Long-Term Disability

LTD claims and denials

Prudential terminated my ERISA long-term disability benefits at the 24-month mark under the group policy's "own occupation" to "any occupation" transition provision based on a vocational assessment naming three "occupations you can perform" - surveillance system monitor, telephone information clerk, and document preparer - all three of which the Dictionary of Occupational Titles itself categorizes as sedentary with six hours of sustained sitting my treating rheumatologist has excluded in writing for the last fourteen months, and the termination letter references no functional capacity evaluation, no updated MRI review, no communication with the rheumatology practice the carrier has been receiving quarterly narrative reports from since 2022, and gives me 180 days to file an ERISA administrative appeal that will be decided by the same claims unit that just terminated me, with the record on any subsequent lawsuit locked under Firestone Tire to whatever i submit inside those 180 days. What are the numbered moves for fighting an ERISA LTD termination at the own-occ to any-occ transition: the administrative record buildout, the treating physician narrative that actually moves an ERISA file (not the checkbox APS form), the FCE decision (obtain one, refuse one, or do it privately), the transferable skills analysis rebuttal, the vocational expert retention, the Social Security disability award leverage, the 29 USC 1132(g) attorney fee statute, and when does an ERISA plaintiff attorney actually take a case at the appeal stage versus after final denial?

i am 47 years old, i was a construction project manager for 19 years at a firm i loved, and i have been on long-term disability with Prudential (group policy through the firm) since 2022 for a...

Posted by anxiousresident589

cigna terminated my LTD after 18 months citing "medical improvement" - my treating rheumatologist and neurologist BOTH say no improvement, surveillance footage cherry-picked, paper review by their in-house "medical director" who never examined me. now they want to pivot to "any occupation" definition. this whole system is rigged.

need to vent before i lose my mind. also asking for community input because i know some of you have been through the cigna LTD termination playbook and i need to make sure i am not missing the...

Posted by stressedBuyer684

Unum denied my long-term disability claim after 18 months on the policy citing 'self-reported symptoms' for fibromyalgia and CFS. Just won the ERISA appeal after submitting FCE results, three specialist reports, and a vocational expert opinion. Here is what worked

Posting this because the ERISA LTD appeal process is one of the most opaque and frustrating things I have ever dealt with and the published guides do not match the reality of what actually moves the...

Posted by stressedpolicyholder341