- Last Updated: 08 November 2015 08 November 2015
Long-term disability policy limitations according to the type of physical illness
Historically, most long-term disability policies did not discriminate according to the type of physical illness. A medically-documented illness diagnosis and a properly documented reduction in physical and cognitive functionality were the required standard for an award of benefits. As long as a patient with ME/CFS, FM, or Lyme disease could establish through a physician's documentation both the diagnosis and necessary loss of functionality, then the patient would be eligible according to the contract language. Needless to say, the insurance companies would frequently attempt to deny benefits to those contractually eligible.
Many patients who have been employed for some years are still covered by these "older" contracts—and many companies still utilize these contracts for new and current employees.
A second type of "newer" contract limits benefits to two years to disabled patients with "self-reported" symptoms—again illnesses largely involving pain, headaches and fatigue. Moreover, these symptoms must be "verified on clinical examination" by a physician, or benefits will not be awarded. Some of these contracts specifically name illnesses such as CFS and fibromyalgia as having benefits limited to two years.