MetLife Long Term Disability Insurance Claim Lawyers

Metlife Disability Claim Denials

MetLife is one of the largest insurance companies in the world, and MetLife provides disability insurance coverage, both for private policies and group LTD (ERISA) policies for employees that receive this coverage through their employment.  Has your MetLife long term disability insurance claim recently been denied or terminated?   You are not alone, as we are contacted every day by insureds who have received a letter or phone call, often near end of fiscal quarter, from MetLife advising that their long-term disability insurance claim has been denied, or terminated. 

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What can you do if an insurance company as big as MetLife has denied or terminated your disability insurance claim?

Review the MetLife Disability Claim Denials:

What is the date of the letter? 

This is extremely important, as the date of the letter is when the clock starts ticking on your deadline to file an appeal. These deadlines are strict, so it’s important to respond promptly.  If your claim is governed by ERISA, the time limits will need to be strictly adhered to.  You have rights and responsibilities under ERISA, and you would be wise to secure guidance for the ERISA appeal process, where you must provide support for your claim or lose rights to pursue your claim in court.

What is the reason given for the denial of the claim? 

MetLife often denies claims based on a review of a partial medical record, which is conducted by a physician (or nurse) who will never examine you in person.   The cursory review of selective portions of medical records is often the basis underlying the claim decision.  The denial or claim termination may be as simple as the doctor stating you are not disabled, despite all evidence to the contrary.  The refusal to consider well supported subjective complaints may be a strategy employed by MetLife and its consultants.

MetLife also denies claims on the basis of claimants not meeting the policy’s definition of disabled. This is typically the response to a group LTD claim, with MetLife stating you are able to perform the duties of your “own occupation,” even though you—and your doctors—know it is simply not true and that your functional deficits and limitations are significant and impairing.  MetLife may fail to consider any of the non-physical work requirements, focusing solely upon the physical demand capacity (sedentary or light) of the job “classification”.  This myopic approach is readily challenged but often seen.

Ignoring the effect that medications have on your work performance is a common way that MetLife decides you are able to work, despite the impact of the medications upon your ability to focus, concentrate or stay awake.   The suggestion that you should stop taking the medicines so you will not suffer from side effects is a classic insurance company response to a disability insurance claim.  We note the significant impacts to support our clients’ claims. 

People suffering from chronic pain conditions are singled out for denials, in part because MetLife considers these to be subjective and because pain cannot be readily measured.  If your disability cannot be measured in a blood test or seen in an MRI, MetLife does not credit the issues properly, or consider you to have a real disability. We fight back on these kinds of denials on a regular basis by offering an array of support developed to rebut these issues.

What is the REAL reason your claim is being denied? 

Along with all disability insurance companies, MetLife profits are tied to the amount it pays out to claimants. The more benefits it pays, the lower its profits.   Clearly, there is a conflict of interest, one which some courts are mindful of in litigation – including the United States Supreme Court in a case entitled MetLife v. Glenn.  

The best approach for you as a disability claimant is to get help from an ERISA attorney with the knowledge and experience to fight back against this industry giant.   With more than twenty five years of experience battling long term disability insurance denials from MetLife, Jason Newfield, Esq. is uniquely prepared to represent claimants throughout the entire claims process.   For your free consultation, call and learn how we can help you with your claim issues and help guide the process smoothly for you.

Even the Courts Find MetLife’s Claims Denials Outrageous

MetLife and its attorneys are criticized on a regular basis by courts for how the company deliberately mismanages claims, and fails to provide claimants with the full and fair review that the law requires.   There are a number of published cases against MetLife where courts chastise  the company’s use of paper only medical reviews by a paid medical doctor whose only practice is to support Metlife Disability Claim Denials of benefits through performing volumes of medical reviews – having abandoned patient care long ago.   MetLife is also routinely criticized for relying on flawed vocational reports.  These issues and its history of biased claim administration are important arguments advanced on behalf of our clients.

Why is a Vocational Evaluation Critical for Metlife Disability Claim Denials? 

