Long Term Disability Lawyers

04/06/2026

🧵 Failed Back Surgery Syndrome & Long Term Disability Insurance
Back surgery is often expected to “fix” the problem. But for many people, pain and limitations persist—or worsen. This is known as Failed Back Surgery Syndrome (FBSS).
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1️⃣ What is Failed Back Surgery Syndrome?
FBSS isn’t a single diagnosis. It refers to ongoing pain, nerve symptoms, or functional limitations after spinal surgery, even when the procedure was technically successful.
2️⃣ Common FBSS symptoms include:
• Chronic low back or leg pain
• Nerve pain (radiculopathy)
• Weakness, numbness, tingling
• Inability to sit, stand, or walk for long periods
• Pain that worsens with activity or posture
3️⃣ Why FBSS often leads to disability claims
Insurance companies often expect surgery to be “corrective.” When symptoms continue, claims may be questioned—even though FBSS can cause lasting functional impairment.
4️⃣ Disability insurance focuses on function, not labels
Long term disability claims are evaluated based on things like:
• Sitting/standing tolerance
• Consistency and attendance
• Ability to concentrate through pain
• Medication side effects
Not just imaging or a diagnosis.
5️⃣ Common challenges FBSS claimants face
• Pain dismissed as “subjective”
• Imaging labeled as “post surgical changes”
• File reviews replacing real exams
• Repeat functional testing
• Surveillance or social media review
6️⃣ Medical proof matters
Strong FBSS disability claims usually include:
• Consistent treatment records
• Imaging showing nerve or degenerative changes
• Pain management or neurology notes
• Clear physician statements describing work limitations
7️⃣ Key takeaway
Failed Back Surgery Syndrome is a real and recognized cause of long term disability. Surgery does not automatically restore work capacity—and many people remain disabled despite appropriate care.
8️⃣ Understanding how insurers evaluate FBSS claims—and how limitations are documented—can make a significant difference in the outcome of a long term disability claim.
Educational insight from the Law Office of Justin C. Frankel, P.C.

03/31/2026

🧵 ERISA Long Term Disability Denied? Here’s What to Know About Appealing ⬇️
If your employer provided LTD claim was denied, ERISA gives you rights—but also strict deadlines. A few basics every claimant should understand:
1️⃣ Is your plan governed by ERISA?
Most private, employer sponsored LTD plans are. Government plans, most church plans, and individual policies usually are not. This matters because ERISA controls how appeals and lawsuits work.
2️⃣ The most important deadline: 180 days
You usually have at least 180 days from the denial letter to file your appeal. Miss it, and you may permanently lose your right to benefits—even if you’re disabled.
3️⃣ What insurers must do on appeal
After you submit an appeal, the insurer generally has 45 days to decide, with one possible 45 day extension (they must explain why in writing).
4️⃣ You’re entitled to a “full and fair review”
That means: • Specific reasons for the denial
• Access to your entire claim file
• A chance to see and respond to new medical or vocational evidence before a final decision
• A fair, impartial decision maker
📌 Tip: Request the full claim file and plan documents in writing, early in the appeal.
5️⃣ Your appeal is often your last chance
In most ERISA cases, a court reviews only the record created during the administrative appeal. No do overs. That means your appeal should include: • Updated medical records
• Treating physician opinions (focused on functional limits)
• Medication side effects
• Functional capacity evidence
• Vocational analysis tied to your actual job
6️⃣ Watch for procedural errors
Insurers must follow strict rules. Failures like vague denial letters, missed deadlines, or relying on new evidence without disclosure can help claimants—and may change how a court reviews the case.
7️⃣ Why the “standard of review” matters
• Courts usually defer to insurer decisions unless ERISA rules are violated
• Conflicts of interest matter when insurers both decide and pay claims
• In NY and the Second Circuit, insurers must strictly comply with ERISA procedures—or lose deference
Bottom line:
A strong, well documented ERISA appeal can be the difference between benefits and a final denial—and it shapes everything that happens later.
This thread is for educational purposes only and is not legal advice.

