Insurers often treat neck and shoulder problems as a reason you cannot do heavy work, and nothing more. “Sedentary work,” they say, “doesn’t require lifting.” But desk jobs require something else: using your arms and hands all day, reaching for the keyboard and mouse, and holding your head still while you look at a screen. For many people with cervical spine or shoulder conditions, those are exactly the things they cannot do.
Conditions this page covers
- Cervical spine: degenerative disc disease, herniated discs, spinal stenosis, nerve root compression (radiculopathy), spinal cord compression (myelopathy), and cervical fusion surgery.
- Shoulder: rotator cuff tears, impingement, frozen shoulder, arthritis, labral tears, and shoulder surgery or replacement.
Many people have both, and neck problems often cause pain, numbness, and weakness down the arm.
Why insurers push back
- “Successful surgery.” Example: three months after cervical spine surgery, the surgeon notes the procedure was a success and pain has improved. The insurer treats the note as proof you can work, while you still have limited neck movement, arm weakness, ongoing pain, medication side effects, and cannot sit at a computer for long.
- Sedentary means no lifting. The insurer focuses on lifting limits and ignores reaching, handling, and neck position.
- One good arm. If only one side is affected, the insurer may argue you can work with the other, even if it is your non-dominant arm.
- Normal neurological exam. As with back pain, a normal exam on one day is treated as the whole picture.
The evidence that matters
- Imaging: MRI or CT of the cervical spine; MRI or ultrasound of the shoulder.
- Nerve testing: EMG and nerve conduction studies documenting radiculopathy or other nerve damage.
- Exam findings: measured range of motion of the neck and shoulder, strength testing, reflex and sensory changes, and grip strength, recorded at more than one visit.
- Treatment history: physical therapy notes (which often record measured range of motion and pain response), injections, medications, and surgery.
- A functional capacity evaluation, which can measure reaching, handling, and lifting directly.
Limits to document
The limits that decide neck and shoulder claims are often not about lifting. Ask your doctor to address:
- Reaching, overhead and forward, for each arm, and how often.
- Handling and fingering: gripping, keyboarding, writing, and using a mouse, and for how long.
- Neck position: how long you can look down at a desk or screen, or hold your head still, before pain increases.
- Sitting tolerance, since many people with cervical problems cannot sit upright for long without increased neck and arm pain.
- Lifting and carrying, for each arm.
- Headaches that start in the neck, how often, and how long they last.
- Medication side effects on concentration.
- Absences for flare-ups, injections, and therapy.
Which arm is dominant, and whether both are affected, should be in the record.
Why these limits matter for desk work
Most office jobs require frequent use of both hands and arms: typing, filing, answering phones, and handling paper. If you can reach forward only occasionally, or keyboard only 10 to 15 minutes at a time, many sedentary jobs drop off the table. When the insurer’s vocational consultant lists jobs, check whether it considered your reaching and handling limits, not just lifting. More: 5 reasons the vocational report may be wrong and My insurer says I can do sedentary work.
After surgery
Surgery is often the turning point for an insurer’s review. Make sure your follow-up records describe what remains: range of motion, strength, pain, numbness, and work limits, not just that the fusion is solid or the repair is intact. If your surgeon releases you to “full duty” without examining your actual job demands, ask your surgeon to clarify what that means for your occupation.
What to do now
- Tell your doctor specifically how your neck or shoulder affects typing, reaching, and looking at a screen.
- Ask that range of motion and strength be measured and recorded at visits.
- Keep a log of how long you can type, read, or look down before you must stop.
- Ask your doctor about a functional capacity evaluation if your claim is disputed.
- Read your policy’s definition of disability and know when it changes.
Denied or cut off for a neck or shoulder condition? Call 770-351-0801 or request a free case evaluation.
Related: Severe back pain · Carpal tunnel syndrome · Why your doctor must describe limitations