Long term disability claim for healthcare worker denied in DC.

I just got off of a zoom call with a nurse working at a hospital in DC.  Nurses, and all healthcare workers really, have a heavy duty, physical job.  They have to lift and turn patients, move heavy medical equipment and respond to patient emergencies.

So it's no surprise that many nurses have back and neck conditions caused by lifting and turning patients who are obese.

And these conditions often result in herniated discs in their back or neck, with pain, numbness and tingling running down their arms or legs.  When it gets really bad, they can't work because they can't lift or carry enough weight to perform proper patient care.

When you can't work due to a medical condition you can apply for long term disability benefits.

That's exactly what this nurse did.  She applied for short term disability first because of her medical condition, and when that ran out, applied for long term disability.

But proving you are entitled to long term disability (and staying on long term disability) can be difficult.

She received a bunch of forms from the hospital's long term disability insurance company, Hartford, and completed the forms and sent them in.  Hartford wanted more information from her doctors and sent her additional forms on this.

Medically, there wasn't much of a dispute that she couldn't do the work, but there was a problem.

Her pain management specialist, providing her with ongoing, monthly appointments to address the pain and radiculopathy caused by her condition, would not complete the form.  His office policy was to "not get involved in disability or legal claims."  The form was 1 page, probably 7 or 8 things to fill out, that could have been copied from her medical chart.

In any disability or injury case, you really need to know how to talk to your doctor about your case - we do that for our clients, of course.

What can you do to help yourself get long term disability benefits?

This nurse just needed some guidance to stand up to the insurance company now that she was in a long term disability process that favors insurance companies (most cases are governed by a federal law ERISA that gives insurance companies discretion to determine eligibility for benefits - because of this, you really need an experienced long term disability attorney to file a thorough appeal - ours are about 30 pages long plus another 50-70 pages of exhibits).

So we had her go to her primary care physician, a doctor she knew well, to review all of her medical information.

She also had a Functional Capacity Evaluation done - a physical test that measures how much you can lift, carry, walk, etc. - that indicated she had limitations on her physical activities, so the doctor could review that as well as a basis for her opinion that the nurse could not return to work.

The insurance company's initial response was disappointing - it was clear this nurse couldn't work and had the medical evidence to back it up - even if her pain specialist wouldn't complete a simple form.

Get advice from a DC long term disability lawyer 

You shouldn't have to go it alone - call us today at 202-393-3320 to get started on a plan so you can get the long term disability benefits you need to be secure, in control and independent.

And if you received a letter denying your long term disabilty benefits, fax that letter to 202-393-3324 or email it to [email protected] and we'll contact you with a specific plan for your appeal.

Frank R. Kearney, Attorney-at-Law
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Experienced DC Workers' Comp, Long Term Disability & Accident Lawyer