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Pandemic complicates things for many LTD claimants

by | Mar 22, 2021 | Long Term Disability Claim Denial

Suffice it to say that COVID-19 has upended lives across the planet.  It has interacted in truly pernicious ways with millions of individuals and families spanning the United States.

The Los Angeles Times notes in a recent article one particular demographic that has been hit especially hard during the is a group collectively termed “long haulers,” which is a descriptor applicable to COVID-19 victims suffering from so-called “long COVID.” That malady is differentiated by the fact that its sufferers can’t seem to shake totally free of debilitating viral symptoms. Their conditions wax and wane, ultimately leading to prolonged periods of disability.

Here’s another downside, as noted by the Times piece: Increasingly, insurers are playing hardball with ERISA long-term disability claimants, refusing to acknowledge the validity of COVID-19 claims and contractually following through on them.

In doing so, they cite to alleged claim deficiencies both multiple and varied, including these:

  • Insufficient medical proofs
  • Presented symptoms that are dismissed for their subjectivity in lieu of objective evidence

The first hurdle is hard for most claimants to overcome, given the paucity and variance in lab testing during the initial months of the viral spread. And the “subjective” rejoinder is a common insurer response in conditions ranging broadly across many health challenges.

Many applicants are forced to appeal initial denials, which the Times duly underscores is a standard ERISA process. Appeals are mandatory before any denied claimant can pursue a court remedy.

It is also important to note this: It is critically important for a claimant to amass comprehensive and accurate information at the appeals stage. An authoritative national legal source on disability claims under ERISA notes that “once you complete the appeal process, you cannot add to or alter the administrative record.”

That dictates getting things done properly in a timely way. A proven disability law legal team can ensure that a claimant does precisely that.