Long Term Disability for Idiopathic Pulmonary Fibrosis: What You Need to Know

Living with idiopathic pulmonary fibrosis (“IPF”) can be overwhelming — not only physically and emotionally, but also professionally.  As the disease progresses, its impact on your ability to work can become impossible to ignore, especially for high-earning professionals in demanding roles.  If you are finding it difficult to keep up with the demands of your occupation due to IPF, you may be wondering whether long term disability (“LTD”) benefits are available to help protect your income and future.

Below we’ll answer common questions about qualifying for long term disability benefits for IPF, discuss strategies for overcoming common insurer tactics, and explain how working with an experienced ERISA long term disability attorney can make all the difference.

How does Idiopathic Pulmonary Fibrosis cause disability?

Idiopathic Pulmonary Fibrosis (“IPF”) is a serious, progressive lung disease that causes scarring (fibrosis) of the lung tissue.  Over time, this scarring thickens and stiffens the lungs, making it increasingly difficult for oxygen to pass into the bloodstream.  As a result, your body’s organs and muscles receive less oxygen, which can significantly limit your ability to perform even basic physical activities — let alone the demands of a professional work environment.

While the cause of IPF is unknown, its impact is unmistakable.  The disease usually worsens over time, and there is currently no known cure.  Treatments may slow the progression, but most individuals experience a steady decline in respiratory function.

Common Disabling Symptoms of IPF

Individuals with IPF typically experience a range of debilitating symptoms, including:

• • Chronic, dry cough: A persistent cough can be disruptive in professional settings, especially in roles that require communication, presentations, or client interaction.
  • Shortness of breath (dyspnea): Even minor physical exertion — such as walking across an office, climbing stairs, or standing for extended periods — can trigger severe shortness of breath.  This symptom often worsens over time, severely limiting stamina.
  • Fatigue and exhaustion: Reduced oxygen levels in the bloodstream can cause profound, unrelenting fatigue, making it difficult to maintain concentration, mental sharpness, and physical energy throughout a workday.
  • Chest discomfort and pain: Tightness or pain in the chest can make it uncomfortable or impossible to sit, stand, or move around for long periods.
  • Weight loss and muscle wasting: As the disease progresses, many individuals experience involuntary weight loss and muscle weakness, further impairing physical function.
  • Low oxygen levels: Advanced IPF often requires supplemental oxygen, which can present logistical challenges and limitations in many professional environments.

For many professionals, such as executives, attorneys, physicians, engineers, and consultants, the symptoms of IPF can be career-ending.  Fatigue and low oxygen levels can impair memory, focus, and decision-making skills, making it difficult to perform mentally demanding tasks.  Shortness of breath and muscle weakness can make it impossible to attend meetings, travel for work, or maintain a typical office schedule.  Most professional roles demand sustained energy, responsiveness, and adaptability — all of which become increasingly difficult as IPF progresses.

Even if your symptoms are manageable in the early stages, the progressive nature of IPF typically leads to increasing functional limitations that ultimately prevent working.  Filing for long term disability benefits for idiopathic pulmonary fibrosis can be challenging, especially when dealing with a complex disease and an insurance company that may not fully understand your limitations.  An experienced ERISA long term disability attorney can be invaluable in guiding you through the process.

Can I receive long term disability benefits for Idiopathic Pulmonary Fibrosis?

Yes, you may be eligible to receive long term disability (“LTD”) benefits if idiopathic pulmonary fibrosis (“IPF”) prevents you from performing the duties of your job.  IPF is a serious and progressive lung disease that leads to scarring of the lungs, chronic shortness of breath, severe fatigue, and reduced physical stamina.  As the disease advances, even routine activities can become exhausting, making it extremely difficult — and eventually impossible — to maintain full-time employment, especially in high-demand professional roles.

Whether or not you can receive LTD benefits due to your IPF will depend on the terms of your policy.  Most long term disability policies require that you meet specific eligibility criteria to qualify for benefits.

The two most common definitions of disability you may encounter in your policy are:

• • Own Occupation Standard: Under this standard, in the initial stages of your claim — typically the first 24 months — you must demonstrate that you are unable to perform the material and substantial duties of your own occupation.  For professionals, even early symptoms like chronic coughing, shortness of breath with exertion, fatigue, and cognitive difficulties (sometimes called “brain fog” due to low oxygen levels) can prevent effective performance in demanding roles.
  • Any Occupation Standard: After the “own occupation” period ends, many policies shift to a stricter “any occupation” definition.  At that point, you must prove that you are unable to perform the duties of any occupation for which you are reasonably suited based on your education, experience, and training.  Given the progressive nature of IPF, many individuals eventually meet this more stringent standard as the disease worsens.

