Individuals in Chicago making a claim under an employer-provided group long-term disability insurance policy frequently assert they have a cognitive decline due to the physical ailments from an injury or illness. Often this is a subsidiary effect of the physical symptoms. But when insurers see you assert cognitive impairment, they often overly focus on those and begin building a denial showing how there is no documentation of cognitive impairment, and that your claim forms indicate you can pay bills yourself and manage your own activities of daily living. Here are some pointers on how to avoid typical pitfalls of alleging cognitive impairment.
Focus on the Physical Illness or Injury First
Depending on your illness or injury, there are most likely other symptoms that triggered the disability claim. Focus on those first. For instance, often chronic pain causes individuals to also have trouble focusing on job responsibilities because of the pain. Focus on the pain first. If you focus on the cognitive impairments, the insurer may send you for an neuropsychological independent medical examination, and if the results come back not showing sufficient cognitive impairment, the insurer may use that to assert you exaggerate your symptoms.
Consider Your Own Neuropsychological Testing Before Asserting Cognitive Impairment
If you suffered an injury that naturally results in cognitive impairment, consider getting neuropsychological testing of your own, with a full battery of validity measures incorporated. This is common if you had head trauma and assert post-concussive syndrome. Insurers often reject post-concussive syndrome cases on the basis concussions resolve in a certain amount of time. A neuropsychological test that demonstrates the level of impairment in key areas, like executive functioning can help.
In Meyer v. Unum Life Insurance Co. of America, No. 8:19-cv-1725, 2021 WL 1102443 (C.D. Cal. Mar. 23, 2021), Meyer was in a car accident, for which Unum approved his long-term disability claim. But when his cognitive complaints did not resolve, Unum terminated the benefits because his physical symptoms should have resolved. As an executive recruiter, Meyer required considerable mental focus and strong communication skills. Meyer obtained neuropsychological testing that corroborated his subjective complaints of cognitive impairments. When Meyer sued under ERISA § 502(a), the court agreed the evidence showed Meyer remained unable to perform his occupation due to the impairments from the post-concussion, and the high cognitive requirements of his job.
Insurers nevertheless remain hostile towards claims involving lasting cognitive impairment, especially from concussions. If you suffered any head injury and the insurer denied or terminated your claim, contact an experienced ERISA long-term disability lawyer right away.