Long Term Disability Cases Against MetLife
A long-term disability claim against MetLife often arises when benefits are delayed, reduced, or denied despite medical evidence showing that the policyholder can’t work. At The Law Offices of Kevin M. Zietz, our long-term disability attorney represents clients throughout California who are filing or appealing long-term disability claims against MetLife and seeks to recover the benefits available under their policies.
Understanding MetLife Long-Term Disability Insurance
MetLife has offered long-term disability (LTD) insurance through employer-sponsored group plans and individual policies. These policies are intended to replace part of a person’s income when a medical condition prevents them from working for an extended period. However, MetLife stopped issuing new individual disability insurance policies in 2016.
MetLife policies usually define disability in stages:
- Own occupation: The claimant cannot perform the material duties of their specific occupation.
- Any occupation: After a set period, the claimant must show they cannot perform the duties of any occupation for which they are reasonably qualified by education, training, or experience.
These changing definitions often become a central issue in a MetLife long-term disability claim, particularly when benefits are terminated after the initial approval period.
Examples of Long-Term Disability Cases Against MetLife
Disputes involving MetLife can arise for many reasons, often tied to how medical evidence is reviewed or how policy language is interpreted.
Common examples include:
Denial Based on Alleged Insufficient Medical Evidence
MetLife may argue that the medical records do not support the severity of the claimant’s condition. This issue often appears in cases involving chronic pain, autoimmune disorders, or mental health conditions, where symptoms may not be fully captured by objective testing alone.
Termination of Benefits After Initial Approval
A claimant may begin receiving benefits under the ‘own occupation’ standard, only to have those benefits terminated when the policy shifts to the ‘any occupation’ definition. MetLife may assert that the claimant can perform other work, even when those positions are not comparable in pay, status, or functional demands.
Reliance on Independent Medical Reviews
MetLife may rely on file reviews conducted by physicians who have never examined the claimant. Those opinions may conflict with the treating doctor’s findings and become the basis for a denial or termination of benefits.
Failure to Consider Vocational Factors
A proper long-term disability review should take into account the claimant’s age, education, training, and work history. Disputes can arise when those factors are ignored or given too little weight.
Each of these scenarios highlights how a MetLife long-term disability case can become highly fact-specific, requiring careful documentation and a structured legal response.
How a MetLife Long-Term Disability Attorney Can Help
A long-term disability attorney plays a central role in developing and presenting a claim that meets both legal and policy requirements. This begins with a detailed review of the insurance policy to determine the applicable definitions of disability, coverage limitations, and procedural rules.
A disability attorney can help by:
- Building a strong administrative record
- Coordinating medical and vocational evidence
- Handling appeals and deadlines
- Addressing bad faith conduct
- Preparing for litigation
A MetLife long-term disability case can affect financial stability, access to medical care, and long-term career prospects. Taking timely action, especially during the early stages of a claim or appeal, can shape the direction of the case.