03/23/2026

Chiari Malformation & Long Term Disability: What Claimants Should Know
Chiari malformation happens when brain tissue presses into the spinal canal, often disrupting cerebrospinal fluid flow. Symptoms vary widely — from severe headaches triggered by coughing or strain, to neck pain, dizziness, balance issues, numbness/tingling, swallowing difficulties, and tinnitus. For many, these symptoms make consistent work impossible.
If you’re filing for long term disability (LTD) due to Chiari malformation, here’s what matters most:
🔍 Strong Medical Evidence Is Everything
Your doctors should clearly document:
• Diagnosis and imaging results
• Symptom frequency and severity
• Functional limitations (balance, concentration, sitting/standing, fine motor tasks)
• Why you cannot perform your job’s essential duties
Vague or inconsistent medical notes can hurt your claim.
🗂️ Be Precise About Your Job Duties
Your employer’s description of your role influences how the insurer evaluates your disability. Make sure it reflects the actual physical and cognitive demands of your job.
🛂 Expect a Detailed Review
Insurers may:
• Request additional forms
• Contact your employer
• Use their own medical reviewers
Neurological claims often undergo extra scrutiny and may take weeks or months.
📁 Consistency Protects Your Claim
Keep everything:
• Medical records
• Forms and statements
• Symptom logs
• Employer correspondence
Complete, organized documentation reduces the risk of denial.
💡 For Claimants Living With Chiari Malformation
Symptoms often fluctuate, and insurers don’t always understand how deeply this condition impacts daily functioning. A clear, well supported LTD claim gives you the best chance at a fair outcome.

Law Office of Justin C. Frankel, PC
📞 Call us today for a consultation
T: 888.583.4959
T: 516.222-1600
🌐 Visit: www.jfrankellaw.com

03/20/2026

What Long Term Disability Policies Are Governed by ERISA?
ERISA (the Employee Retirement Income Security Act of 1974) governs most private sector, employer sponsored long term disability (LTD) benefit plans. It typically does not govern government or church plans, and it generally does not govern individual LTD policies you buy yourself.
ERISA in one minute
ERISA is a federal law that sets minimum standards for employee benefit plans in the private sector, including disability, health, and other welfare benefits. It requires fair claim procedures, disclosure, and fiduciary duties—and gives participants the right to sue for benefits and breaches of fiduciary duty.
Which LTD policies are ERISA governed?
• Employer sponsored group LTD plans offered by private sector employers or unions (i.e., “employee benefit plans”).
• These plans must follow ERISA’s claims procedure regulation (29 C.F.R. § 2560.503 1), which sets deadlines and appeal rights for disability claims and appeals.
If your LTD is part of an employer benefits package (with a summary plan description/“SPD”), it’s very likely subject to ERISA.
Which LTD arrangements are not governed by ERISA?
• Government plans (federal, state, or local employers).
• Church plans (unless they elect ERISA coverage).
• Plans maintained solely to comply with workers’ comp, unemployment, or state disability insurance laws.
• Individually purchased LTD policies (you buy the policy directly, not through your employer). These are typically governed by state contract/insurance law, not ERISA.
Why ERISA status matters to claimants
Process & deadlines.
ERISA plans must follow federal claim and appeal timelines (e.g., a decision on the initial disability claim within 45 days, with limited extensions; and an appeal decision within 45 days, with one 45 day extension for special circumstances).
Forum & remedies.
ERISA disputes are usually litigated in federal court and often decided on the administrative record; remedies primarily focus on the benefits due and fees, not punitive damages. By contrast, disputes over individual (non ERISA) policies are governed by state law (including potential “bad faith” remedies in some states).
How to tell if your LTD is ERISA governed (quick checklist)
1. How did you get the policy?
o Through a private sector employer or union → Likely ERISA.
o Bought it yourself from an insurer/agent → Likely non ERISA.
2. Look for plan documents.
o Summary Plan Description (SPD) or a wrap plan document points to ERISA coverage.
3. Who is the sponsor?
o Government employer or church/faith based organization → typically ERISA exempt.
4. What law is referenced?
o If the claim/appeal procedures cite 29 C.F.R. § 2560.503 1, it’s an ERISA plan.
If your LTD coverage comes from a private employer, ERISA almost certainly governs—and with it, strict timelines and specific procedural rights you can use to keep your claim on track. If you purchased your own policy, your rights and remedies are set by state law and the policy contract, not ERISA. Knowing which regime applies helps you meet deadlines, assemble the right evidence, and choose the right path if your benefits are denied.
Law Office of Justin C. Frankel, PC
📞 Call us today for a consultation
T: 888.583.4959
T: 516.222-1600
🌐 Visit: www.jfrankellaw.com

03/18/2026

Understanding Parkinson’s Disease and Filing for Long Term Disability Insurance

By: Law Office of Justin C. Frankel, PC

Parkinson’s disease (PD) is a progressive neurological disorder that can significantly affect a person’s ability to work. As symptoms advance, many individuals face challenges performing job duties safely, consistently, or at the level their roles require. For those covered by employer provided or private long term disability (LTD) insurance, understanding how to navigate a disability claim is essential.

