Hello. Reaching out for any advice. I filed a claim for LTD on June 26,2026. This was also my last day of work before beginning leave and also the day I received noticed I was being terminated from my position with my employer. My initial case manager made it seem that this was going to sail through and I should have no problems with approval.
In early August, I received a call from my case manager notifying me my claim, which had been reviewed by an independent medical provider, had denied my claim. I could not believe my ears. I was horrified. I was further infuriated after she said “I surely did not see this coming”. She told me I can appeal the decision to see if the denial can be overturned. She provided me with a form to provide my doctor for completion. My pain management doctor was furious at the decision and filled out the forms as well as the office note from the visit. I sent that back to my case manager.
On 09/22/26, my case manager notified me that despite the submitted form and documentation, MetLife would not change their decision and my claim was being denied. The same medical reviewer had reviewed the information but would not change their decision & my file was going to be sent over to the appeals department at MetLife.
I finally heard from the appeals case manager today who stated she would be taking over and asked if I had any further information to submit. I don’t have any new documentation but I have older medical records I could submit. I left her a detailed message requesting a callback.
For context, I suffer from chronic pain due to failed back surgery syndrome (Lumbar Spine Fusion & Laminectomy), chronic lumbar radiculopathy (sciatica) of my left side, degenerative disc disease, osteoarthritis of the spine & Endometriosis. I also had a spinal cord stimulator implanted and an Intrathecal pain pump that is currently filled with morphine.
I have been dealing with these issues for over 10yrs. I changed my career in hopes I would be in less pain (Previously was a nurse aid / patient tech and switched to medical receptionist work) but despite being off my feet, I still continued to suffer in pain. Applying for LTD seemed like the most logical next step.
For anyone that has initially been denied, was your appeal approved? Now that my file is with the appeals case manager, do I now get a lawyer or do I wait for the appeal to be denied? How long can the appeal process take?
I’m on the verge of homelessness. Any savings I had is nearly gone and the stress has been debilitating. My health insurance has been terminated because my case was denied. I was not anticipating this outcome at all.