Can You Get Long-Term Disability (LTD) for Cancer? What to Know
A cancer diagnosis can change every aspect of your life, including your ability to work. However, obtaining long-term disability (LTD) benefits for cancer is not always straightforward.
Yes, you can get long-term disability for cancer. Yet, while cancer is often debilitating, insurers often scrutinize these claims, questioning whether your condition is severe enough to prevent you from working. In this article, CCK Law will discuss:
- Cancer and its impact on a person’s ability to work
- How to file a long-term disability claim when suffering from cancer
- What to do if the insurance company denies your LTD claim
- And more
Cancer and Its Impact on an Individual’s Ability to Work
Many forms of cancer can impact a person’s ability to perform the occupational duties of their job. Cancer is characterized by abnormal cells that develop and divide uncontrollably. They can invade the body and destroy healthy body tissue. According to the CDC, cancer is the world’s second leading cause of death.
It isn’t just the cancer itself that can affect a person’s physical ability to work. Many individuals may also develop mental health conditions because of prolonged treatment or the receipt of a terminal diagnosis. Mental health conditions, such as depression and anxiety, can reduce a person’s cognitive abilities.
Moreover, cancer treatments, such as chemotherapy, radiation, or immunotherapy, can contribute to a person’s inability to work. For example, those receiving chemotherapy treatment may develop a condition known as “chemotherapy fatigue” that renders them unable to work.
Types of Cancer
Cancer exists in many forms. Each type of cancer can affect a person differently. Some types (e.g., pancreatic) are much more aggressive than others. Likewise, one type of cancer may have different complications than another type.
Nonetheless, common types of cancer that may necessitate getting long-term disability benefits include:
- Lymphoma
- Leukemia
- Melanoma
- Breast Cancer
- And others
Cancer Symptoms
Each type of cancer has its own set of symptoms. Generally, several common cancer symptoms commonly arise in various forms of the disease, such as:
- Fatigue
- Lumps under the skin
- Weight changes (i.e., loss or gain)
- Skin changes
- Difficulty swallowing
- Persistent cough
- Unexplained fever
- Unexplained bleeding/bruising
- Pain
- Changes in bowel movements
- And others
Any of these symptoms can affect a person’s ability to work. If the symptoms are severe enough, they may not be able to work at all.
Likewise, certain cancer treatments have their own side effects that can add to these symptoms. For example, cancer treatment can lead to dizziness, brain fog, depression, anxiety, severe fatigue, and more.
Filing an LTD Claim for Cancer
If you develop a form of cancer and it renders you unable to work, then you may be entitled to long-term disability benefits. You should first check if you have an insurance policy. This policy may be privately bought (i.e., an individual policy) or through your employer (i.e., a group policy).
Depending on your LTD insurance policy, it may cover between 60 and 80 percent of your pre-disability earnings.
Despite the difficulties surrounding getting LTD benefits for cancer, it is possible if you can prove that you cannot work due to your condition. To do this, you must show that your cancer disables you under the definition of disability in your policy.
Cancer and the Definition of Disability
To receive benefits for cancer, an individual must prove to their insurer that it disables them under the terms of their policy, namely, the “definition of disability.”
There are two types of definitions a person may see within their policy:
- Own Occupation: These definitions stipulate that a person is eligible for benefits if they cannot perform the duties of their own job. Often, this definition looks at how a job is performed in the national economy, not how it is performed at a person’s specific place of employment.
- Any Occupation: These definitions stipulate that a person is eligible for benefits if they cannot perform the duties of any job whatsoever. This definition is often much harder to prove.
For more information on the definition of disability, you can read our full-length article on own vs. any occupation definitions.
LTD claimants must prove to their insurers, with medical evidence, of their disability, along with other forms of proof. This can include vocational evaluations, functional capacity evaluations, witness statements, and more.
Why Do Insurers Deny LTD Benefits for Cancer
Unfortunately, insurance companies deny cancer claims. They may do this for several reasons. For example, if you were suffering from cancer prior to obtaining LTD coverage, then it may fall under a preexisting condition exclusion.
There are some cases where the insurance company approves the long-term disability claim for cancer only to terminate it later.
“Even if [the insurance company] initially approve[s] your claim for LTD benefits,” says Leah Small, a managing attorney at CCK law, “if your cancer goes into remission, your insurer may then terminate your LTD benefits even if you’re experiencing ongoing side effects from treatment.”
Likewise, if you have an own occupation policy, then it likely will transition to an any occupation definition after a set period. At this time, the insurance company can re-evaluate your claim under the new definition and may terminate benefits.
Regardless, insurance companies will send a denial letter explaining the reasons behind the denial. Claimants need to read this letter thoroughly before filing an administrative appeal.
Filing an Administrative Appeal
All long-term disability claimants who receive a denial of their initial claim or a termination of their benefits have the right to file an administrative appeal. However, there are specific deadlines claimants should know when filing an appeal.
For example, if you have an ERISA-governed LTD claim, then you have 180 days to file your appeal. During this time, you should request a copy of your claim file and gather supplemental evidence and medical proof that directly addresses the denial letter.
How to Prove Your Cancer Qualifies for LTD Benefits
How to prove you qualify for LTD benefits depends on the reason for the denial. If your insurer denied your claim due to a “lack of evidence,” then you can collect additional diagnostic tests, such as X-rays, CT scans, MRIs, and bone scans and submit them as part of your appeal.
Equally as important as the medical evidence are the doctors’ records within your file. Gathering treatment records and obtaining specialized reports from your doctors can show the effects of your condition and how it limits your ability to work.
Call CCK Law Today for Help with Your LTD Claim
Your focus should be on your health, not fighting with the insurance company. Our team can help you at any stage of the LTD claim and appeal process. We can act as a point of contact with your insurer; gather, collect, and submit all evidence on your behalf; track all filing deadlines; and more.
For over 25 years, CCK Law has been helping individuals get long-term disability benefits, and we may be able to help you, too. Call us today at (800) 544-9144.