In addition to the disability definition, you must also satisfy other policy requirements, such as meeting any elimination period (waiting period before benefits begin) and continuing to provide proof of ongoing disability as requested by the insurer.

Determining whether you meet your policy’s definition of disability — both now and into the future — can be complicated.  Every disability policy has its own language, and insurers often interpret that language narrowly to deny or limit claims.  It’s recommended that you consult an ERISA attorney with experience in disability claims.  Working with a knowledgeable long term disability attorney can help you secure your benefits and avoid common pitfalls that could otherwise jeopardize your financial security.

What evidence is needed to support a long term disability claim for IPF?

Successfully securing long term disability (“LTD”) benefits for idiopathic pulmonary fibrosis (“IPF”) requires strong, detailed evidence that proves the extent of your functional limitations.  Insurance companies expect clear, objective documentation showing that your symptoms prevent you from performing your occupational duties.

There are two components to any LTD claim: medical evidence to demonstrate the legitimacy, severity, and frequency of your symptoms, and vocational evidence to explain the physical and cognitive demands of your occupation.

Medical Evidence for IPF Disability Claims

Medical evidence is the foundation of your disability claim.  For IPF, you should submit comprehensive documentation showing the diagnosis, progression, and impact of your disease, including:

• • Pulmonary Function Tests (“PFT”): These tests measure your lung capacity and breathing ability.  Abnormal results showing decreased forced vital capacity ("FVC") or diffusing capacity for carbon monoxide (“DLCO”) are critical to proving the severity of your respiratory impairment.
  • High-Resolution CT (“HRCT”) Scans: Imaging studies that confirm the presence of lung fibrosis are key objective proof of your IPF diagnosis.
  • Oxygen Therapy Records: Documentation showing that you require supplemental oxygen — at rest, during exertion, or both — strongly supports the seriousness of your condition.
  • 6-Minute Walk Test (“6MWT”): This standardized test evaluates how far you can walk in six minutes while measuring your oxygen levels.  Reduced distance or significant oxygen desaturation can objectively show impaired stamina and exertional limitations.
  • Treating Physician Statements: Detailed narrative letters from your pulmonologist and other treating doctors explaining how your IPF symptoms — such as shortness of breath, fatigue, coughing, and weakness — interfere with your ability to work are extremely valuable.  It’s important that these statements are specific and consistent with the medical records.
  • Medication and Treatment History: Records showing attempts to manage your condition, including use of antifibrotic medications, pulmonary rehabilitation, or transplant evaluations, can help demonstrate the seriousness of your disease and your compliance with treatment.

In some cases, undergoing a Functional Capacity Evaluation (“FCE”) can be very helpful.  An FCE is a comprehensive, standardized series of physical tests designed to measure your endurance, strength, flexibility, and physical functioning.

An FCE can:

• • Objectively demonstrate your inability to meet the physical requirements of your occupation;
  • Measure how quickly you fatigue during activity, which is critical in IPF claims where stamina is compromised; and
  • Provide data on whether you require frequent rest breaks, whether you experience oxygen desaturation with minimal exertion, and whether you can sustain full-time work on a consistent basis.
    
    

Vocational Evidence for IPF Disability Claims

In addition to medical documentation, vocational evidence can powerfully connect your medical limitations to your occupational duties.  Useful vocational evidence includes:

• • Vocational Assessment: A formal vocational assessment conducted by a certified vocational expert can assess your ability to perform your occupation in light of your limitations.  The expert will analyze the physical and cognitive demands of your role compared to your functional restrictions.
  • Official Job Description: A detailed explanation of your job duties — especially if your role involved travel, public speaking, long meetings, managing staff, or any physical exertion — helps show why your IPF symptoms prevent you from working.
  • Employer Statements: Letters or reports from your employer verifying your job demands and any accommodations you unsuccessfully tried can further support your claim.

How can I document the progression of my IPF for my insurer?

When you file a long term disability claim — and throughout the duration of your benefits — your insurer will require that you continually document how your idiopathic pulmonary fibrosis (“IPF”) is progressing.  Because IPF is a progressive and often unpredictable disease, insurance companies expect ongoing proof that your condition is deteriorating or continuing to prevent you from working.

