Denials of Long-Term Disability for Sedentary Jobs

Sedentary occupations require sitting most of the workday. Although the employee may move about briefly to retrieve files, make copies, lift light objects, or perform other tasks, most of the job is performed from a seated position. However, even though these individuals may not perform strenuous labor, they are still entitled to long-term disability benefits if they are disabled.

Obtaining long-term disability benefits when you have a sedentary job can be challenging. Insurance companies often deny long-term benefits by claiming a person can perform sedentary jobs, even when the evidence shows otherwise.

If you were denied long-term disability benefits based on a sedentary occupation, you need to know your rights.  Call our long-term disability lawyer at 816-203-0143. We offer free denial letter reviews and can provide you with a strategy on how to recover the benefits you deserve.

What Is a Sedentary Occupation?

The Social Security Administration defines sedentary work as mostly sitting. However, sedentary jobs require much more than sitting to perform job duties.

General job requirements for sedentary work include:

  • Long-Term Disability Attorney in MO & KSBeing able to sit for long periods
  • Lift or push up to ten pounds up to one-third of the day (up to 2.5 hours in an 8-hour shift)
  • Ability to use arms and hands to write, handle small items, type, etc.
  • Ability to concentrate and focus on work
  • Bend or lean over a desk or other structure to perform work

An insurance company focuses on the “sedentary” part of the job. If your doctor states that you can sit or lift up to ten pounds, the insurance company only focuses on those two requirements to deny your LTD claim. However, many disabilities and conditions make sitting for long periods difficult or impossible.

How Does an Insurance Company Decide if You Can Perform Sedentary Work?

Your doctor may tell you that your condition prevents you from working. However, the insurance company states that your condition allows you to take a sedentary job. It may not consider that, even though you can sit for brief periods of time, you cannot sit for six (6) hours a day as required for sedentary work.  There are many medical conditions that cause chronic pain and limited range of motion that prevent this amount of sitting. Moreover, you may be unable to concentrate for long periods due to medications, or you may have other limitations that prevent you from completing all tasks required for the job.

Furthermore, the insurance company will often use job descriptions found in the Dictionary of Occupational Titles (DOT). The DOT was last updated in 1991. It has been replaced by an online database with updated information about job requirements. Even though the DOT is outdated, insurance companies continue to use the job requirements in the DOT to decide if a person has the functional abilities and training to perform a job.

Many jobs have changed dramatically since 1991. For example, your job may have the same title as a job in the DOT, but the requirements for your job today are much more demanding. Furthermore, jobs in the DOT may require much more training now, or different skills than the jobs did in 1991.

Unfortunately, if the insurance company can find a job in the DOT that it believes you should be able to perform, it will deny your claim.

How Can You Fight a Denial Based on Sedentary Work?

First, if your claim is governed by ERISA, you have the right to appeal the denial of your long-term disability benefits. To do so, you must gather evidence of why you cannot perform the duties required for sedentary work. Steps to take as you prepare your appeal include:

  • Review Your LTD Insurance Policy – Many policies have provisions that change the definitions of disability over time.  Our Kansas City long-term disability attorney can review your insurance policy to determine the correct standard of disability for your appeal. This detail is extremely important because you need to address the specific requirements for being “disabled” to win your case.
  • Proper Job Description – What is the sedentary position that the insurance company claiming you can perform.  Is it your “own occupation” or “any occupation”?  (See our video below).  You need an accurate description of the job and its duties. Then, you must highlight job duties you are unable to perform based on your condition.
  • Your Medical Diagnosis – Your physician needs to review the job duties for your job to write a detailed statement explaining why you cannot perform your job duties. In addition, you may need a medical expert to review your case and provide detailed information on why you cannot perform sedentary work.
  • Legal Requirements – A long-term disability attorney can assist you in reviewing the insurance company’s administrative claim file and evidence they used to deny your claim.  Did the insurance company meet all the legal requirements set out in ERISA?  If not, you need to point this out in your appeal.

Important Note: The above steps are just a few of the steps you must take to file an appeal. Remember, you have only one chance to present all the evidence and arguments in support of your claim.

If your appeal is denied and you file a lawsuit for long-term disability benefits, you generally cannot present new evidence you did not present in your appeal. Therefore, it is in your best interest to work with our experienced long-term disability appeal attorney instead of appealing the denial on your own.

 

How Our Law Firm Can Help After a Denial Based on a Sedentary Job

You deserve to receive long-term disability benefits pursuant to the terms of the policy if you are truly disabled. Your policy is a legally enforceable contract with the long-term disability insurance company. However, the insurance company does everything within its power to avoid paying your disability claim.

Our attorney, Kevin J. McManus, is nationally recognized for his work in this area. He and his legal team understand ERISA law and how to fight unjust long-term disability denials. Download a copy of his free book about long-term disability denials to learn why you should not go it alone.

Contact our office by calling 816-203-0143 or completing our online contact formWe offer free denial letter reviews and will provide guidance on how to get the benefits you deserve.

 

Kevin J. McManus
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Kevin McManus is a nationally recognized personal injury and long-term disability attorney in Kansas City, MO.