The vocational evaluation by an expert is often one of many tools we use in building our cases for clients who have been denied by MetLife.  It is not something most people think of when preparing to file a claim, but we know the vocational evaluation can be central to a claim in developing the expert evidence to support MetLife’s efforts to avoid paying claims. 

Think about all the physical and mental tasks you need to accomplish during the course of performing your job.   Every job is different.  Your job may involve travel, which requires the ability to walk, carry luggage, navigate an airport, get to a work location or a job site. For a medical professional, a working day may include moving throughout a building, travelling between the office and the hospital, examining patients, using a keyboard, reading diagnostic tests, and performing medical care with your hands, arms, shoulders and back. 

Having a qualified vocational expert to provide an accurate vocational evaluation provides objective information about the physical and mental tasks needed to perform a claimant’s occupation. If the disability includes cognitive skills, specific tests need to be used that your treating medical professionals are not likely to be familiar with. Our representation of clients often finds us in situations where a flawed vocational evaluation is used by MetLife. We have seen many claim denials based on completely outdated job descriptions and a flawed medical review combined to terminate a long-standing claim.

How Do I Get my MetLife Disability Claim Paid? 

It is possible to have a disability insurance claim from MetLife paid, but you should be prepared for obstacles. In recent years, MetLife seems to have increased claim denials in general, and many of these are ERISA group disability insurance policy claims.   COVID-19, and the life insurance claims explosion and resulting exposure to MetLife, has compelled a more forceful approach by MetLife to claims.  Having an experienced disability lawyer on your side from the start provides you with definite advantages in the claims process. 

MetLife disability claims executives seem to have taken a page from other disability insurance companies and are more willing to take cases through denial and appeal to litigation. They are also pushing for more denials and terminations to reduce claim exposure.   

Knowing this makes any documents you gather for your claim even more important, as they must serve both to apply for benefits and may eventually become part of your evidence for federal court. There was a time when going to federal court was less common; the stakes appear to have become higher for MetLife. But the stakes are even higher for individuals who have paid premiums for decades and counted on having the economic protection of disability insurance.  We fight this fight for you.

Is MetLife Investigating You? 

If you are on claim – being paid long-term disability insurance benefits—or have filed a claim, it is entirely possible that MetLife is using one of their investigators or claims adjusters to gather information about your comings and goings. We advise our clients to document their trips out of their homes. Even though most of what you do may be going to see various doctors or for treatments, MetLife will attempt to characterize these appointments as evidence that you are able to work. Maintaining a list of your appointments and activities will be helpful if you have to rebut your claim.  Being mindful of your surroundings is always advised.

People on claim or who have filed a disability claim with MetLife should also steer clear of social media and ask your friends not to include you in photos or tag you in posts. Insurance companies learned a long time ago how to monitor claimants’ activities when they are active on social media. Regardless of what platform you are on and how you’ve set your privacy settings, the insurance company will find your posts and use them against your claim.

Should You Attend the IME – Independent Medical Examination? 

There is a tremendous amount of case law where disability claimants have fought back against the so-called “Independent” Medical Examination.  It is NOT independent.  The language of your MetLife disability policy may include a requirement that you attend an examination, but you will need to be prepared for the appointment. 

Understand the doctor is not your friend. They are often employees of the insurance company or work for a company whose sole purpose is to conduct medical exams finding claimants to be well enough to work. They are not specialists in your particular disability. They may not have ever read your medical records or have been supplied with incomplete medical records. Your job is not to convince them that you are well or disabled, it is simply to attend the IME and let them do their job without causing you harm. 

We recommend claimants go to these appointments with a family member or trusted friend who can either video record the examination and take notes.  Sometimes, we hired a witness to attend as well.   You want to have your own record of what was said, including comments by the doctor and your responses.   You also should consider seeing your own doctor around the time of the examination, to ensure consistency of findings, or be able to rebut findings.

The Newfield Law Group has decades of experience with MetLife long term disability insurance claims and represents many MetLife policy owners who have had their claims denied, delayed, and terminated without any regard for their illness or injuries. If you need help with a MetLife LTD claim, or private policy with MetLife and have questions, please feel free to call us for a free consultation.

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