This article provides an educational overview of Parkinson’s disease, how it impacts work capacity, and what to know when filing for long term disability benefits.

What Is Parkinson’s Disease?

Parkinson’s disease is a degenerative condition involving the loss of dopamine producing neurons in the brain. Although symptoms vary, they often begin subtly and worsen over time. Common symptoms include:

• Motor symptoms: tremors, stiffness, slowed movement (bradykinesia), balance difficulties
• Non motor symptoms: cognitive decline, depression, anxiety, sleep disturbances, fatigue, speech issues, autonomic dysfunction

Because symptoms progress gradually, individuals may continue working for years before the disease interferes with their ability to meet job expectations.

How Parkinson’s Disease Can Affect Work Capacity

Work impact depends on job type, disease stage, and individual symptom profile. Some of the most common work related limitations include:

1. Physical Limitations
Tremors, rigidity, and bradykinesia can interfere with:
• Typing or writing
• Using tools or machinery
• Lifting, carrying, or standing for long periods
• Fine motor tasks requiring precision

2. Cognitive or Executive Function Challenges
Parkinson’s may impair:
• Memory and focus
• Processing speed
• Decision making
• Multitasking
These changes can be especially disruptive in roles requiring complex thinking or fast-paced problem-solving.

3. Fatigue and Fluctuating Symptoms
“On/off” cycles—periods when medication is effective versus when symptoms return—can make work schedules unpredictable.

4. Speech and Communication Difficulties
Reduced vocal volume, slurred speech, or slower speech patterns may pose challenges in roles requiring frequent communication.

When Parkinson’s Disease May Qualify for Long Term Disability

Long term disability insurance policies generally require proof that a medical condition prevents you from performing the “material duties” of your occupation. Depending on the policy, this may involve:

• Own occupation standard: Whether you can perform your specific job.
• Any occupation standard: Whether you can perform any job for which you are reasonably qualified.

Parkinson’s disease can meet these definitions when symptoms—individually or in combination—make it unsafe or impossible to perform essential job responsibilities consistently.

Key Evidence Typically Required for a Parkinson’s LTD Claim

While every policy is different, most insurers look for comprehensive medical documentation. Strong claims often include:

1. Neurological Evaluations
These may show bradykinesia, rigidity, tremors, gait abnormalities, and cognitive assessments.

2. Imaging or Diagnostic Tools
While Parkinson’s is primarily a clinical diagnosis, tests such as DaTscan may support the record.

3. Medication Response Documentation
Records showing fluctuating symptoms, “on/off” periods, and side effects (e.g., dyskinesia, fatigue) help demonstrate functional limitations.

4. Functional Capacity Evidence
This may include:
• Physical performance tests
• Neuropsychological evaluations
• Speech or occupational therapy reports
• Workplace performance records

5. Statements from Treating Physicians
Detailed opinions describing how symptoms impact work-related tasks are often critical.

Common Challenges in Parkinson’s Long Term Disability Claims

Parkinson’s cases can be uniquely complex because:

• Symptoms may fluctuate, leading insurers to underestimate limitations.
• Early-stage Parkinson’s may appear mild even when symptoms significantly impact job performance.
• Cognitive impairments can be subtle, and documentation may require thorough neuropsychological testing.
• Insurance companies may expect continued work because Parkinson’s is often slowly progressive.

Understanding these hurdles can help claimants prepare complete and accurate submissions.

Practical Tips for Filing a Parkinson’s Disease LTD Claim

• Start documenting symptoms early. Even small changes matter when building a timeline of disability.
• Attend all medical appointments and follow recommended treatments so records remain consistent.
• Describe work difficulties in detail, focusing on specific job duties affected by symptoms.
• Monitor medication side effects, which can be disabling on their own.
• Keep a symptom journal to track fluctuations and their impact on daily functioning.

These steps help create the comprehensive evidence insurers typically require.

