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Cancer and Long Term Disability Insurance Policies

Attorney Stephen JessupAuthor: Attorney Stephen Jessup

It seems that instances of cancer are running rampant these days. Almost daily it seems as if there is a new study documenting the rise of certain types of cancers, deaths associated to cancer, and new medical treatment to combat the flowing tide. It would seem that with such a seeming epidemic that securing disability insurance benefits due to a diagnosis of cancer, or due to the lingering effects of treatment would not be difficult. Unfortunately, this is not always the case.

Diagnosis does not equal Disability

This premise is crucial to understanding how an insurance company is going to review any claim for disability benefits. Typically there are three scenarios that often occur with someone who has/has had cancer and claims for disability benefits:

1) Undergoing intense active treatment that prevents the person from working

In this situation it is more than likely that an insurance company will approve the initial claim for benefits while treatment is being rendered and the person is unable to work. However, as detailed further down in this article, once the treatment is over and the cancer is in remission it can be expected that the insurance company will scrutinize the claim.

2) Undergoing treatment but not experiencing absence from work or a loss of income

If there is no decline in the ability to work – be it time, money or ability on account of your medical condition, then the chances of a claim denial are high. People who are so driven to work, despite the toll it may take on their health while undergoing treatment, often fall into this category. If there is no discernible effect on one’s ability to work the insurance company will likely deny the claim. This scenario is typically one in which we refer to as “working for the insurance company” in the sense that continuing to work, despite the toll it takes on your health, you are saving the insurance company from having to pay you benefits you may be entitled to.

3) Cancer is in remission and the lingering effects of treatment are causing disability.

This scenario is unfortunately all too common. Whether it be “chemo brain” or lingering fatigue from treatment many people continue to suffer symptoms and side effects that impact not only their ability to work but also their day to day functioning. Claims for disability benefits based on these circumstances are often met by the insurance company as completely subjective in nature (akin to how they treat chronic pain or chronic fatigue conditions). What makes this even worse is that the insurance company’s position will frequently be that you are “cured” and since there is no “active cancer” there is no diagnosis and thus no disability.

What do you need to do to enforce your rights under your policy?

Like any claim for disability benefits you must make sure that your doctor is properly documenting your medical problems in a detailed, clear and concise manner. This becomes particularly important if your claim for disability benefits is as a result of scenario 3 above. If you have or had cancer and you are thinking about filing a claim for benefits under a private or group disability please feel free to contact our office for a free consultation to determine how we can assist you in enforcing your rights under your policy.

For more information about this topic please visit our cancer disability claims section of the website.



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