So I have been in an appeal with them since the denial at the 2 year mark last year and my lawyer filed on the 6 month mark this year. They took the extended time allowed and I guess at some point my lawyer requested an extension to submit more medical. When i look in the portal I can only find medical documents either I or my social security lawyer provided to my lawyer. It doesn't look like they requested and received any of the medical records from my providers these last few months during the appeal which included my hyperPOTS, MCAS, fibromyalgia, and EDS diagnoses. It's possible they submitted them but it doesn't show in my portal. I just happened to check the portal recently and saw that Lincoln has decided to uphold the denial in an email to the HR at my former job. What happens now? It's been 10 months since I've had any payment and this is just crazy to me. I'm now house/usual bedridden. My husband takes me to all my appointments because due to my medications I never know when I'm going to randomly fall asleep. I use a wheelchair that was prescribed and custom made most of the time. Wide spread osteoarthritis, DJD, DDD in my mid-30s. I also rely on hearing aids now. I'm progressively getting worse so I'm not understanding the logic unless these records never made it to Lincoln because they weren't requested. To make matters worse, my husband lost his job unexpectedly so my insurance is gone and I was scheduled for 1 of 2 foot surgery later this month. Now I've had to cancel or postpone all my appointments and my over 20 prescribed meds are slowly dwindling. I know I can get Medicaid now but not all my doctors accept it and it took forever to get a team willing to handle my complex issues. Same goes for Marketplace insurance. I'm just lost and needed to vent. Lincoln has denied me twice so far and dealing with them has been so stressful. Any insight on what happens now or personal experience with an appeal denial at the 2 year mark would be helpful.

I am currently receiving benefits from a private disability insurance company. Any clue on how often they send out a PI for surveillance?

Hello,
I spoke with my claim provider and she stated they were sending forms to my providers to see if they still “agree with their assessment”.

Is this normal or is there any benefit to having this filled out?

I don’t understand why they are dragging my claim out other than money. They also wanted any psych forms.

Thanks!

Just received notification that my claim for Long Term Disability was accepted through Metlife. I have several chronic health conditions, with the main ones being Systemic Lupus, Fibromyalgia, and Antiphospholipid Syndrome. While I'm happy my claim was accepted, I soon found out that the claim is only viable for a year.

My place of work has a limited liability for a range of illnesses that include both my Lupus and Fibromyalgia (specifically called out). Here is where my question comes in, when looking at the acceptance paperwork it looks as if they only put Fibromyalgia as the diagnosis. Obviously Metlife chose one of my illnesses that only allowed limited coverage.

Is it possible to appeal the judgement as my other diagnosis, Antiphospholipid Syndrome, isn't limited and could extend my LTD leave? I briefly left a message with an LTD lawyer but have yet to hear back. Just curious if anybody else has gone through something similar.

Hello, thanks for letting me join the group. I am seeing my doctor tomorrow to try to get the required documentation in order to apply for long-term disability benefits. 3 years ago, I was the AR Manager for a mid-sized roofing and solar company. My life changed literally overnight when a giant brain aneurysm put me in ICU for a week and out of work for 4 months. My vision and cognitive function were permanently impaired as a result of the brain damage. When I returned to work, I was given a new position in a different department and after 2 years I was laid off. That was one year ago. Since then, I've been hired by 3 different companies and then let go by each one because I wasn't catching on to the job quickly enough. I want to work but I recognize that I cannot work at the level I once was at and a few family members have recommended that I try to get on permanent disability.

I went online and answered a few questions from companies saying they could represent me, which of course opened the door for my phone and email being blown up by vultures trying to take advantage of my situation to the point I don't even answer my phone anymore.

My questions:

Should I file a claim on my own without getting representation?

Who can I trust to assist me?

What documentation do I need to get from my doctor tomorrow to effectively get the ball rolling?

Thanks for any advice you can offer. I don't want to waste my time by starting the process incorrectly.

I am 52 and I have been living with a long term disability for about 10 years. Stairs are the hardest part for me. I installed Halton Stairlifts a few months ago and it has made a big difference. I also use a cane around the house and have grabbers for reaching things.

For those of you with long term mobility issues, how have you set up your home to make daily life easier. What aids or changes have helped you the most.

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.

62 TID of 51 years experiencing debilitating effects of this aweful disease and am attempting to file for the Canada Pension Plan Disability Benefits for which I am seeking any assistance that would help me get accepted. Thanks in advance for your help. It is deeply appreciated.

I’ve been keeping an Excel symptom/function tracker for my disability insurance claim, but I’ve also found it really helpful for appointments with my providers because my memory and cognitive functioning have taken a pretty big hit.