Parkinson’s disease affects every person differently, and its progression can make sustaining employment increasingly challenging. Understanding how long term disability insurance works, what evidence is required, and how symptoms translate into functional limitations can help individuals navigate the claims process more confidently.

This article is provided for educational purposes only and does not constitute legal advice. Those seeking guidance for a specific situation may wish to consult a professional familiar with long term disability insurance and neurological conditions.

Contact us today to discuss your claim and learn how we can help you move forward.

Law Office of Justin C. Frankel, PC
📞 Call us today for a consultation
T: 888.583.4959
T: 516.222-1600
🌐 Visit: www.jfrankellaw.com

03/12/2026

Yes. Radiculopathy can qualify as a disabling condition for Long Term Disability (LTD) benefits when it produces persistent, well-documented symptoms that prevent a claimant from performing the essential duties of their occupation. Below is a clear, client-facing explanation of why radiculopathy supports LTD claims, what insurers look for, and practical steps to build a strong claim or appeal.
What Is Radiculopathy
Radiculopathy is dysfunction of a spinal nerve root, most often in the cervical (neck) or lumbar (lower back) regions. It results from nerve-root irritation or compression caused by conditions such as herniated discs, spinal stenosis, or bone spurs. Because nerve roots carry sensory, motor, and reflex signals, radiculopathy commonly causes:
• Radiating pain into an arm or leg
• Numbness or tingling
• Muscle weakness or reduced coordination
• Abnormal reflexes
Symptoms may be intermittent or constant and frequently worsen with certain movements, prolonged sitting or standing, or physical exertion.
Why Radiculopathy Can Meet LTD Criteria
Insurers evaluate LTD claims by looking for:
1. Objective medical evidence of an impairment; and
2. A functional link between that impairment and the inability to perform essential job duties.
Radiculopathy often satisfies both elements because it can produce objective findings on imaging and electrodiagnostic testing and cause concrete functional limitations—such as difficulty lifting, grasping, sitting, standing, typing, climbing, or driving—that prevent performance of job demands.
Key Medical Evidence for an LTD Claim
• MRI or CT myelogram — Identifies structural causes of nerve-root compression (disc herniation, foraminal narrowing, central canal stenosis). Insurers expect the imaging level (e.g., C6–C7, L5–S1) to correlate with reported symptoms.
• EMG/Nerve Conduction Studies (NCS) — Provide physiologic evidence of nerve irritation or denervation and are highly persuasive because they go beyond subjective complaints.
• Detailed clinical records — Should document symptom history, neurological exam findings (strength, sensation, reflexes), treatment responses, and how symptoms limit daily and work activities.
• Functional restriction statements — Treating specialists (neurologists, physiatrists, spine surgeons) should specify sitting/standing tolerance, lifting limits, restrictions on bending/twisting/overhead work, hand-use limitations, need for breaks, and expected pain fluctuations. A narrative tying these restrictions to objective findings is essential.
• Vocational evidence — Employer job descriptions, identification of essential functions, and vocational expert analysis when needed to connect medical restrictions to an inability to perform the occupation.
Connecting the Condition to Job Duties
A successful LTD claim must show more than diagnosis; it must demonstrate that radiculopathy prevents performance of the job. This requires:
• Directly linking medical restrictions to specific occupational requirements.
• Explaining how radicular pain, numbness, or weakness interfere with job tasks.
• Describing the impact of medications, fatigue, and symptom variability on sustained work capacity.
• Clarifying why even light-duty or sedentary roles may be incompatible with severe radiculopathy.
Practical Steps to Strengthen a Claim or Appeal
• Submit complete MRI and EMG reports and images when possible.
• Obtain specific restrictions from treating specialists with narrative explanations.
• Keep a symptom and treatment journal documenting daily functional impact.
• Gather employer documentation: job descriptions, attendance records, accommodation requests.
• Consider independent medical or vocational evaluations when appropriate.
• Anticipate insurer pushback and prepare thorough medical, occupational, and narrative evidence.
Common Insurer Arguments and How to Counter Them
• “No objective findings.” → Provide imaging, EMG results, and documented neurological exams.
• “Symptoms do not match imaging.” → Have treating physicians explain anatomical correlation and variable presentations.
• “Claimant is not functionally limited.” → Supply detailed restriction forms, symptom logs, and vocational reports.
• “Condition is degenerative or preexisting.” → Document symptom progression, new objective findings, or functional decline tied to job duties.
When to Seek Legal Help and How We Can Assist
Consult an LTD attorney if you are filing a claim, facing denial, dealing with a biased IME, or confronting ERISA deadlines and appeals. Experienced counsel can ensure the record is fully developed—critical because ERISA appeals are often the last opportunity to submit evidence.
How the Law Office of Justin C. Frankel, P.C. can help:
• Review medical records and identify missing evidence;
• Work with treating specialists to obtain strong medical support and narrative reports;
• Organize imaging and EMG results into a compelling claim package;
• Coordinate vocational assessments and occupational analyses;
• Prepare and submit appeals.
Contact Us
If radiculopathy limits your ability to work and you need help with an LTD claim or appeal, contact the Law Office of Justin C. Frankel, P.C. for a case review and strategic guidance.
Phone: 888.583.4959 or 516.222.1600
Website: www.jfrankellaw.com

