Meralgia paresthetica, also known as Bernhardt-Roth syndrome, is a physical medical condition caused by compression of the lateral femoral cutaneous nerve. Symptoms include burning sensations, numbness, and tingling in the outer thigh. The compression of the nerve that supplies sensation to the skin surface of the thigh causes meralgia paresthetica. Patients may experience an aching sensation in the groin or sensitivity to a light touch on the outside of the thigh.
Common causes include:
- Weight Gain;
- Constrictive (tight) clothing;
- Hip or back surgery; and
- Standing or walking for long time periods.
However, meralgia paresthetica may also be caused by local trauma or a disease, such as diabetes.
As discussed in the article “Meralgia Paresthetica, The Elusive Diagnosis“, meralgia paresthetica is not an uncommon condition and in most cases is not serious. If the cause is addressed, it usually goes away on its own. It is frequently misdiagnosed as other conditions, which can cause it to worsen and may lead to significant disability if the underlying cause is not found.
Diagnosing Meralgia Paresthetica
A physician will conduct a thorough physical exam to understand the extent of the symptoms and the possible causes. They will ask if you have had any recent surgery, what medicines you take, and other conditions that you may have. Your doctor will also ask about your lifestyle, such as your clothing choices and how long you must stand or walk at your job.
Your doctor may also order additional diagnostic tests to be sure of your condition. Possible tests include:
- MRI or X-ray of the hip and back;
- Electromyography (EMG);
- Nerve conduction velocity studies of the area; and
- Nerve block of the area (if the pain immediately goes away, this is a positive test result for meralgia paresthetica).
Treating Meralgia Paresthetica
Treating meralgia paresthetica depends largely on the root cause of the condition. Addressing the cause is usually enough to decompress the nerve and relieve the pain. Even if the pain may be caused by something else, losing weight and wearing loose clothing can help relieve symptoms. Over-the-counter pain relievers like Ibuprofen can offer temporary relief. Massage and physical therapy can both relieve pain and prevent the problem from reoccurring. If conservative measures are not enough, prescription medication and even surgery may be an option. Even in severe cases, medication is usually enough to treat the pain.
Disability Evaluation of Meralgia Paresthetica
Generally, cases of meralgia paresthetica are not severe enough to qualify as a disabling condition. However, some severe cases may limit people from working or normal life activities. People who cannot work because of their meralgia paresthetica must apply for Long Term Disability (LTD) benefits. The insurance company will review their claim to see if they qualify under the terms of the plan.
Definition of Disability
Most LTD plans consider a person disabled if they have a medical condition that causes them to 1) be unable to perform their work duties for the first two years of the policy and 2) be unable to work in almost any job for the following years. Each LTD plan defines disability as slightly different, so look over your plan policy to see how your plan determines “disabled.”
Evaluating Disability for People with Meralgia Paresthetica
You must prove that your meralgia paresthetica keeps you from doing your old job or any job that you could be trained to work and that the condition will last for at least a year. The insurance company will look to see if your symptoms match closely with another condition in the Blue Book, the document the Social Security Administration (SSA) uses to list conditions that are recognized as disabling. Chronic pain is the condition that the SSA uses to compare against cases of meralgia paresthetica.
Pain is evaluated on:
- How your everyday life is affected;
- The location, frequency, intensity, and duration of your pain;
- What causes, worsens, or relieves your pain;
- Medications used to treat pain and their side effects;
- Any treatments you have used to alleviate your pain and their effectiveness; and
- Any other factors that affect your pain.
The insurance company will also look at the Residual Functional Capacity (RFC) form to determine the extent of your symptoms and how they may keep you from working.
What the Insurance Company Needs from You and Your Medical Providers
It is important to tell the insurance company about any doctor that has seen you for your meralgia paresthetica. The insurance company will need to obtain all relevant medical records to get the full picture of your health. If for any reason they cannot get these records from your doctors, you should request them and provide them to the insurance company yourself. Important records to include are:
- Physician notes;
- Physical therapy notes;
- Diagnostic test results; and
- Surgical notes.
You will need to provide proof of your diagnosis and your ongoing symptoms, as well as proof of how you are affected by your symptoms. If your doctor diagnosed you by clinical assessment, you may want to get additional diagnostic testing to help your case. Providing detailed documentation is key to a successful claim. Residual Functional Capacity (RFC) assessments determine how you are affected by the condition and what you can do despite your limitations. It is used to determine what jobs you may still be qualified to perform.
Working with a Disability Attorney
An experienced disability attorney will give you the best chance of getting the disability benefits you deserve for your meralgia paresthetica. Even if you have been denied disability benefits, that does not mean you are out of options. It is not unusual to be denied the first time you apply. You have the right to file an appeal and try to get more information that may help your case. Getting expert help is often the difference between being denied and being approved for benefits.
While the process can be intimidating, your disability attorney is an expert on the process. Since they receive their payment from awarded funds, they do not get paid unless you win your case. You can seek help without worrying about upfront costs or unexpected bills.
The Ortiz Law Firm has successfully represented people in disability cases across the United States. If you would like to talk to one of our experienced disability lawyers about your meralgia paresthetica and its impact on your ability to work, call us at (888) 321-8131. We would be happy to evaluate your case and to discuss how to help you through the process.