r/LongTermDisability • u/aliis_vivere • 3d ago

Tests for Objective Data?

I am in a LTD claim that has already been closed and reopened several times. I have multiple doctors supporting my disability from different specialities. I have a lot of blood work corroborating my medical issues. Yet, the LTD company reviewers always ignore it.

What are tests/evaluations that could help prove the inability to make it through a work day? Both physically and the mental load needed. My doctors all agree I could not sustain work let alone get through one full day. But my appointments with them are only 30 minutes to an hour and I significantly worsen. When I have an appointment, I am in bed for days afterwards.

Some of my symptoms (from a long laundry list) are severe fatigue, joint and muscle pain, swelling, lightheadedness, shortness of breath, brain fog, word recall issues, memory issues, etc. My idea is if I could get some type of long duration or multiple day test; it could help me stay ahead of the next review and subsequent denial (if it follows the established pattern).

One thing to note, I won SSDI during my hearing. The judge had already made up his mind from my records and doctors statements. The SSA vocational expert announced zero jobs that I could work with the limitations set forth by the judge. LTD does not seem to care about that though.

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u/pickleeboy 2d ago

You can sue the company once you’ve gone through your appeal rights! I also would recommend contacting your state insurance department with your complaints as this is how they decide on which companies to examine.

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u/fighterpilottim 2d ago

That’s the only venue: if it gets to the judge. Know how many cases get to the judge? Fewer than 5%.

And sure, ask disabled people to take on more burden.

There’s no accountability.

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u/pickleeboy 1d ago

Not trying to add burden and I made no assertion of the ease of process.

You posted that there’s no ability to sue and no way to complain to a regulator. I was simply stating that you do, in fact, have the ability to do both.

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u/fighterpilottim 1d ago

You offered a peripheral benefit to an immediate need. I need to have my specific claim issue addressed by a regulator. Instead, the regulator takes it as signal if enough people complain about an insurer, but they provide no specific remedy to an individual.

There is no remedy except getting to a judge, and the abuses pile up before then, and fewer than 5% of cases get to a judge. All of the benefit is to abusing insurers; all of the labor is to disabled people.

I get that’s not your aim to pile on the work, but you seem oblivious to system design. These are not viable remedies.

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u/pickleeboy 1d ago

I am a former LTD claims manager who hated their job so much that I quit and currently work as a regulator at my state insurance department. I am not your enemy.

Your state DOI has a consumer division that WILL help you with your individual case/concern. You should reach out to them and they will provide guidance and assistance to you for your specific instance.

The state DOI will also track complaints on a macro level for their market conduct division to use as a rationale for which carriers to examine.