03/10/2026

# # # Proving Multiple Sclerosis for Long‑Term Disability — Quick Guide

**“Multiple Sclerosis (MS) is a wellrecognized neurological disease, but securing longterm disability (LTD) benefits requires more than a diagnosis.”**

If you or a loved one has MS and needs LTD benefits, insurers often accept the diagnosis but deny claims when the record doesn’t show how MS **objectively and specifically** prevents job performance. Below is a short, shareable checklist and next steps you can use right away.

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**What to gather now**
- **Neurology records** — clear diagnosis, subtype, relapse history, serial exams, EDSS or similar scores.
- **Up‑to‑date objective testing** — recent MRI (brain and spine), CSF/evoked potentials, neuropsych testing.
- **Treatment history** — disease‑modifying therapies, steroid courses, hospitalizations, medication side effects.
- **Detailed treating‑provider RFC** — specific, quantified limits (standing, walking, fine motor, concentration) tied to job tasks.
- **Objective functional testing** — FCE, 6‑minute walk, gait analysis, cognitive testing.
- **Workplace documentation** — job description, employer letters, ADA requests, performance/attendance records.
- **Daily symptom log** — dated notes on fatigue, relapses, days missed, recovery after exertion.

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**How to describe limits**
- Replace “unable to work” with **measurable** statements: *“Can stand 15–30 minutes before a seated break,” “Requires microbreaks every 15 minutes,”* or *“Unable to perform fine motor tasks for more than 30 minutes.”*
- Map cognitive test results to job tasks (e.g., reduced processing speed → cannot safely multitask for full shifts).
- For clinicians: explain how fatigue, balance, fine motor issues, or cognitive fog affect specific procedures.

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**If your claim is denied**
- Update MRIs and neuropsych testing if older than 12 months.
- Obtain a **detailed treating‑provider RFC** that lists frequency and examples tied to job duties.
- Consider independent evaluations (IME, FCE, neuropsych battery) to rebut insurer reviewers.
- **Engage an LTD/ERISA attorney early** — appeals are document‑driven and time‑sensitive.

**“Start by securing a detailed treatingprovider RFC and updating objective testing.”**

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**Need help?**
The Law Office of Justin C. Frankel, P.C. can review your file, suggest targeted evidence, and assist with appeals.
**Call:** 888‑583‑4959 or 516‑222‑1600
**Visit:** **www.jfrankellaw.com**

If this post helps, please **share** so others with MS know what evidence matters.

03/06/2026

https://www.linkedin.com/pulse/understanding-your-rights-when-filing-long-term-claim-justin-frankel-86mmc

Law Office of Justin C. Frankel, P.

03/05/2026

https://www.linkedin.com/pulse/fighting-24month-mentalnervous-limitation-longterm-claims-frankel-nedue

Law Office of Justin C. Frankel, PC Long‑term disability insurers increasingly rely on the 24‑month mental‑nervous limitation to cut off benefits for claimants whose disabilities involve depression, anxiety, PTSD, or other psychiatric conditions.

02/19/2026

https://www.linkedin.com/pulse/what-expect-during-independent-medical-examination-imeand-frankel-vvc6c

Law Office of Justin C. Frankel, PC If your disability insurer schedules an Independent Medical Examination (IME), you’re not alone.

02/16/2026

https://www.linkedin.com/pulse/how-surveillance-can-destroy-your-long-term-claim-justin-frankel-hkjsc

Law Office of Justin C. Frankel, P.