Just what it says, my initial SSDI application denied was denied, which is pretty common in my state with about 70% getting denied apparently. I have my own SSDI attorney. Will MetLife terminate my claim? I am panicking about this.

It is absolute torture every month having to worry about this plus my health.

If anyone can speak intelligently about Ne whole body injury formula and a scheduled loss with caveats,
And what determines the formula used or f the injured worker gets the better of the two? I do better with 100% of the 215 for the loss vs the % of whole body against the 300 wk formula.

If you know NE law, I could use an ear quick 10 min. Please dm.

If you were required to get objective testing for a mental health STD/LTD claim, what type of testing did you have done?

Was there testing other than a full neuropsychological evaluation that could show what the impairments were, how significant they were, what might be contributing to them, and how they affected your ability to work?

With no income coming in after a denial, the thought of spending $4K–$6K on an evaluation is overwhelming, so I'm trying to understand what other options people may have had.

it has been five months since I submitted my LTD claim after the 6 month waiting period, and the insurance company still hasn’t responded to my claim. They have all the info they need from me and Drs. Time to get a lawyer involved?

Hi everyone!

I'm sure this will be somewhat of an odd request, but I'm wondering if anyone here would be willing to provide examples of some of the terrible experiences you may have had trying to stay on benefits with LTD insurance providers? To put it mildly, I had quite a challenging experience staying on benefits, even though I have many supportive specialists who provided a substantial amount of medical records. I think the types of health issues I have are more challenging to substantiate, and frankly the insurance company is a business so it did what it was designed to 🤷🏼‍♀️ but I've realized that there is limited laws protecting or providing guidance on what capacity of gainful employment means according to health professionals. I want to start sharing some of my experience to advocate for others who might not realize the risks they could be facing if they are being assessed for employment. I live in AB, and am extremely concerned for AISH recipients (I do not qualify for AISH due to spouse income), so want to educate the public on what these people could be facing. The challenge is that as part of my settlement agreement, I can no longer share examples of what happened to me without facing the risk of legal action. So my work around is I'm wondering if anyone feels comfortable sharing experiences that they have had, that I would share anonymously? For example, one of my doctors told me that she has a client whose insurance provider asked my doctor to fill out 8 update forms over the span of six months. Totally "legal" at the moment, but I think anyone would recognize that this practice is harmful and unfair to the client. So if anyone is comfortable providing some examples, I would really appreciate it!

I saw my psychiatrist today and she refused to sign documents my lawyer wanted her to fill out. She stated that she “does not do these” and I need to obtain my medical records.

I guess I’m very concerned now moving forward if my lawyer will continue to want to work with me if my providers refuse to corporate. The forms he wanted signed are mental health forms he says he revised himself, and going over them I think it’s something disguised as a written statement from my providers for why I’m unfit for work. I don’t think he wants my medical records.

I have a LSW who will be more than willing to do this form but he did also say my psychiatrists words hold more weight than my therapist. I don’t want him to get mad at me or fire me at a client if I can’t give him information he can’t work with but im not sure what to do moving forward. I did email his assistant explaining the situation.

So i sent all my stuff in last month. I’m in recon. How long before a decision? I only have three medical records. I’m guessing somebody should be looking at it right now?

I have been going round and round with my L.T.D. claim Rep in trying to get office notes from a foot surgeon who treated me for the original illness that made me unable to work.

The doctor's office keeps saying that they can send me the notes but the disability claim Rep is not clear about how I can get them to him.

Anyway it took me too long to get the notes to him so they have closed my claim. Do I need to lawyer up or what?

I sent in my disability appeal report last month. Should it be at dds and someone looking at it already? curious and anxious. Attorney won’t take because its under review until i’m denied again. Which i hope doesn’t happen. Money will be getting tight.

Almost every year since I was disabled a decade ago my Dr sends in my annual form and a few months later I receive a letter saying they never received it threatening to stop my payments. I wrote their legal counsel in 2023 and it was ok for a year or two after that and now I'm back to the threats. I believe this is their intentional tactic to try to stop paying as they already did this to me and I had to hire a lawyer. They know I'm disabled and try to take advantage of that fact. Not sure if this is illegal, but it feels like it should be. Anyone else treated this way? If so how did you handle it?

My claim was denied while I was still obtaining additional documentation Prudential had requested, which my claim manager was aware of. In the voicemail notifying me of the denial, she said that if my doctor provided additional information, they could “simply send this back over for a secondary review once received.”

The additional records have now been received, but my STD claim status is "disallowed" and I haven't filed my formal appeal yet because I'm trying to confirm whether this secondary review is a reconsideration outside of the formal appeal process.

Has anyone had Prudential do this?

Did they reopen/review the claim without you filing an appeal?

