When Shoulder Injuries Interfere with the Ability to Practice Your Profession, a Pennsylvania Shoulder Injury Attorney Helps with Disability Insurance Claims
Your shoulder is connected to core parts of your body, but it also serves as a conduit to the smaller, specialized components of your hands, wrists, and fingers. An injury to the shoulder impacts people in ways they never expected. Until they’ve experienced it for themselves, people often believe a shoulder injury does little more than prevent you from swinging a golf club or baseball bat.
But the consequences actually can extend to nearly every aspect of daily life—even sleep. If you’ve suffered a shoulder injury, it can severely limit your ability to work or even prevent you from working at all. Your disability insurance policy should provide the resources you need to make up for lost income in this situation.
Unfortunately, the insurance companies that sell these policies often undervalue the impact of shoulder injuries and deny related claims. Fortunately, an experienced Pennsylvania shoulder injury attorney at Seltzer & Associates knows how to overcome these objections and demonstrate that injured policyholders are eligible to receive proceeds under their private disability insurance policies.
Common Types of Shoulder Injuries
The shoulder is a complex, highly flexible ball-and-socket joint connecting the arm to different parts of the trunk with an array of muscles, ligaments, tendons, and bursae. This joint is designed to operate with an extensive range of mobility, but injuries can restrict that range to the point where even simple movements become difficult or impossible.
Some of the most common shoulder injuries include:
- Torn rotator cuff damaging the tendons that connect muscle to bone, leading to intense pain and weakness
- Tendonitis and bursitis caused by inflammation of the tendons or fluid-filled bursae protecting the joint
- Labral tears damaging the ring of cartilage that lines the shoulder socket
- Shoulder separation disconnecting the collarbone from the shoulder blade
- Adhesive capsulitis, also known as frozen shoulder, caused by gradual thickening and increasing tightness in tissue surrounding the shoulder joint
- Dislocations and fractures
Some of these injuries can heal with rest and stabilization. Other injuries require surgery or other intensive forms of treatment. Full healing may not be possible, leading to permanent impairment. When recovery is lengthy, or disabilities are likely to continue indefinitely, it makes sense to file a claim with your disability insurance provider if the injuries are interfering with the ability to work.
Impact of Shoulder Injuries
In general, shoulder injuries limit the affected person’s range of motion, reduce grip strength, and lead to chronic pain. Not everyone needs to reach high as part of their job, so the reduced range of motion may not seem like a problem. But it can cause problems with tasks such as twisting to look back before backing your car down the driveway. If the day starts with stiffness and pain, it can progressively worsen through the day, interfering with concentration.
When shoulder injuries interfere with the ability to grip, then it becomes nearly impossible for professionals such as surgeons, dentists, chiropractors, and other medical professionals to perform their jobs properly. Pain and impaired grip can also interfere with the ability to perform other professional jobs. If your thoughts are interrupted by pain every time you pick up a pen, it can be nearly impossible to complete complex tasks that require intense concentration. A knowledgeable Pennsylvania shoulder injury attorney can help you explain how your injuries prevent you from working and thereby demonstrate your eligibility to receive proceeds of your disability insurance policy.
Symptoms and Treatment Options
An injury to the shoulder can have effects that manifest elsewhere in the body, so it is not always obvious when symptoms indicate a shoulder injury. Symptoms may include:
- An ache or sharp pain radiating down the arm. It often becomes worse at night
- Difficulty in lifting or pushing
- Inability to raise the arm
- Swelling in the shoulder or arm
- Feelings of instability
Doctors may try to treat shoulder injuries with physical therapy or medications to reduce inflammation and pain. Cortisone injections can sometimes provide temporary relief. However, it is often necessary to resort to surgical options to reduce pain or regain functionality. Complex fractures, joint replacement, or major tendon tears require open surgery, while arthroscopic surgery may work to repair smaller tears. Surgery often only achieves partial success, with residual injuries remaining indefinitely.
FAQs About Disability Claims Involving Shoulder Injuries
Does my shoulder injury qualify for disability if I can still do “some” work?
If your disability insurance policy provides residual disability coverage, then you should be eligible for partial payments if your injury limits your earning capacity, even if you’re able to perform lesser amounts of work.
How does Pennsylvania law treat “specific loss” for shoulder injuries?
In Pennsylvania, a “specific loss” generally refers to a total loss of use of a body part. A shoulder injury would be considered a “specific loss if it was severe enough to prevent the use of the arm. However, a “specific loss” is a term used in workers’ compensation claims, and it may not be applicable to losses covered under a private disability insurance policy. A Pennsylvania shoulder injury attorney at Seltzer & Associates can review your policy and explain what qualifies as a disability based on the terms of your policy as interpreted under Pennsylvania law.
What is the difference between an ERISA plan and an Individual Disability Insurance (IDI) policy?
When an employer offers disability insurance as part of a benefit package, that insurance is generally provided through a group policy, and the provisions are governed by the federal Employee Retirement Income Security Act of 1974, known as ERISA. Because these plans are negotiated in bulk, the policyholder has little control over the terms. If an employee has a problem with a claim under an ERISA policy, it must be handled through government-mandated processes. By contrast, when someone contracts directly with an insurer to obtain an individual private disability insurance policy, they have more control over coverage options and can negotiate or litigate dispute resolutions under general contractual principles. At Seltzer & Associates, we assist claimants with ERISA plans as well as individual short-term and long-term disability policies.
No Matter Where You Are in the Claims Process, Seltzer & Associates is Ready to Assist
It is important to file long-term disability claims as quickly as possible—but it is also importantto submit your application with the correct supporting documentation, and that can be difficult to do unless you’ve had extensive experience dealing with disability insurance claims. Insurance companies are always looking for reasons to deny claims or minimize payouts, and they structure applications in a way that makes it easy for them to do so.
At Seltzer & Associates, we have decades of experience helping professionals obtain the full amounts they should be receiving from their disability insurance policies. We know the information insurance companies need to see but won’t ask for outright. If your ability to work is limited due to a shoulder injury, we invite you to call us at 888-699-4222 or contact us online for a free consultation to learn more about how we can help you obtain the full amounts available in your situation.