If you cannot work due to an upper extremity amputation, you may be able to pursue long term disability (LTD) benefits. The upper extremity impairment long term disability attorneys of Abell and Capitan Law focus on long term disability insurance law. Though our physical bases are in Philadelphia, PA, and Louisville, KY, we support clients across the country in documenting their disabilities, filing strong long term disability applications, and appealing denials. Contact our office today at (267) 419-7888 for a no-cost, no-obligation case review.
What Are Upper Extremity Amputations?
Researchers estimate that roughly 500,000 Americans have an upper extremity amputation, which is a third of the nation’s total amputee population. Someone may need amputation surgery if they have a severe injury or disease and efforts to spare the limb fail. No matter the reason for an upper extremity amputation, it will significantly impact a patient’s professional life, perhaps leaving them unable to work altogether.
Upper extremity amputation is the loss of:
- The hand at the wrist
- One or more fingers
- The forearm
- The entire arm, below or above the shoulder
A doctor may recommend one of these amputations if someone sustains a traumatic injury to their limb and no options are available to save it. However, amputation could also be a complication of certain medical conditions, such as:
- Vascular disease – Narrowing blood vessels and restricted blood flow could lead to tissue death over time, potentially necessitating the removal of the limb.
- Frostbite – Excessive exposure to cold temperatures can kill tissue and may require amputation.
- Cancer – Certain severe forms of soft or connective tissue cancer may require amputation to prevent them from spreading to other areas of the body.
- Sepsis – While sepsis is treatable if addressed early, doctors may recommend amputation if there is no other option to stop severe or prolonged infection.
Upper extremity amputations are life-altering. After you are discharged from hospital care, you may need to “re-learn” how to perform everyday tasks, such as eating, dressing, bathing, or writing. While prosthetic equipment may help you regain some of your normal function, you may still grapple with depression and grief, mourning the loss of your limb. You may also experience chronic “phantom pain” in or near the stump area.
How Could Long Term Disability Benefits Help?
Your employer may provide you with long term disability coverage from a private insurer, such as Anthem or MetLife. Or perhaps you bought your own long term insurance coverage. This coverage will provide the portion of your lost wages specified in the policy if you sustain a qualifying injury or medical condition during your employment.
Private long-term disability plans come in many forms, and eligibility requirements vary. You should obtain a copy of your policy and determine the following information:
- What “disability” means – Your policy will contain information on what constitutes a disabling medical condition.
- What “unable to work” means – With some policies, you may only qualify for benefits if you cannot work in any field due to your disability. Other policies are less strict, only requiring that you are unable to work in your specific occupation.
- What conditions are excluded – Some long term disability plans will exclude certain named conditions from eligibility. They may also exclude disabling injuries someone sustained under specific circumstances, even if they would otherwise qualify.
- What “pre-existing conditions” are – To be eligible for benefits, you must have had coverage before you became disabled. Many insurers will conduct more detailed investigations if you become disabled within a year of the policy’s start date. If they deem a condition “pre-existing,” they will likely deny benefits for it.
- How eligibility or benefits change – Certain terms of your LTD plan may change over time. For example, the longer someone has coverage, the stricter their plan’s eligibility requirements may become. In some cases, benefits cease after a specified period of time, regardless of whether your condition remains the same.
If you have questions about any aspect of your policy, don’t hesitate to ask your lawyer.
Documenting Amputation for an LTD Application
When preparing an application for long-term disability benefits, it’s essential to document the specifics of how your amputation occurred and how it affects your ability to work.
Medical documentation is the most critical component of an LTD application. You and your medical team should answer questions such as:
- What portion of your limb was removed, and why?
- What surgical procedures did you undergo?
- What do X-rays, CT scans, MRIs, or other medical images indicate?
- What were the results of relevant blood work?
- What prescription drugs, medical devices, and/or prosthetics do you use for treatment?
- If your amputation was related to another medical condition, what treatments have you tried that failed?
- How does the amputation affect your mental health?
- How does the amputation affect your ability to work in your current role?
- How does the amputation affect your ability to work in another occupation?
How We Serve Clients
Abell and Capitan Law can offer support wherever you are in the long term disability process. Our services include:
- Application support – We can help you understand your policy, determine whether you might qualify for benefits, and secure the documents you need to apply. Retaining counsel as you file your application can save you time and money, especially if your situation is particularly complex.
- Appeals – If the insurer denies your application or alters your benefits, we can represent you in the appeals process and fight for the best possible outcome in negotiations.
- Negotiation support – If an insurer offers to pay you a lump sum in place of recurring benefits, we can represent you in negotiations and fight for the most ideal outcome.
Contact Us Today
If you’re pursuing LTD benefits after an arm, hand, or finger amputation, let the nationwide disability attorneys of Abell and Capitan Law be your guides and advocates. Attorneys Erik Abell, Joe Capitan, and Greg Scott stay up-to-date on the federal laws governing long-term disability insurance and tailor our services to meet each client’s unique situation. We don’t charge fees unless we get you the benefits you deserve. Don’t wait to call our office at (267) 419-7888 for a free initial consultation.