Providing consistent, thorough documentation is critical to showing that your disability remains legitimate and meets your policy’s requirements.  Here are a few key ways to document the progression of your IPF:

• • Regular Pulmonary Function Testing (“PFT”): Pulmonary function tests measure how well your lungs are working.  By undergoing regular PFTs — often every three to six months — you create a clear, objective record of your declining lung capacity and worsening respiratory function.  Decreases in your forced vital capacity (“FVC”) or diffusing capacity for carbon monoxide (“DLCO”) over time are strong evidence of disease progression.
  • High-Resolution CT (“HRCT”) Imaging: Repeat imaging studies, such as HRCT scans, can visually confirm the increase in lung fibrosis over time.  Comparing imaging results from different dates helps show the structural worsening of your lungs.
  • Six-Minute Walk Tests (“6MWTs”): A series of 6MWTs can track how your functional endurance declines.  If you are walking shorter distances, experiencing more oxygen desaturation, or needing higher oxygen flow rates during testing, it clearly demonstrates disease advancement.
  • Treatment Changes and Escalations: If your pulmonologist adjusts your medications, increases your supplemental oxygen needs, or recommends more intensive interventions like pulmonary rehabilitation or transplant evaluation, these changes should be documented.  Escalating treatment shows that your disease is no longer stable.
  • Detailed Physician Statements Over Time: Your treating pulmonologist and other specialists should provide updated narrative letters that describe how your symptoms — such as shortness of breath at rest, severe fatigue, and coughing fits — are worsening.  These letters should be specific, not general, and ideally tied to the functional impact on your daily and work activities.
  • Symptom Diaries and Self-Reports: Keeping a personal symptom diary can be helpful.  Note episodes of extreme shortness of breath, fatigue, weakness, use of supplemental oxygen, and limitations in daily activities.  Your insurer may request claimant statements, and having a consistent record can help you answer accurately.
  • Hospitalizations and Acute Exacerbations: If you are hospitalized for respiratory issues, infections, or acute exacerbations of IPF, be sure to provide full hospital records.  Hospitalizations are significant indicators of disease progression.

Insurance companies often conduct ongoing reviews of claims, especially for progressive diseases like IPF.  If there are gaps or inconsistencies in your medical records, your insurer may argue that your condition has improved or is not as disabling as initially presented.  Consistent documentation ensures there is no doubt about the trajectory of your illness and your ongoing eligibility for benefits.

Working with an experienced long term disability attorney can also help you stay proactive.  Your attorney can guide you in gathering the right types of documentation, coordinating with your doctors, and anticipating your insurer’s scrutiny — helping to protect your benefits for the long term.

What are common reasons insurers deny claims for idiopathic pulmonary fibrosis?

Despite the serious and progressive nature of idiopathic pulmonary fibrosis (“IPF”), insurers frequently deny long term disability (“LTD”) claims related to the disease.  Insurance companies often look for ways to minimize their financial exposure, and IPF claims — particularly in the early or moderate stages — are not immune to scrutiny.  Understanding why your insurer may deny your claim can help you avoid pitfalls and strengthen your claim from the beginning.

Common reasons insurers deny IPF claims may include:

• • Alleging Insufficient Objective Evidence: Insurance companies often argue that there is not enough objective evidence to support the severity of your symptoms.  For example, they may claim that pulmonary function tests show only mild to moderate impairment, imaging results do not demonstrate significant fibrosis, or there is no documented need for continuous supplemental oxygen.  Because insurers heavily rely on objective medical tests, any perceived gaps or inconsistencies in your medical documentation can be grounds for denial — even if your symptoms are truly disabling.
  • Downplaying the Impact of Symptoms: IPF symptoms like shortness of breath, fatigue, coughing, and weakness can fluctuate or be subjective in nature.  Insurers may argue that you should still be able to perform sedentary work, even if physical exertion is limited, or that your symptoms are not corroborated by clinical findings.  They may also disregard the cumulative effect of multiple symptoms, focusing instead on each symptom individually to downplay the overall impact.
  • Relying on Outdated or Incomplete Medical Records: If your medical records are outdated, sporadic, or fail to show a worsening trend, your insurer may assert that your condition is stable or improving.  For progressive diseases like IPF, it is essential to show ongoing decline and escalating limitations through frequent and consistent medical updates.
  • Citing Lack of Aggressive Treatment: Insurers sometimes deny claims by arguing that if your IPF were truly disabling, you would be undergoing more aggressive treatment.  They may point to a lack of oxygen therapy, no referral for pulmonary rehabilitation, or no consideration of lung transplantation.  They use this reasoning to suggest that your condition is not as severe as claimed, even if your physician has determined that aggressive treatment is not appropriate in your case.
  • Misclassifying the Nature of Your Occupation: For professionals in high-responsibility roles, insurers sometimes misclassify the demands of your occupation, treating it as “sedentary” simply because it is office-based.  They may ignore the reality that even desk jobs often require significant stamina, mental sharpness, communication, travel, or extended periods of activity — all of which can be severely impaired by IPF.
  • Using Biased Defensive Medical Examinations (“DMEs”): Insurers may require you to attend an “independent” medical examination conducted by a physician they select.  These doctors are often financially motivated to produce reports that minimize your restrictions and support claim denial.  Oftentimes these examinations are cursory and the examiners will underreport your symptoms, suggest you can work with “reasonable accommodations,” and/or dispute the severity of your functional limitations, despite all evidence to the contrary.
  • Surveillance and Misleading Observations: Sometimes, insurers hire investigators to conduct video surveillance, hoping to catch you performing daily activities that they can portray as inconsistent with your claimed limitations.  Innocent activities — such as slowly walking to your car or attending a doctor’s appointment — can be taken out of context and used to question your credibility.

