What You Should Know Before You Read:
- Long-term disability insurers frequently cite “improvement” as a reason to terminate benefits, even when the medical records show no actual improvement in functionality.
- Insurers often rely on selective evidence, misinterpretation of medical records, and biased evaluations to justify ending valid LTD claims.
- Understanding how insurers misuse “improvement” can help you protect your disability benefits before problems arise.
- Dabdoub Law Firm was built to win disability insurance cases and represents clients nationwide with a proven record of success in federal court.
Understanding the “Improvement” Tactic
Once you are approved for long-term disability benefits, the insurance company continues to review your claim. Reviews may occur every few months or once a year, depending on your policy and medical condition.
In many cases, these reviews lead insurers to claim that you have “improved” to the point that you no longer meet the policy’s definition of disability. While long term disability insurance companies will reevaluate claims periodically, , they are not allowed to misrepresent or mischaracterize medical evidence in their favor. Yet, we often see the insurance company use “improvement” as a strategy to close claims early.
This tactic is especially common in chronic conditions such as autoimmune disorders, neurological conditions, severe mental health disorders, migraines, or chronic pain. These conditions have flare ups when things go from bad to worse but disability insurance companies often ignore this medical reality.
How Insurers Make Up “Improvement” in a Long Term Disability Claim
Insurance companies rarely rely on one piece of evidence when approving or denying a LTD claim. Instead, they build a narrative of improvement by combining selective findings, misinterpreted records, and biased reviews. Common examples include the following.
1. Misreading or Misstating Medical Records
Medical records are written primarily for treatment, not disability assessment. A physician may write “stable,” “improved,” or “better today,” which in medical language simply means your condition is not worsening, but rather you might have had a good day. This does not mean, however, that your condition is cured or even overall better or improved. Yet, disability insurers often take these routine phrases out of context to claim you are suddenly capable of full-time work.
2. Highlighting Gaps in Care
If you experience a temporary gap in treatment because symptoms plateau, medications stabilize, or appointments are delayed, the insurer may argue that this means you are no longer impaired. In reality, stability does not equal recovery.
3. Surveillance Footage
Insurers frequently hire investigators to observe you around medical appointments, IMEs, or capture you running errands. Video of you walking into a pharmacy or carrying light bags is used to argue that you are capable of sustained work activity. However, courts have referred to these moments as snapshots in time and have held that they do not represent a person's everyday, ongoing functionality.
4. Biased Independent Medical Examinations (IMEs)
Insurers often schedule IMEs with physicians who perform a large volume of exams for insurance companies. These physicians are anything but independent and typically issue reports that minimize limitations or question credibility of the claimant.
5. Paper Reviews by Disability Insurance Company In-House Doctors
Many terminations rely on “file reviews” by doctors who have never met you. These reviewers frequently claim your records show improvement even when your treating physicians say the opposite.
6. Vocational Assessments Ignoring Real-World Limitations
Insurers will use their own internal medical reviewers purported restrictions and limitations to perform a vocational assessment. Thus resulting in an inherently biased vocational review. Typically they will claim that, with “improvement,” you can perform sedentary or light work, even if symptoms such as chronic pain, cognitive impairment, or fatigue prevent consistent productivity.
Why “Improvement” Does Not Automatically Mean Ability to Work
Most disabling conditions involve fluctuations, flare-ups, and periods of temporary stabilization. In other words, most conditions that lead to disability will have good days and bad days. Insurance companies consistently fail to recognize the difference between:
- A temporary improvement in symptoms, and
- The ability to sustain full-time work on a reliable schedule
Disability is not determined by whether you can perform activities occasionally. It depends on whether you can perform them reliably and consistently, day after day, week after week without disruption.
Insurance companies often ignore this distinction because the real objective is to close claims, not evaluate them fairly.
What to Do If Your LTD Benefits Are Terminated Due to Alleged “Improvement”
Receiving a termination letter is frustrating and frightening, but it is not the end of your claim. You have the right to appeal, and many “improvement” terminations are reversed when the appeal is handled properly. .
1. Request Your Entire Claim File
If your LTD policy is governed by ERISA, you have the right to request the full claim file, which includes internal notes, medical reviews, surveillance, and the evidence the insurer relied on. This file often reveals inconsistencies, errors, or biased assessments. In some cases, there are hidden gems that support ongoing disability.
2. Address the Insurer’s Stated Basis for Termination
Carefully review the termination letter. Identifying exactly how the insurer claims you improved is crucial to compiling evidence to rebut their argument. You want to show you did not in fact improve to a point where you can now work.
3. Strengthen Medical Documentation
Your treating physicians can provide updated opinion letters, detailed functional assessments, and clarifying statements that explain why you remain unable to work despite any reported stability or mild improvement.
4. Document Your Daily Limitations
Maintain a symptom diary to show the frequency, duration, and severity of your symptoms and capture the reality of your day-to-day limitations.
5. Avoid Delays
ERISA appeals have strict deadlines. Missing one can permanently harm your rights. Calendar all deadlines and begin preparing your appeal immediately.
6. Consult a Disability Insurance Attorney
The appeal stage is the most important part of an ERISA claim. It may be your last chance to provide additional evidence before the record closes. You need an attorney who understands how insurers manipulate the concept of improvement and knows how to build a record strong enough to win in federal court if necessary.
How Dabdoub Law Firm Can Help
Long-term disability insurance companies repeatedly misuse the idea of “improvement” to justify terminating valid claims. At Dabdoub Law Firm, we know these tactics. Our practice was built to win disability insurance cases, and we use our national experience to protect clients from unfair terminations.
We represent clients across the country in:
- Appeals after benefits are terminated for alleged improvement
- Challenges to biased IMEs or paper reviews
- Negotiation of lump-sum settlements when appropriate
- Federal court litigation under ERISA
We have taken on every major disability insurance company and built a proven record of success in federal court. Because most disability cases fall under federal law, we can represent clients nationwide.
If your LTD benefits were terminated for “improvement,” contact Dabdoub Law Firm at (855) 276-3760 for a free consultation. You pay no fees or costs unless you receive benefits.