Your Disability Benefits Have Been Denied Or Terminated By Metlife. What Can You Do? The ERISA Law Center Can Help You.
Most disability benefit claims are governed by ERISA. Some disability benefit claims, those based on government plans and some church plans, are not governed by ERISA. Either way, the ERISA Law Center can help you. We regularly represent persons who have been denied both and ERISA and non-ERISA disability benefits by MetLife.
Disability benefit claims denied by MetLife often follow a common pattern. Sometimes MetLife denies disability benefits because you or your doctors did not complete and submit to MetLife forms or medical records it requested. You can often fix that problem yourself by completing the forms, seeing your doctor, and getting your doctor to do complete forms, and provide medical records.
In most MetLife disability policies, the definition of “disabled” changes after you receive 24 months of benefits. For the first 24 months, you are entitled to benefits if you are unable to do your own occupation. After 24 months, you are entitled to benefits only if you cannot do any occupation. MetLife will often terminate disability benefits with just a few months of “own occupation” benefits to be paid. Another common pattern is that MetLife terminates benefits after paying all the “own occupation” definition of disability benefits.
Often MetLife will deny or terminate disability benefits during the “own occupation” definition of disabled not because it claims you can do your own job but because MetLife claims you can do a similar job. Most MetLife policies define “your occupation” not as what you actually do for your employer but what people doing similar jobs generally.
Most MetLife disability policies have a change of definition to the “any occupation” definition after you receive 24 months of benefits. Often MetLife terminates benefits at the end of 24 months, claiming you can do some other job. Often the jobs MetLife claims you can do are make-believe. Often the wages MetLife claims you can earn are also make-believe. But, MetLife has a report from a vocational expert – employed by MetLife who says you can perform these jobs and earn these wages.
When MetLife denies or terminates benefits it invites you to request a review and file and “appeal.” Typically, after the appeal is submitted MetLife obtains new medical or vocational reports and invites you to review those new reports and comment on those. When you only have a few months left of benefits under the own occupation standard and it denies those benefits, it forces you to do a full appeal and to comment on its new medical and vocational reviews for just a few months’ benefits – and then typically denies benefits again when the definition of disabled changes to the any occupation definition.
Sometimes MetLife pays disability benefits for the entire own occupation period and then for many years under the any occupation definition of disabled. Sometimes you can go for years without MetLife ever requesting new medical records – just an annual statement from you and your doctor that you continue to be disabled. But then MetLife terminates your disability benefits even though you have never gotten better.
MetLife uses a variety of medical professionals – nurses and doctors it employs and nurses and doctors employed by others to review your records. These nurses and doctors often “cherry-pick” your medical records – picking bits and pieces out of context to support the conclusion that you are capable of working.
Sometimes MetLife will require that you attend an “independent medical examination” or a “functional capacity evaluation.” Often MetLife secretly surveils you while you are going to and from these examinations and on the days before and after these examinations – and then claim that because you can walk to your car, drive your car, and maybe fill it with gasoline, you are capable of working.
MetLife has a lot of hidden rules and practices which it does not share with claimants. Often MetLife “moves the target” or “hides the target.” That is, MetLife tells you in general terms to submit certain types of records to support your claim or appeal; but no matter what you submit it is never good enough, and your benefits are denied or terminated or your appeal is denied. It “moves the target” by rejecting whatever you provide; it “hides the target” by not telling you what you should provide. MetLife uses a lot of the same inside and outside doctors to evaluate claims – and these doctors write the same reports or essentially the over and over again, which MetLife uses to deny or terminate benefits.
MetLife policies often have a lot of complicated exclusions and limitations of benefits, which MetLife often misrepresents and misconstrues to claimants.
The law – whether ERISA or if not an ERISA claim, state law – gives you the right to fight back to recover your disability benefits. The ERISA Law Center can help you. We know the law. We know MetLife’s common practices. We know what evidence you need to demonstrate either to MetLife or in court if your internal appeal is not granted to recover your disability benefits.