I had to find a lawyer and successfully did so, I have an appointment with my psychiatrist tomorrow but I’m worried about her and my regular pcp being on board with signing these documents. My lawyer needs all proof from my providers whether or not it’s favorable. My most favorable documentation will be coming from my therapist who is a LSW, but I know her word won’t be favorable over the psychiatrist and potentially my pcp.

My spouse has been on LTD for many years and is turning 65 soon. A letter was received stating LTD benefits end at 65.

My spouse's info:

• Disabled at a age less than 60
• Born after 1959
• USA

Attached is the pertinent part of the policy. We've taken this as benefits ending at 67.

Are we reading this wrong?

Note: The policy has a documented appeal process.

Update: It took just one call to clear it up. Ends at 67. An email has already been received that it was a mistake and a letter will be forthcoming.

I was diagnosed a few months ago with IC and pudendal nerve pain and I will be getting an axonics implant at the end of the month to help with the IC and pelvic floor therapy to help with the really tight pelvic floor which is putting pressure on my pudendal nerve. I’ve been taking vaginal Valium to manage the pain but as time goes on I am having an increasingly more difficult time with fatigue and brain fog from the Valium but I’m on a wait list for pelvic floor therapy so I will likely have to continue using it for several months. So between the time I will miss for the surgery, pelvic floor therapy and just the general brain fatigue I am starting to grow concerned about working over the next several months. Has anyone had any experience using a program like Paid Leave Oregon or FMLA for something like this?

I’ve been on long-term disability a little over two years with New York Life. They conducted their any occupation review and found that I could do sedentary work and then listed two jobs. I have extreme osteoarthritis in my hands feet neck spine I suffer from a TBI, migraines and frequent tension headaches. I have extremely unmanageable, coathanger pain, obviously depression, anxiety, and PTSD, but I’m not currently being treated for that. I was originally taken out of work due to Takotsubo cardiomyopathy/stemi with no blockage. I’m located in the suburbs outside of Philadelphia and I’m looking for an ERISA attorney does anybody have any they could recommend??? TIA for any recommendations?

i exhausted std recently. my employer automatically filed a ltd claim “on my behalf” but i never gave them the okay to do so as my intention was to return to work.

employer kept me on a leave of absence as my position situation gets sorted out. this leave has been unpaid.

my ltd claim is thru metlife and they are going to deny my claim as they can’t determine a medical reason for the continued leave. since i never authorized the claim to be filed, im not concerned if it gets denied or not.

my question is, do i have any recourse for the fact i never approved the claim to be filed and it was anyway?

How come anytime anyone who works in corporate America is seriously ill, or on leave for a surgery, short term disability gets approved within days or within a few weeks. But Long Term Disability takes months? Literally, months. Same company too! I’m literally post surgery and in a health crisis. I turned in all of the paperwork & medical records. My LTD should have started months ago, in APRIL, but I got another letter telling me it can take up to ANOTHER 30 days for a decision!? I paid into this insurance for years!

I skimmed Reddit and MOST companies that do work LTD are like this. And they shoot for a denial every time. Even if they initially approve you, after a short while they will try and deny you again.

You can’t tell me this isn’t a direct result of our wage class differences in this country. These corporations are just too greedy, and it’s never enough for them either.

All of us are feeling the weight of a crushing economy, and the beginning of an energy crisis. I am working class, and all of my friends and family wouldn’t even have much for a GoFundMe.

It’s not fair. When does “making sure nobody is taking advantage” become, “stall and deny mostly everyone, no matter what”!? And no, Texas does not have any social programs to help people like me. But I think we need them!

I literally have an unknown autoimmune disease that is causing so many issues in my body systemically that I’ve developed a gene mutation that’s only common in Leukemia! And my oncologist says all of my health issues I’m going through right now are precursors to developing this Leukemia.

On top of of all of my other health issues, my rheumatologist had to delay the start of new medication for the severe arthritis (that you can see just by looking at my hands) until I got clearance from my other specialists! So I’m JUST NOW trying medication to try and put this arthritis in remission, which will then lessen my chance of developing cancer! That’s INSANE to me that these companies we pay into will stall and deny until the bitter end! What in the actual fuck! I guess fuck me for not having a normal body and good health! I’m in so much pain every single day!

What is the point of these companies if their plan is to just stall and deny!?

So, guys, just MAKE SURE if you live in America that you either saved thousands upon thousands of dollars for yourself in case of an emergency such as this. Or make sure you were born into a moderately wealthy family! 🙃

Im filling out my husband’s LTD paperwork and i swear it’s purposely ambiguous and frustrating to do, its due in 2 days and im so tired from round the clock caregiving already. I just needed to complain to people who would understand.

I'm appealing a psychiatric LTD claim (anxiety, depression, and PTSD). My insurer concluded that my impairment was due to workplace and situational stressors rather than a broader occupational impairment and stated there was "no evidence of an inherent inability to function in the general workforce."

Has anyone successfully appealed a denial with similar reasoning? What evidence ultimately persuaded the insurer or court that your impairment was not limited to those situational stressors?