Invisible illnesses are not treated with the same respect as other disabilities. This is despite the fact that chronic illnesses, mental illnesses, and invisible disabilities are common, debilitating, and require the same level of care, medical attention, support, and treatment as any other illness. When you have a hidden disability and are trying to navigate a long-term disability claim, understanding your chances of approval for disability insurance benefits is important to moving forward.
What Is Invisible Illness?
An invisible illness is any condition that lacks visible or quantifiable medical evidence to prove its existence. It may be an illness there is no accurate test for or that is not able to be proven with undisputable evidence.
Invisible illnesses can carry with them extensive chronic pain and mental health difficulties. Unfortunately, these conditions and illnesses cannot be seen and are therefore not easily diagnosed. Due to this, insurance companies often deny disability claims relating to invisible illnesses, arguing that there is not enough evidence to support the argument that a claimant is disabled.
As with other illnesses, a person can become disabled from an invisible illness. They can severely impact a person’s quality of life and their ability to work. Like with other illnesses, if this occurs, you should have the right to access medical benefits and coverage on a long-term disability plan.
List of Invisible Disabilities
There are dozens of invisible disabilities. These include anxiety disorders, brain injuries, chronic pain, fibromyalgia, Lyme disease, depression, chronic fatigue syndrome, psychiatric disorders, and rheumatoid arthritis. Each tends to fall into one of four primary categories, though there may be some that do not.
- Chronic pain refers to conditions that involve debilitating pain without obvious physical evidence.
- Mental health disorders are invisible disabilities that affect cognitive and emotional functioning which often translates to significant workplace difficulties, such as attention deficit disorder, bipolar disorder, and other chronic conditions.
- Autoimmune disorders are conditions such as lupus and rheumatoid arthritis that may flare up unpredictably. A person may appear healthy, however, their mobility and energy levels can be easily impacted by a flare-up.
- Neurologic conditions include epilepsy, visual or auditory disabilities, traumatic brain injury, and multiple sclerosis. They typically lead to unseen but severe functional impairments.
As these medical conditions are not immediately apparent, people with invisible illnesses are often accused of faking or imagining their disabilities.
Examples of Invisible Disabilities in the Workplace
How an invisible disability presents in the workplace can be in several ways. Productivity often reduces on account of a person having to work slower and navigate a symptom such as chronic pain. Absenteeism increases, leading to job security concerns. A person may struggle with cognitive tasks, with their focus, decision-making, and memory affected. Restrictions in movement or stamina mean many invisible illness sufferers will struggle with tasks requiring prolonged physical exertion. There is also unfair treatment or dismissal due to all of these limitations and restrictions. As an invisible illness progresses, it makes it more difficult to find and keep work.
Once a person who is disabled is unable to work, it is recommended they apply for long-term disability benefits.
The LTD Claims Process
The long-term disability claims process is an exercise in acquiring and supplying evidence. Comprehensive medical documentation that provides a clear diagnosis of your illness and that identifies the trajectory or progress of it over time is important.
Most importantly, this documentation should also identify how your invisible illness impacts daily functioning. As you gather evidence, you will likely want to see multiple doctors, including letters and evaluations from specialists who understand your condition. These physicians can reinforce your claim and validate the severity of your symptoms.
After you have your evidence, the next step is to complete the insurer’s forms and file them by the deadline. Provide consistent, detailed answers on your LTD claim form. Ensure there are no discrepancies that may delay or deny approval.
After your long-term disability claim is filed, the next step is to wait for an approval or denial.
In the meantime, continue to work closely with your doctor and other medical professionals you’ve been recommended. Ensure the care and progression of your invisible illness is still being documented and that your ability to work, or lack thereof, is still a focus.
Common Reasons for a Denied Claim
Insufficient Medical Documentation
Medical evidence is typically required by insurance companies to justify any sort of disability claim. With invisible disabilities and chronic medical conditions, even more evidence is often required. When you seek treatment, doctors always record a note and document the stage of an illness or condition, which acts as evidence. In some cases, an insurer may argue the medical documents do not support the extent of your disability claim. A long-term disability lawyer can help you obtain the documentation and put forth the argument you need to present a case of why you are unable to work.
Lack of Appropriate Treatment
You may have been recently diagnosed with an invisible disability by a family physician but have not yet seen a specialist or enough specialists for an insurance company to approve your claim. They may deny your claim by stating that you have not yet obtained the appropriate treatment that the insurance company accepts and recommends for a person with your invisible disabilities. This is often the case with chronic pain sufferers who are required to seek out specific specialists to back their claims. While you’re waiting to see a specialist, however, this should not prevent you from receiving benefits you are rightfully owed.
They Deny Your Disability
An insurance company may not believe you fit the legal definition of ‘totally disabled’ and may argue yourself still capable of working, even with a physical or mental impairment. That said, if your invisible disability is preventing you from performing a significant portion of your occupation, or any other occupation for which you could normally fulfill the role, you qualify for long-term disability. Disability benefits are not strictly for individuals who have a catastrophic injury or who have been incapacitated.
They Deny Your Lack of Ability to Work
Many insurers will take the stance that someone with an invisible disability may not be able to fulfill the expectations of the job you had but that there is similar work available. You may not subscribe to this belief and a doctor’s medical advice may not agree with the insurer. You may be suggested to complete a skills assessment, such as if you’re arguing your chronic illness ties to a mental illness or social or emotional development. If you complete a skills assessment and the results are different from your doctor’s advice, it’s best to contact a disability lawyer without delay.
Why You Need a Long-Term Disability Lawyer
A long-term disability lawyer specializes in LTD claims and is able to guide you through the process of fighting for your rights after you’ve been denied benefits.
Their expertise and experience ensure you submit the strongest application possible with the necessary documentation. A lawyer can help obtain the strongest possible medical evidence and will work to identify legal errors that may exist in an insurance company’s refusal to provide benefits.
Long-term disability benefits relating to invisible illnesses can be complex. The criteria can sometimes be unclear and technical details can make filing an appeal or even filing a claim a difficult process. Maximize the likelihood of success when you apply and save yourself time and stress. Secure the disability benefits you deserve as someone who is not able to work because of invisible disabilities.
What Should I Do if My Invisible Disability Claim Was Denied?
- Request a reason your disability claim was denied if one was not provided. Ask what evidence they require.
- Gather additional medical evidence that will strengthen your claim, such as more detailed reports, physician testimony, and diagnostic tests.
- Note the appeal deadline. Work with a lawyer before filing your appeal to ensure there isn’t alternative legal action to take.
An insurance company refusing to pay when you rightfully claim compensation through long-term disability benefits is a fairly normal occurrence. If your LTD claim for an invisible disability is denied, it can be devastating. Already suffering from the stress and pain of a hidden disability, and now you have an insurer denying that you have the right to benefits.
Talk to a long-term disability lawyer about what to do next. Do not accept being denied your rights. An insurance company may recommend you appeal the denial, however, it’s strongly recommended to not go through the insurance company’s appeals process. This is often a tactic to run out the clock on the time limit to file a claim while also eventually denying your claim. Talk to your lawyer first.
The disability legal team at Joshua Goldberg Law wants to sit down with you if your invisible disability claim was denied. We will review your situation, advise on what your best strategy is moving forward, and are willing to advocate to your insurance company on your behalf. If your insurer owes you money under the requirements of the law, we will ensure you receive the compensation you deserve.
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