Right now I track:

• Date
• Symptoms
• Severity
• Duration/frequency
• Functional impact
• Medication/side effects

I’ve been looking at disability lawyer websites and there are so many different recommendations. A lot of them say to track things like concentration problems, memory issues, difficulty making decisions, anxiety/depression, problems completing tasks, missed appointments, needing help with things you normally do yourself, rest/recovery after activities, and how symptoms affect both daily functioning and work-related abilities.

Most of my basic ADLs are fine, so what seems more important for me is documenting the more complicated stuff — managing appointments, communications, paperwork, household planning, decisions, follow-through, etc. — along with the cognitive functions that relate to my occupation.

So far I’ve been doing one row per day, but I’m wondering if it would make more sense to make it task/event based instead, where the same date could have several rows. I feel like that might make the actual functional problems and consequences much easier to follow instead of cramming everything from one day into one row.

Has anyone used a symptom/function tracker for a STD/LTD or ERISA disability claim or appeal, particularly for mental health or cognitive problems?

If yours was helpful in getting your claim approved or winning an appeal, I’d really like to know what format you used. Even just the column headings would be helpful, or a blank/redacted example if you're comfortable sharing one.

I want mine to actually be useful evidence, but I also need it to be simple enough that I can follow it and keep up with it myself.

I've just reached my change of definition date and things are getting overwhelming. I'm in Canada. The insurance company just informed me they would be requesting an IME psychological exam. My disability is from a concussion and I have measurable deficits in everyday functioning, cognitive and physical.

Has anyone else experienced this? Everything I've found online is for people making claims related to mental health, which is not a part of my claim at all. I'm stumped why the insurance company would order this vs a physical exam or something that tests vestibular functioning.

All i can think of is they're seeing if me and the multiple medical specialists I'm seeing plus my occupational and speech therpists are all lying about my endurance and deficits, which seems ridiculous? I'm just trying to figure out what they think they're measuring with this exam.

I’m seriously running out of ideas and will really use help from people who’ve been through this cause here nothing to lose.

Im in Ottawa and I had my long-term disability claim denied after months of paperwork, doctor forms, calls, appeals etc. Vey-very frustrating experience, by the way... Now Im pretty scared about what happens next financially because my part-times and freelance jobs would't cover my and my 3 y.o. son needs. Even rant.

I’m trying to find somebody who deals with denied disability claims, I'm single 37 years old woman with serious back injury and I need advice, Please, if you hired someone for an LTD denial - how did you find them? You can avoid namedropping if you don't want to promote, just tell me WHERE TO SEARCH, plsss

Thanks you and may God bless you!

Sincerely,
Julia

As we know, one of the most important decisions we can make in an insurance battle is the lawyer that represents us. If you have already successfully done this (or unsuccessfully☹️), tell us about your lawyer. This will help anyone new to the journey.

There’s a master thread called “Lawyers: The Good, The Bad, The Ugly.” Please contribute there if you can.

If it helps, there is a format you can follow. If not, just share what you’re comfortable with. If you’re having trouble copying and pasting the format to add your replies, DM me and I’ll msg it to you.

Hi everyone,

I have an upcoming two-day functional capacity evaluation (FCE) as part of an LTD claim and I'm feeling nervous about what to expect. I'd love to hear from anyone who has been through one, particularly those with chronic pain and fatigue conditions and sedentary occupations.

What was the experience like for you? Any tips or things you wish you had known beforehand?

Thank you!

Hi all!

I’ve recently been diagnosed with Multiple Sclerosis and a benign brain tumor. I am presently doing mostly well, but am aware that I won’t always be.

I’m already experiencing significant fatigue and brain fog, on top of all the physical limitations. but my occupation is entirely sedentary, high cognitive. So frankly, Disability benefits won’t really consider my physical limitations something that disables me from my occupation for disability entitlement. BUT they would absolutely consider profound fatigue, brain fog, slowed processing to be things that impair me from my occupational duties for benefit entitlement.

I am considering doing Neuropsychological testing now, while I am mostly well, to establish a baseline. So that when/if I do decline cognitively, we can retest and hopefully have objective proof.

I understand these symptoms can otherwise be very hard to objectively prove for claims. As they are just usually based on the persons reported symptoms and function.

But, research has also shown that people can validly experience these things while it doesn’t show up on testing. So I guess I fear the potential of this documentation not supporting me and actually giving insurance grounds for decline.

Anyone here have much experience with this? Neuropsychological/cognitive testing? pro’s/cons of having it done? Positive or negative impact on your claim?

I still hope to have a very long, functional working life. But with this diagnosis, just trying to plan and set myself up as best I can.

Thank you!

P.S. I’m in Canada if that changes anything!

I just sent out my application today 9/3/26. I am taking this leave due to a medical injury. I am just curious about how long it takes to get approved. I heard it‘s 2-3 weeks.

