Why are LTD disability claims usually terminated or denied?

Every claim is decided individually, but long-term disability insurance companies often follow the same playbook when coming up with reasons to deny benefits.  Finding a long term disability lawyer who knows that playbook can help you respond quickly and effectively to a wrongful denial of your benefits.

Some of the Reasons we see over and over again for denying or terminating benefits:

You can still perform your “regular occupation.”

Most policies don’t look at your job the way you performed it, but instead, rely on an arcane publication called the “Dictionary of Occupational Titles.”  Most of the job descriptions in this publication haven’t been updated since the late 70s, and so they very rarely accurately portray modern work requirements.   By relying on this publication, the insurance companies can find you capable of performing your “regular occupation,” even if it barely resembles what you actually did every day.

There are no “objective findings” to support your disability. 

This gets used by insurance companies most often when someone is disabled based on pain, fatigue, or other subjective symptoms, even when those symptoms are caused by an objectively diagnosed illness.  Denials like this provide almost universal cover for insurance companies to reject any limitations based on symptoms they can’t objectively measure.  Unfortunately, some policies exclude subjective limitations based on pain, fatigue, or other symptoms.  But, if your policy does not contain this kind of exclusion, the insurance company cannot deny your claim simply because there is no easy way to “measure” your disability.

Terminating after 24 months due to a mental health limitation.

This is a very common move by insurance companies.  Most policies limit disabilities that are based in whole or in part on mental health limitations to a maximum period of 24-months.  After this period, you have to prove that your disability is solely due to physical conditions.  This is a convenient cut-off for insurance companies since most people who are disabled struggle with some degree of depression and/or anxiety as they face the reality of no longer being able to earn a living.  Showing that any psychiatric symptoms are solely secondary to underlying physical conditions can sometimes be an effective strategy to overcome this tactic.

We help disabled workers fight denials and terminations regardless of the reason for the denial.  We have helped other professionals, attorneys, physicians, and executives, who often have a particularly hard time proving disability due to their advanced educations and experience.  Likewise we work with clients from team members at Wawa to engineers at Lockheed Martin and everywhere in between.  Disabilities don’t discriminate and neither do insurance companies in their efforts to deny benefits.

If you suffer from lumbar or cervical spine pain, chronic fatigue or fibromyalgia, Lyme’s Disease, Multiple Sclerosis, autoimmune diseases, inflammatory bowel disease (crohn’s or colitis), or any other serious health problem that prevents you from working, call or message us today for a free claim review.

Comments are closed.