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Top 7 Tactics Used by Long Term Disability Insurance Companies to Terminate Benefits

Although it may come as a relief to learn that you have been approved for long term disability benefits, insurance companies utilize a variety of tactics to terminate disability benefits at a later date. After your approval, the insurer will continually investigate whether they believe you are still disabled and they will periodically request your recent medical records. Unfortunately, insurance companies may terminate your long term disability benefits by using these common long term disability claims practices:

  1. Employing medical staff to review your records. Insurance companies employ nurses and doctors who review medical records to determine whether someone is disabled. As an employee of the insurance company, the reviewing nurse or doctor has a conflict of interest when deciding whether you are disabled.
  2. Contracting with “peer reviewing” medical staff to review your medical records. These doctors or medical professionals are not employees of the insurance company, but they still receive payment from the insurance company to review your medical records. These doctors will never examine you, yet they will provide an opinion about whether you are disabled. At times, these doctors may even call your treating providers and ask questions about your medical condition.
  3. Claiming that your disability is not supported by objective evidence. Some conditions, such as depression or fibromyalgia, cannot be diagnosed by objective tests. Even for conditions that do not allow for objective testing (like an MRI or x-ray), the insurance company may wrongly insist that objective evidence is required in order to prove a disability.
  4. Claiming that you no longer meet the definition of “disability”. Most group long term disability policies have a definition of disability that changes after one or two years. After initially requiring that the claimant show they are disabled from working in their own occupation, the definition of disability changes to requiring that the individual is disabled from working in any occupation. Long term disability insurance companies will deny benefits after this change of definition and claim that the person can return to work in a different job. The insurer may utilize a vocational consultant who identifies different jobs that they believe a disability claimant can perform.
  5. Hiring an “independent” doctor to examine you. This is known as an “independent medical examination”. The doctor is chosen by the insurance company and may or may not take time to review the claimant's medical records.
  6. Private investigators may be contracted to perform surveillance on you. Usually, the investigator will learn of a time that the individual is scheduled to leave the house—such as an appointment to see their doctor or attend an independent medical examination—and the investigator will record the individual traveling to and from the doctor's office. The private investigators may even perform surveillance of the individual for several days at a time.
  7. Alleging that your disability is caused by a mental health condition. Group long term disability insurance policies usually have a limitation for disabilities caused by mental health conditions. For example, long term disability benefits may be only payable for 24 months if the disability is due to depression or anxiety. Even when an individual suffers from both physical and mental conditions, the insurance company may claim that the disability is due to a mental health condition, and therefore benefits are limited to 24 months of payment.

Our Disability Attorneys Can Help You Keep the Benefits You Need

The attorneys at Keller & Keller are dedicated to fighting for wrongfully denied short term and long term disability benefits. We offer every Indiana resident a Zero Fee Guarantee, meaning you'll never pay for a consultation and the only way we are paid is if you receive disability benefits. Fill out our free contact form or call us at 1-800-253-5537 for a consultation with one of our experienced Indianapolis disability attorneys today.

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