Why a Change in Disability Definition Can Result in Claim Denial
One of the top reasons for terminating a claimant’s long term disability benefits involves the change in the disability insurance policy’s definition of “disability.” This definition change often happens in conjunction with a vocational review, or an analysis of a claimant’s medical records that tells the insurance company which jobs the claimant should be able to perform. It’s crucial for long term disability insurance claimants to know what to expect from the vocational review process and what one’s medical records must show in order to continue to qualify for long term disability benefits.
Usually 6 months prior to the change in your definition of “disability” the insurance company will start reviewing the claim to determine your continued eligibility.
If you have a group or ERISA long term disability policy, you can usually expect your policy’s definition of disability to shift at around the 24-month mark. This means that after you’ve been on claim for a year and a half, the disability insurance company will begin digging into your medical records and claimant statements to see whether you’ll still qualify for benefits under the policy’s new definition of disability.
This new definition is the “any occupation” standard – that is, your benefits will continue only if your medical records and the vocational review show that you’re unable to perform any occupation, not just the last job you had before you went on claim.
What does a disability company vocational review involve?
The disability insurance company has a vested interest in denying benefits whenever it has a reasonable basis to do so – and since the insurance company undertakes this vocational review on its own, this can mean that it’s a fairly cursory process. It’s also common for the vocational reviewer to look at the types or levels of activities you can do on your best day and extrapolate this into a 40-hour-a-week job. It’s important for a claimant’s medical records to emphasize that even if the claimant can do certain tasks in moderation (like sitting, standing, walking, lifting, or bending), this alone isn’t enough for them to hold down gainful full-time employment.
Can the disability company just find any job and rely on that as a basis to deny long term disability benefits under the “any occupation” definition of disability?
Even under the “any occupation” definition of disability, you’re not necessarily expected to work a minimum wage position. The disability insurance company will take into account your education, skills, and prior positions, and it generally won’t consider a job to fall within the “any occupation” standard unless it pays 60 percent or more of your pre-disability pay.
Can disability insurance companies rely on a Social Security Disability benefit denial as a basis to deny your long term disability insurance claim?
Long term disability insurance and Social Security Disability (SSDI) are two very different programs with different requirements and standards. Many claimants must apply for SSDI multiple times before they’re approved, and this process can take a long time. Because of this, an SSDI denial isn’t a valid basis to deny your long term disability claim if your medical records and other documentation show that you’re unable to work full-time.
Hiring a vocational consultant to prepare a report for your appeal and also undergoing a functional capacity exam may be very helpful in winning your appeal.
One way to fight back against the vocational review process is by hiring your own vocational consultant who can rebut the disability insurance company’s vocational report. Undergoing a functional capacity examination, which performs a deeper dive into how your symptoms and limitations can prevent you from working, can also be a good way to fight back against any attempts to end your long term disability benefits.
Don’t go through this process alone – let Dell Disability Lawyers help. We’ve worked with thousands of people to secure their continued long term disability benefits, even after the vocational review process. Just give us a call today to schedule your FREE consultation with one of our long term disability insurance attorneys.
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Submit a Strong Appeal Package
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Get Your Disability Application Approved
We help claimants throughout the entire application process.
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Negotiate a Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Disability Company Reviews
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Showing 8 of 660 Reviews
Lincoln Financial
Uses every dirty trick in the book
It’s next to impossible to get $ out of them without a lawyer. They use plenty of intimidation and unfair tactics. They don’t want to pay. And yet, their CEO made 13 m... read more >
Unum
Unum is evil
On 11/3/2021 I got shot by my boyfriend and my spinalcord got hit, paralyzing me from the neck down and accepting Unum benefits was the worst decision I ever made. I sued ... read more >
Lincoln Financial
Every month I get paid on a different date
I will start by saying that my experience is not as horrible as others, like the folks who have valid claims but get nothing from Lincoln. I feel for you and hope to god y... read more >
MetLife
They will do anything to not approve your claim
MetLife’s handling of my short-term disability claim has been incredibly frustrating and stressful. I followed all the necessary steps prior to my surgery, providing the... read more >
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Sedgwick
Don't trust them, they like to play games
They suck the life out of people that need help. They falsely advertise for helping people that they care. Sorry to tell you it's all about money, they do not care for any... read more >
New York Life
Lyme Disease Disability Claim Denial
I have had repeat claims for genuine medical leave and they have repeatedly been denied by NY Life. I have even been diagnosed with Lyme and going through treatments and t... read more >
New York Life
Disappointed with NY Life Disability Excuses
I am beyond disappointed with NY Life Disability Insurance’s handling of my father’s claim. My father, a 66-year-old man who has suffered two strokes and continues to ... read more >
New York Life
New York Life is a joke!
