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What is a Neuromusculoskeletal Limitation in an LTD Policy?

What is a Neuromusculoskeletal Limitation in an LTD Policy?

Some group long-term disability policies contain neuromusculoskeletal restrictions, which limit the duration of benefit payments for some related medical conditions, usually to 24 months. These limitations typically refer to neuromuscular, musculoskeletal, or soft tissue disorders. Relevant medical conditions could include diseases or disorders of the spine, extremities, or soft tissue, including muscle and joint strains and sprains. In many cases, the limitation restricts coverage for these medical conditions, with a few exceptions. Specifically, there must be objective evidence of seropositive arthritis, spinal tumors, radiculopathies, or a few other conditions.

The problem with these broad exclusions is that they can prevent or limit coverage for a wide range of medical conditions, many of which are severely disabling. For instance, they arguably could limit common orthopedic and neurological conditions, such as herniated discs and degenerative disc disease. Even though MRIs and other tests can provide some objective evidence of these conditions, even testing may not be able to definitively pinpoint the source of the pain. Many diagnoses of neuromusculoskeletal disorders arise from a combination of testing and patient-reported symptoms. In the past, some insurance companies have attempted to limit benefits for conditions based on insufficient objective evidence.

These limitations underscore the need for individuals to look carefully at their long-term disability policies for exclusions before they ever need to file for long-term disability claims. Very few people would assume or realize that they were limited to 24 months of benefits for specific neuromusculoskeletal disorders or related conditions.

Bonnici Law Group has the experience and knowledge that you need as you seek the long-term disability benefits that you deserve. We know how to help you create and maintain a strong claim for benefits based on evidence of your disabling conditions and obtain the best outcome possible in your case. Do not hesitate to contact Bonnici Law Group at 619-259-5199 or help@bonnicilawgroup.com.

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