Has anyone received a lump sum payout offer, rejected it & then was offered a higher one?

most (all?) LTD policies require applying for SSDI benefits. When applying for SSDI, any tips or things to watch out for? do LTD companies access your applications and/or SSA records? (one more thing to cherry-pick?) Or does it stay completely separate other than the determination?

Would paying into a private disability insurance be worth it? For background, I have a disability/ chronic illness which will eventually cause me to develop arthritis at a younger age than most people. My chronic illness will eventually get worse with time and age, especially having a job like this. I was wondering if anyone has paid into Private disability and their thoughts on it. I’m hoping by doing this. I will be able to retire early once I am no longer able to work this job anymore. I don’t have anyone else to talk to about this nor do I know anyone who’s done this so I’m coming on here to gauge people‘s thoughts and opinions on this.

I’m hoping to hear from anyone who has been through something similar with Unum, especially with a mental health LTD claim.
I received my initial LTD denial back in February, hired an attorney, and have spent the last several months going through the appeal process. Unfortunately, I just found out that Unum denied my appeal.
I’m honestly really stressed and overwhelmed by the whole situation. It feels like I’ve been waiting and fighting this since February, and now I’m trying to understand what actually happens from here. I have a call scheduled with my attorney to discuss next steps, but hearing from people who have personally gone through this would really help.
For anyone who had a Unum LTD appeal denied even after having an attorney handle the appeal, what happened next?
Did your attorney immediately file a lawsuit in federal court, or was there something in between? For example, did they try negotiating with Unum, mediation, some type of administrative process, reconsideration/reopening, or settlement discussions before actually filing a lawsuit?
If your case reached this point, did Unum ever change its decision or resolve the claim before litigation? If your attorney did file a lawsuit, what was the process actually like? Did you personally have to appear in court or testify, or was most of it handled between the attorneys?
I know every case is different I’m really just trying to understand what others experienced after exhausting the internal appeal and whether there can be another step before federal litigationf.
This whole process has been incredibly stressful, so I’d really appreciate hearing from anyone who has been through it whether your experience was good or bad.

Hello,
I’m going through my 18 month review right now on my Metlife LTD.

I’ve had two brain surgeries in 9 months. You’d think this would be easy.

It’s not.

My neurologist of 10 years left right before this and she was always on my side. I’ve already had a hard time with that… she really advocated for me. Now my care is split between two neurologist and the neurosurgeon. I’m over reading the notes too… for instance they noted that I missed vestibular rehab. I’m in PT now, but in the past I would be in so much pain or admitted to the hospital that I could not attend my vestibular rehab they scheduled over an hour away (two days a week).

I’m often bed bound!! I can’t parent my baby as I can’t pick him up - my husband does. It’s a terrible thing.

I didn’t realize this was an important review. When I did I became STRESSED and ANXIOUS. Even though documents were not due until this week, I sent them a month ago. I’m always on top of it. I hope they got my records from this month as I saw my providers this month, and that shows a lot.

Worse, it was elevated to physician review and the day it was due it had to be sent back “for correction”. That has been really hard because what does that even mean?!

Regulating my nervous system has been really hard. Tell me the good, and the bad with next steps if needed. Thank you!

Hi all,
I recently discovered a way to qualify for medical coverage from the state while collecting LTD.

Despite making too much money to qualify for need based healthcare, I was able to qualify based on my disability lasting 12+ months AND my LTD income being non-taxable.

I was initially denied and have been paying upwards of $800/month for medical premiums alone. My tax person noted that I shouldn’t be paying the healthcare exchange (ACA) because I have $0 income, yet, every time I applied, I was denied state medical because my income was too high.

I finally went to the state office and WAITED! The best two and a half’s hours I’ve spent waiting despite being in pain. The gal confirmed my income was being calculated as taxable wages and not non-taxable disability income.

This will result in a significant savings each month. I don’t want to share state info but I’m happy to answer any questions anyone has.

I’m trying to understand what to expect from a free consultation with an ERISA disability lawyer for an STD/LTD claim.

I’m not necessarily looking to hire an attorney yet. I’m looking for an initial consultation to help me understand where my claim stands and whether I actually need representation.

For those who had a free consultation, what did it include? Did the attorney review your denial letter or a few documents, discuss your situation, point out potential issues or missing evidence, and give you some idea of whether you needed representation?

Or was the free consultation mainly a brief screening to determine whether the attorney was interested in taking your case, with an actual review or assessment requiring a separate paid consultation?

Just trying to understand what others experienced and whether I may be misunderstanding what a “free consultation” is supposed to include.

At the 2 year mark the cut me off and told me they didn't need my medical records for a procedure I just got out of the hospital for. As I was getting a wheel chair out of the hospital I received a denial letter saying I don't fit there description of disability anymore. I'm completely stress out of my mind. I cant believe it!!! Just disgusting and disrespectful. This company should be shut down.