A bad knee can end a career on your feet: nursing, teaching, retail, construction, warehouse work, anything with standing, walking, climbing, or kneeling. Long-term disability insurers usually accept that during the own-occupation period. Then they make a predictable argument: you can sit at a desk, and sitting does not require knees.
For many people with serious knee problems, that is not true. Here is how to build the claim.
Conditions this page covers
Osteoarthritis, meniscus and ligament tears, chronic instability, failed or repeated surgeries, knee replacement, and complications after replacement. Many people have both knees involved, or knee problems on top of back or hip problems.
Why insurers push back
- “Sedentary work.” The insurer agrees you cannot stand all day and says you can sit.
- “Excellent surgical result.” After a replacement, a surgeon’s note that the implant looks good on X-ray, or that you are “doing well,” is treated as proof you can work.
- You can walk. A note that you walked into the office without a cane, or surveillance of you walking through a store, is used against you.
The evidence that matters
- Imaging: X-rays showing joint space loss and arthritis, and MRI showing tears and damage.
- Exam findings recorded over time: measured range of motion, swelling, instability, crepitus, and abnormal gait.
- Treatment history: physical therapy, injections, bracing, medications, and each surgery, with how you responded.
- Assistive devices: a prescription for a cane, walker, or brace, and your doctor’s note that it is medically necessary.
- A functional capacity evaluation, if your claim is disputed.
Limits to document
- how long you can stand and walk at one time, and in total in a day,
- how long you can sit with your knee bent before stiffness and pain force you to move,
- whether you need to elevate your leg, how high, how often, and for how long,
- climbing stairs, kneeling, squatting, and crouching,
- use of a cane or other device, and whether it is needed for all walking or only some,
- swelling and flare-ups, and how many days a month they keep you down, and
- medication side effects.
Why knee limits can rule out desk work
This is the core of most knee claims after the any-occupation switch.
Sitting is not free. Many people with knee arthritis or after replacement stiffen when they sit with the knee bent and must stand and move regularly.
Elevation. If your doctor says you must elevate your leg, at or near waist height, for part of the day, that is very hard to do at a typical desk. Make sure the requirement, the height, and the time are written down, with the medical reason, such as swelling.
Getting there. Even a desk job requires walking from the parking lot, around the office, and to the restroom. A medically required cane occupies one hand.
Combined conditions. Knee problems combined with back, hip, or weight-bearing problems on the other side multiply each other’s effect. Your doctors should consider all of them together.
When the insurer’s vocational consultant lists sedentary jobs, check whether it considered your elevation, position-change, and walking limits. More: My insurer says I can do sedentary work.
After a knee replacement
Recovery takes time, and results vary. Make sure your surgeon’s follow-up notes describe what remains: range of motion, swelling, pain, walking tolerance, and need for a cane, not just that the implant is well positioned. If you have had complications, revisions, or ongoing pain after replacement, those records are central to your claim.
Own occupation
During the own-occupation period, document the physical demands of your actual job: hours on your feet, walking distances, stairs, kneeling, lifting patients or stock. A job description and a supervisor’s statement help. More: Own occupation vs. any occupation.
Be accurate
If you can walk through a grocery store with a cart but then need to elevate your leg for an hour, say exactly that. Surveillance of a short walk is far less damaging when your records already explain what happens afterward. More: Can they cut me off because I drive, shop, or travel?
What to do now
- Ask your doctor to record measured range of motion, swelling, and gait at visits.
- If you must elevate your leg or use a cane, ask your doctor to say so in writing, with the reason.
- Keep a log of how long you can sit, stand, and walk, and how often you elevate your leg.
- Document every surgery and how you recovered.
- Know when your policy switches to any occupation.
Denied or cut off for a knee condition? Call 770-351-0801 or request a free case evaluation.
Related: Severe back pain · Why your doctor must describe limitations · Mistakes that sink LTD claims