Understanding these common denial tactics is the first step in protecting your claim.  Consistent medical documentation, honest communication about your symptoms, and early involvement of an experienced ERISA long term disability attorney can greatly improve your chances of approval and help you fight back if your claim is unfairly denied.

Will my insurer continue to monitor my condition over time?

Yes, if your long term disability (“LTD”) claim for idiopathic pulmonary fibrosis (“IPF”) is approved, you should expect your insurance company to continue monitoring your condition for as long as you receive benefits.  Approval is not the end of the process, as your insurer will require you to regularly prove that you remain disabled under the terms of your policy.

Because IPF is a progressive disease, insurers recognize that your condition will likely worsen over time.  However, they will still require consistent proof that your disability continues to prevent you from working.

Insurance companies use a variety of methods to monitor your claim after approval, including:

• • Requesting Updated Medical Records: Your insurer may ask for updated records from your pulmonologist and any other treating physicians every 3 to 6 months, or sometimes annually, depending on your policy and your insurer’s practices.
  • Requesting Updated Attending Physician Statements (“APS”): Your insurer will likely send your doctors forms to complete, asking them to verify your ongoing diagnoses, symptoms, treatment, and functional limitations.
  • Requesting Personal Claimant Updates: You may be asked to complete periodic questionnaires describing your daily activities, symptoms, and ability to perform tasks at home.
  • Conducting Defensive Medical Evaluations: Your insurer might request that you attend a new medical examination with a doctor of their choosing to reassess your condition.
  • Surveillance and Social Media Monitoring: Insurers sometimes conduct video surveillance or monitor your social media profiles to look for evidence that contradicts your reported limitations.

While it can feel invasive, ongoing monitoring is a standard practice in LTD claims — especially for chronic conditions like IPF.  If you fail to provide requested information, or if your records appear inconsistent or incomplete, your insurer may attempt to terminate your benefits.

That’s why it’s so important to maintain regular treatment, follow your doctors’ advice, and consistently document your symptoms and limitations.  Showing a steady record of disease progression, ongoing treatment, and adherence to medical recommendations strengthens your position and protects your benefits.

An experienced ERISA long term disability attorney can help you manage this ongoing process by advising you on insurer requests and coordinating with your doctors to ensure that medical updates accurately reflect your continuing disability.  An attorney can also proactively respond to insurer tactics, including challenging unfair IME requests or misleading surveillance if your insurer tries to terminate your benefits without cause.

How often will I need to provide updated medical records?

If your long term disability (“LTD”) claim for idiopathic pulmonary fibrosis (“IPF”) is approved, you will be required to provide updated medical records on an ongoing basis to maintain your benefits.  Insurers do not simply approve a claim and walk away — they continuously monitor your condition to ensure you still meet the definition of disability under your policy.

Many insurance companies request updated medical records and physician statements approximately every three to six months during the first couple of years after a claim is approved.  This frequency can vary based on your specific insurer, the severity of your condition, and whether your policy transitions from “own occupation” to “any occupation” standards.

If your claim has been ongoing for several years and your disease progression is well documented, your insurer might reduce the frequency of requests to once per year.

Failing to provide updated medical records when requested — or submitting incomplete or inconsistent records — can give your insurer a reason to terminate your benefits.  It is critical to stay proactive, maintain consistent treatment, and make sure your medical records accurately reflect your ongoing symptoms and limitations.

How can an attorney help with my Idiopathic Pulmonary Fibrosis long term disability claim?

Filing for long term disability (“LTD”) benefits due to idiopathic pulmonary fibrosis (“IPF”) can be overwhelming — especially when you are already coping with the daily challenges of a progressive lung disease.  An experienced long term disability attorney can make a major difference in both getting your claim approved and protecting your benefits over the long term.

