What types of medical conditions are most commonly challenged by disability insurance companies?

The claims most commonly challenged by the disability insurance carriers are the claims that are subjective in nature, claims that don’t have objective medical proof, such as MRIs or x-rays that can show for instance herniated discs. Subjective claims include fibromyalgia, chronic fatigue syndrome, even so much as depression or other mental health disorders.

A lot of these policies even now have a two year limitation with regards to this where they will only pay you a maximum of two years of benefits during your life time of the entire policy. Subjective claims are challenging in nature because it’s going basically on what you report, there’s no way to measure it, no way to test it, no way to show validity.

Usually in these claims as well, for instance if it is fibromyalgia and you’re claiming that you have severe pain and you can’t leave your home, more often you’ll be put under surveillance and they’ll follow you to determine what exactly you’re doing on a day to day basis and try to find any reason and then deny your claim based upon what they see or observe.

Leave a comment or ask us a question

There are 6 comments

  • Ric,

    Please feel free to contact our office to discuss your claim. If Aetna is requesting an FCE they are definitely investigating your claim to determine your entitlement to continued benefits.

    Stephen JessupJul 23, 2015  #6

  • I have RSD / CRPS and am not able to west socks, shoes, or even pants due to the pain in my left leg. I even had to wear flip flops and shorts in the snow the past 2 years. I sleep 45min to 2 hours a night bease of the pain. I have lit relatons hips and family membets because of it. Plus, I was in a roll over car accident and now I have to have my C4,5, & 6 fused. I also have degenerative disc disease. My pain mgmnt Dr wants a spinal cord stimulator put in. Lumbar and sympathetic nerve blocks never took long enough to be worth anything. I have been collecting LTD from AETNA and now they want an FCE done. I already get SSI as well. Since this is a neuro disease what would be my best way to tackle this?

    Ric M.Jul 22, 2015  #5

  • John,

    It is normal for the disability insurance companies, especially Cigna, to do medical reviews of your policy. It sounds like you have some very serious medical issues and that Cigna should consider to pay you. If you contact us privately, we can discuss your claim and some things that could be done to strengthen your claim.

    Gregory DellSep 18, 2012  #4

  • I have been on disability since mid-2009 when I was injured. Cigna is my LTD company and has been great thus far. Now that it has been over 3 years they assigned a new claim manager who requests paperwork and reports over and over again. I found out today that they re-submitted my claim for a medical review and will be “discussing my case tomorrow.” Obviously, I am concerned.

    I receive Social Security disability and was approved on my first application. I am concerned, however, about surveillance. I have debilitating migraines 5-6 days a week. Some last hours, but most last days. During these episodes I cannot function to do basic things. Maybe one to two days a week, when I am without a headache I can function and walk with a cane instead of a wheel chair or walker. I can sometimes go to the post office or store when I am not having an episode. I try never to drive due to medications, but on occasion, when I feel up to it, I have driven and even gone to the store. That is not the way my life is normally. Normally I spend the day in bed and am on about 7 medications.

    If I get a denial at this point, and am cut off, what do I do?

    John RobinsonSep 17, 2012  #3

  • Arlene,

    There are lot of things you can do to prepare yourself for filing a disability insurance application. As a starting point I would suggest you watch our video on the application process. Contact us for a free consultation to discuss your potential claim.

    Gregory DellOct 6, 2011  #2

  • I have purchase STD and LTC from CIGNA because I work as an CNA where I lift patients all day and on my feet 12 hours a day, with scoliosis. It is very painful. I am 49. I was diagnosed 33 years ago and had 2 back surgeries.

    My question: I know it is a matter of time before I am no longer able to do my job. Will I have a hard time collecting benefits? I have read the horror stories concerning CIGNA, is there anything I can do to prepare myself? I live in Georgia.

    Thank you,
    Arlene

    ArleneOct 5, 2011  #1

FAQ

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, GoToMeeting.com 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.

Reviews

Bruce R. (Arizona)

Steve Dell has done an exceptional job with my disability application process. The firm is extremely well managed. They have acquired an incredible amount of experience over many years. I recommend them for disability insurance claims without reservation. 

Don (Florida)

I called this firm a few months ago completely disparaged due to a company cutting off disability benefits at a time that nearly caused me to lose everything.

Attorney Alex Palmera and Danielle worked hard to reach an amicable settlement and my case was settled a few months later. This is a good firm and the specific expertise in disability claims saved me countless hours of hassle at a time when an already fragile state existed.

Thank you Mr. Palamara and Danielle.

Sandra B. (Arkansas)

I have nothing but good things to say about how my buyout was handled with my disability claim. The level of professionalism was amazing. All of my questions and concerns were answered either by Danielle L. or Alex P. in such a timely manner and with such care I would recommend them in a heartbeat to anyone needing to approach their provider with buyout options.

They did a fantastic job communicating between the provider and me, always keeping my best interest at heart and always answering my many many questions. They really did take most of the stress out of this whole situation. I would give them a 10 out of 10 for every step of this crazy journey. Thank you so much for helping me through this.

Brenda R. (New York)

I needed assistance with an appeal for a LTD claim that was initially denied. Stephen understood what needed to happen to win the appeal and he did win the appeal for me.

Michael C. (Virginia)

Greg Dell and his assistant Anneli have been extremely responsive and helpful, not only our initial consultations, but in follow-ups 1 and 2 years later with the insurance company to ensure that they comply with their agreements (which they did), as well as a separate and only slightly-related inquiry about our health insurance. I always hear back from them very quickly, which is rare and greatly appreciated.

Jeff P. (Oklahoma)

After a very long and frustrating ordeal to keep my LTD payments coming I decided to seek assistance from and attorney. After much research and asking those in the legal profession Dell & Schaefer seemed to be the top choice. I reached out and Alex Palamara was the attorney assigned to my case. All I can say is the experience was outstanding. Both Alex and his Paralegal, Danielle Lauria were excellent to work with. They were very kind, concerned, understanding of my frustrations and treated me with the utmost respect. Communication was excellent with regular updates and telling me what I could expect in each stage of the process.

Alex was also very straight forward with what to expect and no pie in the sky promises or expectations were made. In the end we won our case and I believe it was solely due to their experience and knowledge of not only the laws but the insurance companies as a whole. I would highly recommend them and am very grateful for the help they afforded to me.

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us