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Why Would Long Term Disability Be Denied?

Monday, March 28th, 2022

Why Would Long Term Disability Be Denied?   

A woman recently shared her story of coping for six years with an invisible disability, fearing both the loss of her career and health insurance. She was suffering from vestibular attacks, the result of a brain injury from a hiking accident.

For six years, she struggled to hide her invisible disability and didn’t disclose her condition to her employer, while the attacks got worse, longer in duration and more frequent. Most of her income went to doctors and medical care. She went to countless doctors to try to figure out what was wrong and find some relief.

When a neurologist told her she would become bedridden if she did not immediately avoid the triggers that led to her vestibular attacks, she started to make changes.  One of her changes was becoming a career coach, focusing on people working in corporate settings, in part to allow her to prioritize her health.

We can’t imagine how this high-functioning woman managed to continue growing her career in a highly competitive workplace environment that demanded a high-level of cognitive skills for six years with her invisibility disability. Many of our clients do their best to continue working, often pushing themselves past a reasonable time when they should have stopped working and filed a long term disability insurance claim, but usually they do not last six months, never mind six years.

What is an invisible disability?

An invisible disability is a medical term used to describe any type of medical illness that is not easily seen by others. There are millions of Americans with invisible disability. In fact, studies cited by Disabled World estimate 10% of Americans live with an invisible disability or a hidden disability. These are often neurological disabilities, as in the case history above.

Hidden disabilities present a number of problems for long-term disability claimants, whose claims are often red-flagged early in the claims process. If the person appears “normal,” but their disability is an illness with symptoms that cannot be clearly seen in a lab test or an x-ray, MRI or CT scan, the automatic reaction by the long-term disability insurance company is to deny the claim. It doesn’t matter if you are sending a year’s worth of diagnostic tests, doctor’s reports, even vocational expert reports, that detail why you are no longer able to perform the duties and tasks of your occupation. Your claim is as invisible as your disability.

What are Common Invisible Disabilities?

While the clinical diagnostic processes for some invisible disabilities have changed over the years (such as the presence of certain antibodies or bacteria indicating the causes of a hidden illness), claimants with these illnesses are often considered suspect:

  • Asperger Syndrome
  • Asthma
  • Chronic Fatigue Syndrome
  • Chronic Pain
  • Crohn’s Disease
  • Depression
  • Epstein-Barr Disease
  • Extreme Sleep Apnea
  • Fibromyalgia
  • Long-Haul COVID-19
  • Lupus
  • Lyme Disease
  • Migraines
  • Reflex Sympathetic Dystrophy
  • Schizophrenia
  • Tinnitus
  • Trigeminal Neuralgia

Invisible Disability Conditions and Long Term Disability Claim Denials

Making a long-term disability claim for an invisible disability or chronic condition is often an exercise in frustration. You’ve likely gone to more doctor’s visits and had more diagnostic tests than other people with a disability because your kind of disability is harder to pin down.

Yet the insurance company maintains its position: you aren’t disabled and can do the tasks required from your job. “Insufficient Medical Documentation” is frequently the response to an invisible disability. The requisite “objective evidence” doesn’t exist because it doesn’t show up on an X-ray or an MRI. Chronic crippling pain caused by nerve inflammation may or may not show up in a diagnostic image.

What You Can Do to Protect Your Long Term Disability Insurance Claim

If you have been like the woman in the story at the start of this blog, continuing to work despite your pain and suffering, you need to lay the groundwork for your disability claim. Start by taking a reasonable look at your ability to work. Are you using a combination of PTO, sick days, and family leave days to continue to work without going public with your disability? Or have you asked your employer to make any special accommodations for your disability?

Once you are ready to discuss your disability with your employer, you need to start documenting the impact your disability is having on your ability to work.

If you can’t work, in most cases you’ll need to file for short term disability. If you do, and if your short term disability benefits are being paid, don’t get too comfortable. Paying for a few months of disability benefits is easy. Making the switch to long-term is not. Very often, companies are self-insured for short-term benefits, but the long-term benefits come out of the insurance companies’ pockets. That’s when benefits are terminated.

If you are suffering from an invisible disabling condition and need help with your long-term disability insurance, contact our office at 877-583-2524. We have represented many claimants with Fibromyalgia, CFS, Chronic Fatigue Syndrome, Lyme Disease, and other invisible disabilities. Call us to learn how we can help.


Justin C Frankel

Written By:

Justin C. Frankel - Disability Insurance Attorney

Justin Frankel is a founding partner of the disability insurance law firm Frankel & Newfield and is a highly skilled litigator and advocate. He has published numerous articles on the challenges facing clients with private or individual disability insurance policies and those who own group or ERISA disability insurance policies.

Learn more about Justin | See Justin’s Publications



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This is about a Social Security Disability claim.

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