence to prove that your condition falls within this definition.
The CPP Disability Program is under Service Canada, which is an agency within the Department of Employment and Social Development. Service Canada representatives make the initial decision to approve or deny benefits claims. They are also in charge of the first level of appeal called the Reconsideration or Reconsideration Appeal. If your Reconsideration Appeal was denied, you could appeal to the Social Security Tribunal, which is an administrative law court.
Those who apply for CPP disability benefits would do at least the bare minimum. This involves going through all the steps to have an application that can be considered as “complete.” However, you must not stop there, especially if you want to increase your chances of getting your claim approved.
Long-Term Disability Insurance for neck and cervical disorders
The majority of disability benefits plans in Canada are insurance-based disability plans including those offered as part of an employee benefits package, which is a type of group disability insurance policy. You are insured as part of a group, and your employer bought the policy from an insurance company for your benefit. It would be good to consult your group insurance benefits booklet to see if your plan includes long-term disability benefits.
If you work for a public sector organization, then you might have disability benefits through non-profit disability plans instead. They differ from group disability insurance because the insurance company is only administering the plan and is not providing the insurance policy. This is done through administrative services only (ASO) agreements between the insurance companies and the boards of trustees of organizations. When claiming benefits through a non-profit disability plan, it is best to seek legal advice as you will be faced with more complex procedures and greater restrictions on your legal rights.
The types of disability benefits that you can avail include paid sick leave, employment insurance (EI), and disability monthly payments. The latter is a percentage of your salary, a specific monthly amount, or a combination of both as indicated in your insurance policy. The payments can last for a certain number of years until you reach a certain age, or a combination of both.
You have the right to make a claim for disability benefits if you have become disabled due to an “accident” or “illness.” You should consult a lawyer to determine whether your neck and cervical disorder falls under the definitions given in your insurance policy. Insurance companies will also review your disability to see if it falls under their definition of “total disability,” which usually means that you are unable to do your own occupation for the first 24 months after you became disabled and that you are unable to do any occupation after those 24 months.
How to win disability benefits for neck and cervical disorders
Applying for disability benefits from the CPP or insurance companies is a long and difficult process. There are also challenges that are unique to claims due to neck and cervical disorders. That is why it is crucial to recognize the nature of your condition and the way benefits providers think.
1. Provide objective evidence and medical test results
In order to diagnose your neck and cervical disease, your doctor will take a look at your medical history. You can help your physician with this by keeping your own journal that details the occurrence and type of neck pains that you experience along with other symptoms that might be related to your condition. Take note that your own records are not enough to prove that you have a history of the disease. This data should be reflected in your doctor’s medical records to be admissible as evidence in a benefits claim.
It should also be backed up by medical test results. The following are common tests used to diagnose neck and cervical conditions. Your doctor would advise which of these should be performed for a conclusive diagnosis.
- neurological exam is used to test arm movement, strength, and reflexes to determine if there is an abnormality in the nervous system.
- nerve conduction study (NCS), also known as a nerve conduction velocity test, measures the speed of conduction of an electrical charge through a nerve to find out if it is damaged.
- Pain injections, though often considered as treatments, can also be used in diagnosis to locate the source of pain. These include discography, medial blocks, and selective nerve root blocks.
- An x-ray will be able to show any degeneration, fractures, or infection in the bones of the cervical spine.
- Computer Assisted Tomography or CAT scans are more intensive than x-rays and can show the soft tissues between the cervical discs.
- Magnetic Resonance Imaging or MRI can show any abnormalities in the discs, soft tissues, and nerves. Sometimes, this test is enough to definitively diagnose neck and cervical disorders.
2. Credibility of the claimant is very important
It is the claimant’s responsibility to prove that he or she is suffering from a disability that is making it difficult to earn income. Simply asserting that you have chronic stiff neck will not suffice, especially when the tests listed above do not show any conclusive results. Such a case will be a challenge to win since your credibility becomes the key issue.
You must understand that insurance providers can dedicate a lot of resources, time, and money to deny a claim. For instance, it is not uncommon for them to hire private investigators to secretly record you on video everywhere you go. The companies might also monitor your social media accounts for any indication that you might be getting better or that you are not disabled by pain. Be aware of any photos, posts or comments that might give rise to suspicion.
3. The claimant should show that he or she has followed all medical recommendations
Benefits providers would present to you the terms of their agreement to approving your claim. This varies between companies, but they usually include medical recommendations that you must follow in order to continue receiving benefits payments. It might involve a certain number of physical therapy sessions or prescribed treatments to prevent further disc degeneration. You must be able to show that you are trying to get better and go back to work as soon as possible.
Companies might ask for regular reports from your doctor or conduct follow-up calls. You should comply with any requests. Otherwise, your benefits might be quickly terminated without prior notice once your company suspects that you might be misrepresenting your current disability or that you are not following medical orders.
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