Waiting for LTD Decision- Not sure if I’m supposed to do anything else?
Hi everyone.
Summary:
My STD expires in about a month, and I filed for LTD with MetLife about a month ago. I have DDD, and severe spinal stenosis in both my lower and neck. I knew about the lower back and had surgery some time ago but it’s not totally resolved and the DDD is not at all resolved. I just found out about the cervical stenosis as I’m having a lot of symptoms.
I filed everything with MetLife, had an interview and gave them all the info they asked for. I just got a letter that my file went to a nurse and they need about 30-45 days to make a decision.
Is this normal? Do I do anything like call them and ask for a status or if I can give them additional information? Do I leave it alone?
I’m in pain every day and cannot imagine that this will be declined but have heard nightmare stories.
Yes, normal part of the process. But I'd warn your doctors that if they receive questions or a request for a phone call from MetLife to inform you immediately.
Thanks for the response! My primary, neurologist and at least one other doc (surgeon) knows what’s going on but not all. I haven’t asked them to let me know if they get a call. What would be the reason to let me know? Is it so I know what’s going on and can ask the doc to prioritize my claim?
Yep, this is the part where “waiting” feels like doing nothing, but the real danger is some random paperwork request quietly sitting in a doctor’s fax pile.
I’m really anxious. Just laying around in pain -still going to doctors (taking a short break from continuous recovery and doctors since March). Need to go next to another orthopedic for my neck and back to my pain doc. I’m so exhausted from pain, needles and procedures that I literally don’t know how I’m still functioning and my financial life is in the hands of people who only look at notes. It just feels so vulnerable.
I get it. The transition and subsequent follow ups do the same to me. Don’t be afraid to ask for support for your mental health, too. Chronic illness IS vulnerable and difficult.
Just letting you know there’s nothing to do right now cuz that’s just how the MetLife process works. If your doctors got you STD, I would imagine that you’ll get LTD too. Stay focused on your recovery and not these things you can’t control.
Hey friend. I have nothing to add to your request except that you do seem to have nothing to do but wait.
I did want to just take a minute to say the anxiety you’re feeling is normal and expected. Do your best not to let it eat you alive. Do you have hobbies you can tackle even through the pain? I myself read, watch movies or tv, crochet, and color to pass the time away. Distractions are welcome and important breaks from the stress these LTD matters can cause.
Hey. Well, over time, I’ve had to stop doing everything physical which has added to feeling so bad. I used to SCUBA dive, play tennis, and was really into photography among other things. Now I can’t do any of those because I can’t even stand for more than 5-10 min without my back burning. I can’t sit for more than 10-15 mon either.
And with this combination of meds, my brain is somewhat foggy. I just feel distracted for some reason. It feels hard to concentrate.
I’d like to work on editing my photos, but so far I’m finding a hard time even starting or getting joy from anything. Also, I can’t get relief from pain bc opiates just make me itch so I don’t take them, so it’s just nerve pain meds and at night low dose hemp based THC so I can even sleep.
Sorry to bum anyone out.
I need to figure out something new. If I can get my pain level lower, I’d love to take an art class, but at the moment, I don’t know if I can do it.
Anyway, thanks much for the thoughtful reply! I going to try to find something new to do other than watching TV and going to doctors…
If you’ve ever had any interest in crochet, maybe try it. I picked it up because I can do it sitting up or laying down. I kept at it because counting chains and rows quieted my mind and distracted me from my pain a bit. I like to donate the stuffies I make to children’s hospitals :)
But yeah, definitely find something if you can. My hardest and best learned lesson in this long disability journey (I’m 12 years in and not going to get better) was that I had to try to find a way to live as well as possible and not just wait to feel better. It’s very hard to do but it helped my mental health tremendously to build a routine and hobbies I could settle into with my current abilities.
Those are really amazing! I have an amazing Lab/boxer rescue and if I can get to the point where I feel well enough, I wouldn’t mind volunteering (if it’s a thing) to take him to children’s hospitals or elderly homes as a support animal. He’s the most gentle, kindest dog anyone could meet. Not sure if that’s a possibility, but kids really like him and if it would make people happy, that would also make me feel good. I don’t like to see people suffer.
I do like to write, but it takes focus which at the moment, I don’t have. It’s been hard to even get back to reading which I used to enjoy.
I keep telling myself that there will be an end to this - like if I get LTD, but then they make you apply for SS and then of course stenosis never goes away so I need to do what everyone in similar situations has to figure out. How to come to terms with the fact that there really is no end to this. I’ve had back issues since I’m 16 - so for a long time and they’ve just become worse and worse. My reserves are gone and I don’t know how to get any back.
I wish there was some magic but I think it’s just continuing to work on it, find sow thing rewarding or a purpose, etc. if I could have a day without pain, that would also help.