This company sucks when it comes to disability claims. They are slow at processing stuff, then they always say they didn't recieve the doctors information. You spend your ... read more >
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Disability Denial Reason #2 - Change of Disability Definition & Vocational Review
One of the top reasons for terminating a claimant's long term disability benefits involves the change in the disability insurance policy's definition of "disability." This definition change often happens in conjunction with a vocational review, or an analysis of a claimant's medical records that tells the insurance company which jobs the claimant should be able ... Read More >
Disability Denial Reason #1 – Paper Review & IME
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Seven Surgeries and The Standard Still Denies Disability Insurance Benefits
Our client was employed with the State of Oregon as a Technical Support Representative. She sought disability through her employer provider LTD Policy with Standard due to low back, hip, and lower extremity pain. She had two hip, two knee and three back surgeries.After paying her for 1.5 years Standard hired a board-certified neurologist to perform a review ... Read More >
Sun Life Wrongfully Denies Disability After Paying For 23 Months
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Our client, a registered nurse for Dignity Health, found herself in a difficult situation after being diagnosed with lumbar spondylosis and left knee arthritis. She continued to work, however, struggled while attempting to work through chronic lower back pain and left lower extremity radicular symptoms on a daily basis. Sadly, her condition failed to improve and... Read More >
Lincoln Reverses Decision to Terminate LTD Benefits of Corporate Attorney after Dell Disability Lawyers Appeals the Decision
The claimant is an 64 year old former Corporate Attorney and at a prominent Florida business law firm who was forced to cease working in his highly successful and rewarding profession, job, and career on January 27, 2021, and to seek disability compensation under his policies with Lincoln due to severe symptomatology stemming from or following a viral COVID-19 i... Read More >
Transportation Manager with Brain Injury Wins Unum Disability Benefit Appeal
Unum unjustly terminated our client’s disability insurance claim after it had approved and accepted liability for six months. Unum unreasonably concluded, without any evidence of improvement, that the claimant had resumed the sustained work capacity to perform the material and substantial duties of her high level occupation as a Transportation Division Manage... Read More >
Prudential reverses decision to terminate LTD benefits of MRI Tech with Primary Progressive Multiple Sclerosis and degenerative Disc Disease
The claimant is a 58-year-old former MRI Technologist for Fairview Health Services who has long suffered from the debilitating effects of her chronic medical conditions. She has a history of neck pain as well as right arm pain and numbness dating back to 2005 with a reoccurrence of severe symptomatology in 2013. MRI of her cervical spine performed in August of ... Read More >
Engineer With Depression Wins Prudential LTD Appeal
The claimant is a former Senior Technology Services Engineer for Accolade, Inc. who was forced to cease working on May 25, 2021 and to apply for disability insurance benefits under his policy with Prudential because of severe symptomatology related to depression and anxiety. Prudential initially approved his claim for LTD benefits as his symptoms were demonstrat... Read More >
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5 Ways We Help Get Your Benefits Paid
Get Your Disability Application Approved
Our goal is to get your application for disability insurance benefits approved. Applying for disability insurance benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their hired gun doctor.
Through our experience of having helped thousands of disability insurance claimants, our disability insurance lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.
Submit A Strong Appeal Package
If your disability insurance benefits have been wrongfully denied, then our disability insurance lawyers know exactly what it takes to get your disability claim approved. You only get once chance to submit an Appeal, therefore every piece of evidence that will support your disability claim must be included. The goal is to win your disability benefits at the Appeal level, but while preparing your Appeal you must consider how a federal judge will review your disability claim if your benefit denial is upheld.
Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of disability. We encourage you to contact any of our long-term disability attorneys for a free immediate review of your disability denial.
Sue Your Disability Company
98% of the disability insurance lawsuits filed by our law firm have resulted in either the payment of benefits or a lump-sum settlement agreement. Our disability insurance attorneys have filed ERISA governed and private policy long term disability insurance lawsuits against every major disability insurance company in state and federal courts nationwide and we love fighting for the little guy against the multi-billion dollar insurance company giants.
We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.
Prevent A Disability Benefit Denial
Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.
Our disability insurance law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.
Negotiate a Lump-Sum Settlement
Let's discuss if a lump-sum settlement or buyout of your disability insurance claim is both available and makes financial sense for you. Our disability insurance lawyers have negotiated more than five-hundred million dollars in disability insurance buyouts and we know how to get you a maximum settlement. A disability insurance company is not required to offer a buyout and not every disability company offers them.
Questions About Hiring Us
Who are Dell Disability Lawyers?
We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.
Our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement in more than 98% of our cases. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.
We offer disability insurance attorney representation nationwide and we welcome you to contact any of our LTD lawyers for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 900 videos and regularly provide tips to help protect your disability benefits.
Who do you help?
Our disability insurance attorneys help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.
Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.
A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.
Do you work in my state?
Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability insurance lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.
What are your fees?
Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.
The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.
In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.
Do I have to come to your office to work with your law firm?
No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via phone, email, fax, or video conferencing sessions. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.
How can I contact you?
When you call us during normal business hours you will immediately speak with a disability insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.