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Question

How do I manage the conflict between standard of care medicine and my approach to joint health and still win my LTD claim?

Asked on October 11th 2023 by Whole body osteoarthritis

I have a very bad degenerative musculoskeletal condition affecting many joints. Standard of care medicine prescribes nonsteroidal, anti-inflammatory drugs (NSAIDs) for my condition. These archaic drugs do nothing more than mask the pain in the short term at the expense of shutting down a vitally important part of your physiology. There is growing concern supported by several studies that these drugs actually accelerate disease progression long-term. I also believe philosophically that pain is a signal from your body telling you that your joints cannot take a given level of stress anymore. Masking the pain to enable a continuation of activities that exacerbate the pain is medically irresponsible. Hence, I choose to avoid NSAIDs even if a doctor recommends them and rely on expensive, out of pocket regenerative medicine procedures such as PRP instead. In my view, I am disabled at the point when I cannot continue working without NSAIDs. I’m sure the insurance company will disagree. How do I manage the conflict between standard of care medicine and my approach to joint health and still win my LTD claim?

Answer

Answered on October 11th 2023 by Attorney Stephen Jessup

That is a very good question and a situation many people find themselves in. The best way to stack the cards in your favor is finding treatment with a doctor who shares your approach such as a functional medicine practitioner or regenerative medicine. I have had clients who live in states where medical marijuana is legal and have ceased taking the standard list of pain killers in favor of the medical marijuana and insurance companies do accept that. The problem arises when one's treating physician is at odds with what the patient wants as it relates to care and either stops treating, refuses to complete claim forms, or agrees with an insurance company doctor opinion regarding care/restrictions and limitations/etc. One other thing to keep in mind is the language in the policy as more carriers are also writing 24 month limitations for neuromuscular, musculoskeletal, soft tissue disorders with limited exceptions to the application of the policy limitation. There are other pieces of the puzzle to be able to add to a claim due to a musculoskeletal condition to establish disability. Please feel free to contact our office to discuss your situation in greater detail.

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