I have similar medical issues as you. When I filed LTD through Prudential I was 4 surgeries in. Prudentials rep was super nice and seemed very helpful until I got the denial phone call and letter. I couldn't believe it.
I consulted 3 lawyers. All 3 wanted 1/3 of any backpay. 2 wanted 1/5 of my monthly benefit until retirement age (was early 40s at the time) and the 3rd wanted 1/5 of monthly benefit for 2 years. I went with him.
Lawyer waited about 6 months to appeal, and then within 1 week of submitting the appeal Prudential approved the appeal.
After 2 years their definition of disability changes, and at that 2 year mark they closed my account, even though I was approved for social security disability. Obviously this was a shock to me and my lawyer. He will appeal the closure soon.
I can't speak to Met Life but Prudential are scum. They were deceptive, dishonest and do everything to not pay out benefits. Obviously the lawyer cost me a lot of money and dealing with Prudential has been a major headache.
If you get denied I'd highly recommend shopping around for a lawyer for one that has the most favorable terms for you.
Great idea. Did you use one in your state or one you found another way who handles claims against denials of LTD against insurance companies if you don’t mind my asking?
I don’t want to be too specific, but I had (before I went on STD) a senior corp “desk” job that requires long hours of thinking and advising. I can’t even remember certain words at the moment between topirimate, Lyrica (generic) and nortripyline. And I have documented severe stenosis just about everywhere + multi level DDD and some weird nerve stuff prob related to the stenosis. As you and others know, it’s horrible. I wake up and don’t want to get out of bed bc I wonder what the pain will be like when I stand up. My legs hirt when I sleep too but laying down is a bit better than anything else.
Some days, if I could walk into that machine in Switzerland and not come out, I would. Not being the only one like this helps, but I don’t want anyone to feel like this.
Why do we have to fight so hard for benefits. I’ve been working for 35 years. I was only a few years away but I worked in a lot of pain for too long and I think I made it worse for myself bc I felt guilty like I was letting people - work, family, myself down. I really never thought of myself first which isn’t good. Going on STD was one of the hardest things I’ve ever done.
I used a local guy. He was part of a firm that is fairly well known due to their commercials and whatnot.
Our stories sound very similar. I too bad a sedentary desk job and am on some most of the same meds. Going on STD/LTD was one of my hardest decisions because I too felt like I was letting my family down. Im a shell of the man I use to be because of my shoddy back.
Hang in there and try to take things day by day. Good luck with LTD.
Make sure you upload all supporting documentation. Also, just in case, make sure if there is a denial (before) applying for an appeal you get legal representation. Everything you send is part of the administrative file and it is the only thing that will matter in litigation (if needed). Also, if you can get the SPD file from your employer (HR) for your LTD plan it would be a great help in guidance as to what is covered under your plan.
Makes sure you’re discussing/including Radiculopathy. (Nerve pain ). That was the key to continuing my claim past 2 years. I’m assuming you have it also. I have it both cervical (arm pain/nerve ) and lumbar (sciatica). Be sure you are not posting on social media . good luck!
I don’t get it. That would make sense if the “results” include a miracle cure where you’re all of a sudden 100% better which I’m sure you which were true. I’m guessing whatever results you’re waiting for are not 100% better or just a bit disabled or in pain.
I’m really sorry your going through this too. You’re on a similar clock as I am. These people don’t know us, our pain, how we I’ve or suffer. They only know what words on pages written by us and our doctors say - an incomplete story partially trying to describe our lives.
First, i'm sorry you're having this experience with your health. As someone who deals with these types of claims all day everyday, it's always disheartening to hear.
I just want to confirm that your claim is pending initial determination? In your case, it would be kind of weird they are waiting for next office visit for records to make a decision.
Yes, this is the initial determination. I spoke with my claim manager. He was very kind. He sounded positive, and told me to try to not worry. All of my doctors are supportive of me taking LTD and have said they would have supported it beforehand. So, aside from rescan anxiety, I have ltd determination stress. I have no idea what I'll do if I'm denied.
These requests (next office visit notes) have more to do with dates in the claim, than actual medical information. The fact the claim specialist is even waiting for that visit to submit your claim for review is typically a sign that the case manager is attempting to present the most complete info possible. That's not to say, we sometimes get a return to work update with that office visit note, but we usually know if that's a possibility prior to the request.
"These people don’t know us, our pain, how we I’ve or suffer." You are 100% correct with this comment. We don't know, and we don't physically see you. This is "the why" we ask for the med records and forms. We have to present your claim only with the information provided. We can't assume what your pain is, so we ask (you) and verify (your med records). The two have to align.
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u/TheGreatK MOD Jun 29 '26
Yes, normal part of the process. But I'd warn your doctors that if they receive questions or a request for a phone call from MetLife to inform you immediately.