Long Term Disability Law Blog
In this video, Gregory Dell and Stephen Jessup discuss a New York Life disability insurance denial they successfully overturned for an elementary school teacher with a PhD who was forced to stop working due to multiple sclerosis. Despite the claim being filed for MS, New York Life’s short-term disability department treated it strictly as a mental health issue, using only behavioral health reviewers and psychologists rather than a neurologist. They denied the claim, ignoring the neurological basis of her condition entirely.
Jessup’s strategy involved filing for long-term disability benefits even after the short-term denial — a move that surprised the client, who assumed a short-term denial would automatically block long-term approval. As part of the appeal process, the attorneys arranged neuropsychological testing that documented a mild neurocognitive disorder tied to the MS, not mental health, providing objective evidence of her cognitive limitations. The long-term disability department, staffed by different reviewers than the short-term side, approved the claim. Jessup then leveraged that approval to pressure the short-term department into reconsidering, since long-term eligibility logically depends on being disabled during the short-term elimination period.
The attorneys highlight several important takeaways: insurers like New York Life often try to reclassify physical conditions as mental health claims to limit benefit duration to 12 or 24 months; short-term and long-term departments within the same company can reach opposite conclusions; and claimants should not give up after a short-term denial, since long-term approval remains possible and carries far greater financial value. They also stress the importance of ongoing claim management, including handling forms, doctor communications, and Social Security coordination, to prevent future denials.