Info Library

 Clear Information About Long Term Disability Claims

The Info Library is a comprehensive educational resource for people navigating long term disability claims.

Here, you can learn how disability insurers evaluate medical conditions, occupational duties, policy language, medical evidence, appeals, benefit terminations, and litigation. Each guide focuses on a specific issue that may affect your eligibility for benefits or the strength of your claim.

Use the search feature above or browse the topic areas below.

Diagnoses

A medical diagnosis can have a profound impact on your ability to work, but not every diagnosis is evaluated the same way by disability insurance companies.

Our diagnosis guides explain how specific medical conditions may affect your eligibility for long term disability benefits, the evidence insurers typically look for, and the unique challenges claimants often face throughout the claims process.

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Occupations

Your occupation is one of the most important factors in a long term disability claim. Disability insurance companies evaluate more than just your diagnosis; they assess whether your condition prevents you from performing the material duties of your specific occupation.

Our occupation guides explore the unique demands of different professions and the evidence that can help support a successful disability claim. Whether you are filing an initial claim, appealing a denial, or protecting ongoing benefits, understanding how your occupation is evaluated is essential.

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Insurers

The insurance company handling your long term disability claim can significantly impact your experience throughout the claims process. While every insurer evaluates disability claims differently, each has its own procedures, priorities, and common reasons for delaying, denying, or terminating benefits.

Our insurer guides examine the practices of major disability insurance companies, explain the challenges claimants commonly encounter, and provide insight into the strategies that can help strengthen your claim at every stage.

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Policy Terms

Your disability insurance policy is the foundation of your claim. The language in your policy determines who is eligible for benefits, how disability is defined, what limitations or exclusions may apply, and what evidence you need to provide throughout the claims process.

Our policy guides explain the key provisions found in many long term disability policies and help you understand how your policy can affect your eligibility, benefits, and claim strategy.

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Claim Strategies

Every long term disability claim presents unique challenges, and the steps you take throughout the process can have a significant impact on your ability to obtain and maintain benefits. Understanding how disability insurers evaluate claims can help you make informed decisions from the outset.

Our claim strategy guides cover important topics such as documenting your disability, working with your treating physicians, responding to insurer requests, preparing appeals, and protecting your benefits throughout the life of your claim.

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Litigation Issues

If your long term disability claim cannot be resolved during the administrative claims process, the next step may involve litigation or mediation. Understanding how these proceedings work can help you make informed decisions about your legal options and what to expect as your case moves forward.

Our litigation and mediation guides explain important legal concepts, court procedures, settlement discussions, standards of review, and other issues that may arise after a claim has been denied or terminated.

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Case Studies

Overcoming Denial: A Chronic Fatigue Syndrome Success Story

Success Stories Manager Case Studies Strategy - Appeal a Denial Diagnosis - Myalgic Encephalomyelitis Dignosis - Chronic Fatigue Syndome Diagnosis - Chronic Fatigue Syndrome (CFS)

“Christine” was employed as a data manager at a newspaper when she became terribly ill with Chronic Fatigue Syndrome. For more than a year Christine struggled to continue to work, only to find that each day it became more and more difficult.

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Engineer with Fibromyalgia Secures Long Term Disability Benefits

Success Stories Diagnosis - Fibromyalgia Engineer Case Studies Strategy - Appeal a Denial

“Carol” was an engineer at a major communications company. She was required to conduct on-site inspections, sometimes requiring her to crawl through cable tunnels. It was a very demanding job, but she loved it. When Carol became afflicted with Fibromyalgia she attempted a part-time schedule but was ultimately unable to work even in a limited capacity.

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Spondylolisthesis Disability Disrupts Attorney's Career

Success Stories Attorney Diagnosis - Spondylolisthesis Case Studies Lawyer Diagnosis - Spinal Condition

“Barbara” was an ambitious young associate attorney at a major law firm. She had been hampered by a degenerative back and spine condition most of her life but was still driven to complete law school and obtain a job at a prestigious law firm. By the time that she reached her early 30’s, however, Barbara could no longer fight her debilitating pain. She stopped work and applied for disability benefits on her own.

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Trader Overcomes Hearing Loss to Win Disability Benefits

Success Stories Traders Diagnosis - Hearing Impairment Case Studies

“Arnold” was a successful trader at a small brokerage firm reaping the benefits of a strong market. Unfortunately, Arnold was struck in the head during a mugging, and as a result suffered permanent left-sided hearing loss, including conductive as well as high frequency sensorineural hearing losses. Even though Arnold can hold a conversation with someone in a quiet room, he has tremendous difficulty hearing in a noisy environment such as a trading room. The insurance company denied Arnold’s claim for long term disability benefits on the unscientific premise that his hearing deficit could be corrected by a hearing aid.

Riemer Hess commenced a lawsuit on his behalf in Federal court. The Firm prepared a detailed motion for summary judgment arguing that there was substantial scientific evidence establishing that a hearing aid would make Arnold’s hearing loss worse not better. Rather than opposing the Firm’s motion, the insurer approached the Firm for a settlement. A settlement was reached providing Arnold with a substantial lump sum payment.

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Lawsuit Won for Senior Manager With Depression

Success Stories Manager Case Studies Success Story Diagnosis - Depression

“Larry” was a senior manager at a major consulting firm. As a result of a series of major stresses in both his personal and professional life, Larry was hospitalized with major depression and suicidal ideation. When the insurance company denied Larry’s claim, Larry hired Riemer Hess to prepare an appeal.

The Firm submitted comprehensive letters from Larry’s treating psychiatrists, who opined that Larry was disabled from any occupation; detailed statements of Larry’s family and co-workers, corroborating his incapacity; and an in depth affidavit from Larry describing how depression slowly but surely made him unable to function and took away all joy in his life. The insurance company still denied Larry’s appeal, asserting that Larry did not submit objective proof of his depression even though it is well known that disability from depression cannot be demonstrated “objectively.”

Riemer Hess immediately commenced a lawsuit on Larry’s behalf in Federal Court. Our persistence eventually convinced the insurer to settle the case. Larry received a substantial lump sum settlement and can now get on with his life.

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