Long-term disability insurance is designed to provide financial support when a medical condition prevents someone from working. But for many people, getting those benefits can become a lengthy and difficult process.
One Houston-area woman says she’s been fighting for two years after her claim was denied, despite being unable to continue working because of a chronic illness.
At 34 years old, Lydia Arleen says she lives with nearly constant pain caused by fibromyalgia, a chronic condition that can cause widespread pain, fatigue, cognitive issues and other symptoms.
In addition to severe pain, Arleen says she experiences gastrointestinal issues, brain fog, depression and muscle weakness, making it impossible to continue working as a project geologist.
After applying for long-term disability benefits through the insurance plan provided by her employer, Arleen says her claim was denied. She later lost her job and has continued fighting for benefits.
According to Arleen, the insurance company cited the complexity of fibromyalgia and the lack of a definitive diagnostic test as part of the reason for denying her claim.
Three ways to strengthen a long-term disability claim
Attorney Marc Whitehead, who represents workers seeking long-term disability benefits, says there are several important steps applicants can take to improve their chances of approval.
1. Thoroughly document your medical limitations
Whitehead says medical records should clearly explain not only a diagnosis but also how the condition limits a person’s ability to work.
That documentation should include physical limitations—such as difficulty bending, lifting, standing or using your hands—as well as mental or cognitive impairments, if applicable.
2. Accurately describe your job duties
Whitehead says disability claims should include a detailed description of what your job actually requires on a daily basis.
If your work responsibilities are incomplete or inaccurately documented, insurers may conclude you can still perform your job.
3. Appeal quickly if your claim is denied
If a claim is denied, Whitehead says applicants generally have 180 days to file an appeal.
During that time, it’s important to submit additional medical records, physician opinions and other evidence supporting why you cannot perform your job.
Don’t overlook a vocational expert
Whitehead also recommends hiring a vocational expert, who can evaluate the physical and mental demands of your occupation and explain why your medical condition prevents you from performing those duties.
He says that expert testimony can play an important role during the appeals process.
As more workers navigate long-term disability claims, consumer advocates say understanding the application process—and acting quickly if a claim is denied—can make a significant difference.