MetLife Removes 24 Month Limitation for Mental Health Condition for Financial Advisor

The road to long term disability benefits is far too often a difficult and arduous journey for many insured. Our client’s story is a testament to the lengths an insurance company will go in an attempt to avoid its obligation to pay benefits under a disability policy. I first wrote about my client’s battle to secure the remaining month of his short term disability benefits on account of a multitude of medical conditions, which included Restless Leg Syndrome, Insomnia, Chronic Lumbar and Cervical Pain, Cognitive Impairment, Depression and Anxiety. Following a successful appeal MetLife approved our client’s remaining month of short term disability benefits. However, in doing so, they did not initially award Long Term Disability benefits. Our client’s claim was then sent to MetLife’s long term disability department for further review, where it took an additional month to make a decision as to our client’s entitlement to long term disability benefits. Despite a plethora of medical evidence supporting disability from a physical impairment, MetLife determined that our client was only disabled on account of his diagnosed Mental Health conditions of Depression and Anxiety, which according to his policy has a maximum benefit period of 24 months of payment.

Limitations for Mental Health Conditions

More often than not a physical illness or injury that leads to disability has a secondary component of depression, anxiety or some other mental health condition. Secondary, by nature, does not mean primary, but rather “but for x condition, the mental health condition would not be present.” It is not uncommon for an insurance carrier to ignore physical evidence of disability in favor of a mental health condition as a means to limit its liability to an insured under the policy.

Almost every ERISA governed Long Term Disability policy has some type of limitation for disabilities caused by a Mental Health Condition that typically, limits claims for benefits caused by a Mental Health Condition to a maximum of 24 months. Each disability carrier defines Mental Health Condition and/or the limitation differently, and thus a close examination of the particular language in an applicable policy is crucial.

With a potential maximum payment period of 24 months it is obvious to see the advantage to an insurance company in making a determination of disability based on a condition subject to a limitation in the policy. Needless to say, this determination is always to the detriment of the insured – as was the case with our client.

Do Not Wait to Challenge a Decision to Limit Benefits

All too often an insured will wait to challenge an insurance company’s position that a claim is subject a limited pay period until after the limited benefit period ends. By waiting for the expiration of the limited benefit period the insured is forced to appeal a denial of benefits while no money is forthcoming from an insurance company. When time and money is of the essence action must be taken quickly. As soon as MetLife approved our client’s claim on account of a mental health condition and benefits were being issued, we set out immediately to ensure MetLife would make a determination that our our client’s claim was in fact due to the multitude of physical medical conditions he suffered from. All the while our client was still collecting monthly disability benefits from MetLife based upon its prior determination of entitlement due to his mental health diagnoses. With additional evidence to support his claim for physical disability, to include a confirmed diagnosis of Lyme’s disease, MetLife notified our office that it had determined our client was in fact disabled on account of his physical medical conditions and that it was removing the 24 month mental health limitation it had placed on his claim.

Is Your Claim Being Wrongfully Subjected to a Limited Benefit Period?

If your insurance company is placing your claim into a limited benefit period, such as those for Mental Health conditions, or what it deems to be a “Self-Reported Symptom” condition, don’t wait to challenge their position. Please feel free to contact our office to discuss how we can assist you in collecting the benefits you are entitled to.

Questions About Hiring Us

Do you help MetLife claimants nationwide?

We represent MetLife clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a MetLife disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from MetLife. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by MetLife.

How do you help MetLife claimants?

Our lawyers help individuals that have either purchased a MetLife long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with MetLife:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

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 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 telephone, e-mail, fax, sessions, or Skype. 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 attorney. We can be reached at 800-682-8331 or by email. Lawyer 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.

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My experience has been very good; but for his representation the insurance company would not have agreed to pay my disability benefits.

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