Here’s how an attorney can help at every stage of your journey:

• • Evaluating Your Eligibility Before You File: An attorney will review your disability policy carefully to explain the specific requirements you must meet, including whether your policy uses an “own occupation” or “any occupation” definition of disability, what deadlines and elimination periods apply, and what specific evidence your insurer will expect.  Understanding these details upfront helps you avoid mistakes that could weaken your claim.
  • Building a Strong, Evidence-Backed Claim: Insurance companies often deny claims that are incomplete, inconsistent, or unsupported by objective evidence.  Your attorney can help by gathering comprehensive medical records, securing detailed, supportive statements from your pulmonologist and other treating physicians, and coordinating vocational evidence, such as a vocational assessment, to show why you cannot meet the demands of your profession.  Your attorney knows what insurers look for — and how to present your evidence in the strongest possible light.
  • Protecting You from Common Insurance Tactics: Insurers may try to delay, underpay, or deny legitimate claims by mischaracterizing your symptoms as “mild” or “manageable” or claiming you can still perform sedentary work.  They also may use biased defensive medical examiners or surveillance to challenge your disability.  Your attorney will anticipate these tactics, respond aggressively, and protect your rights at every step.
  • Handling Appeals if Your Claim is Denied: If your claim is denied, you have a limited time to file an administrative appeal.  The appeal is often your best and only chance to strengthen the record before litigation.  An attorney can review the denial letter carefully to identify your insurer’s weak points, develop a comprehensive appeal strategy, and submit powerful new medical, vocational, and legal evidence to overturn the denial.
  • Litigating in Court if Necessary: If your appeal is unsuccessful, your attorney can sue your insurer in federal court.  LTD litigation is highly technical, and having an experienced litigator greatly increases your chances of success.
  • Supporting You Throughout the Life of Your Claim: Even after approval, insurers continue to monitor your condition and can try to terminate your benefits.  An attorney can ensure that your periodic medical updates are handled properly, intervene quickly if the insurer issues new demands or threatens termination, and advise you on how to protect your claim as your IPF progresses.

Managing a long term disability claim while living with idiopathic pulmonary fibrosis is not something you should have to face alone.  A skilled ERISA disability attorney acts as your advocate, shielding you from insurer tactics, ensuring your claim is properly documented, and giving you peace of mind — so you can focus on your health and your future.

Client Success Story: Idiopathic Pulmonary Fibrosis

At Riemer Hess, we have over three decades of experience in securing long term disability benefits for professionals and executives, including those with idiopathic pulmonary fibrosis. 

Below is a real life example of a client with IPF who came to Riemer Hess for help:

“Bill” was a successful hedge fund partner who had managed to work for years despite a chronic sarcoid condition that left scarring in his lungs.  But when he began experiencing new, severe symptoms, he was diagnosed with Idiopathic Pulmonary Fibrosis (“IPF”), which inflamed previously unaffected areas of his lungs.  The disease required him to use oxygen and left him with profound fatigue.  Although he hoped to continue working on a reduced schedule from home, his condition—and the hours of pulmonary rehab his doctors prescribed each week—made full-time work impossible.

When Bill came to Riemer Hess, he was uncertain how to proceed.  He hoped to maintain a limited role at his hedge fund but was concerned about how this would impact his long term disability claim.  Our attorneys carefully explained the risks of pursuing a residual (partial) disability claim, including the potential for increased insurer scrutiny and reduced benefits.  Despite these concerns, Bill was committed to continuing some work, so our attorneys developed a tailored strategy to pursue residual benefits while minimizing his risk.

Riemer Hess worked closely with Bill’s employer to secure a detailed letter describing the demands of his full-time partnership role and how his health prevented him from meeting them.  Our attorneys helped shape his narrative to emphasize that, while he retained the capacity for limited tasks, he could no longer engage in critical duties like high-level client meetings, investment oversight, or business development.  Riemer Hess also obtained complete medical records and collaborated with Bill's treating physicians to craft detailed, consistent support letters tying his symptoms and treatment to his functional restrictions.  We documented every aspect of his condition to support his reduced capacity.

With a carefully coordinated strategy from Riemer Hess and consistent evidence, Bill’s insurer approved his claim for residual disability benefits.  Having secured his benefits with help from Riemer Hess, Bill was able to maintain a limited professional presence while receiving the financial support he needed.  Bill was grateful to Riemer Hess for our assistance and continued to retain the firm for benefit protection.

If you’re looking to file a long term disability insurance claim for lung cancer, appeal a wrongful claim denial, or litigate your insurer, Riemer Hess can help. Contact us today at (212) 297-0700 or click the button below for a consultation on your disability case.