Denial of Long Term Disability Benefits

Older woman using a walker with a therapist in rehab facility

61-year old woman with diagnoses of spinal stenosis, cervical spondylosis, and lumbosacral disc degenerative disease.

Claim for continued LTD benefits after receiving LTD and SSD for five years was denied by the carrier, based upon an Independent Medical Exam and Transferrable Skills Assessment by carrier’s Vocational Rehabilitation Specialist that found her capable of performing Sedentary work.


Last employed as a registered nurse in July 2009


Limited independent performance of daily activities; brief stand and ambulate with a quad cane; dependent on family for homemaking


  • Limited and painful cervical and lumbar spine and shoulder mobility
  • Significantly reduced hand grip strength bilaterally
  • Ability to perform isolated coordinated hand movements, but only very briefly, with increased hand/arm and neck pain, and need for intermittent breaks
  • Inability to maintain an upright seated posture for more than 30-40 minutes, with need to sit in a semi-reclined posture with head and neck support
  • < 10 minute tolerance to type at a very slow rate (< 10 words per minute) in a semi-reclined posture for majority of the 2-day evaluation
  • Significant difficulty completing basic clerical tests that require sustained viewing and focus
  • Stand tolerance and slow walk tolerances of < 10 minutes, each, with cane support
  • Ability to negotiate steps very slowly with non-reciprocal foot placement, rail and cane support
  • Occasional abilities to lift and carry < 5 pounds with neck and arm pain


Mary is unable to resume work as a nurse that is associated with Medium physical demands, or any of the recommended alternative jobs associated with Sedentary or Light physical demands that could utilize her 30 year nursing experience based on a Transferrable of Skills Analyses.

Objective evidence based on the two day Functional Capacity Evaluation testing found that Mary demonstrated significant limitations in mobility, strength, lift and carry, sit and stand tolerances which the physician had incorrectly assessed on a Residual Function checklist and which then served as a faulty premise on which the Vocational Analyst made assumptions regarding this nurse’s abilities to resume work after being on claim for five years..