Can I File a Long Term Disability Claim If My Employer Requests I Return to the Office?
- Matthew Maddox
- 4 days ago
- 11 min read
Yes. You may be able to file for long term disability (“LTD”) if your employer requires you to return to the office. Navigating the complexities of LTD claims can be challenging, especially when changes in your work environment impact your ability to perform your job duties effectively. As remote work becomes less common and employers increasingly request employees to return to the office, individuals with medical conditions may find themselves in need of exploring their rights and options under LTD insurance policies.
Understanding these options is essential for ensuring continued support and accommodation in the face of new workplace demands.
In this article, we’ll answer common questions about filing an LTD claim if your condition prevents you from working in an office or other work environment so that you can better navigate the process.
How Soon Should I File a Long Term Disability Claim If I Am No Longer Allowed to Work from Home?
When considering filing a long term disability (“LTD”) claim, especially if you are no longer allowed to work from home and must face the challenges of working in an office environment, it’s crucial to act promptly. Filing your claim as soon as you recognize that your disability will prevent you from performing your work duties effectively in an office setting can be crucial. Early filing ensures that all necessary documentation and evidence are collected and submitted while still relevant and fresh. Delays in filing can complicate your claim, leading to missing documentation or difficulties in establishing the severity and onset of your disability.
Many LTD insurance policies include an “active employment” requirement, stipulating that you must be actively working, either full-time or meeting the minimum hours as defined by your policy, when your disability begins. If the transition from working at home to an office exacerbates your condition or reveals new challenges related to your disability, this could impact your ability to meet these criteria. Understanding and navigating your policy’s active employment clause is crucial under these circumstances.
Before initiating your claim, consulting with a disability insurance attorney is essential. An attorney can provide guidance and ensure you avoid common pitfalls during the claims process. Here’s how they can assist with each step:
Reviewing Your Policy: Carefully reviewing your policy is crucial to understanding its specific provisions, such as timelines or notice periods for notifying your insurer about your disability. An attorney can help interpret complex policy language, ensuring you fully understand your rights and obligations.
Notifying Your Employer and Insurer: Notifying both your employer and insurer of your intention to file a long term disability claim is a critical step, particularly if company-specific procedures or forms are involved. An attorney can help you craft clear and accurate communications and ensure you meet any procedural requirements to avoid delays or denials.
Filing Your Claim: Filing your claim promptly is essential, especially if your ability to work in an office is compromised, as policies often include active employment requirements. An attorney can guide you in providing clear, timely documentation and in maintaining effective communication with your healthcare providers, employer, and insurer.
Having an attorney involved from the outset ensures that each step is handled properly and improves your chances of securing the benefits you need without unnecessary complications.
What Are the Legal Grounds for Filing a Long Term Disability Claim in This Scenario?
If your employer requests you to return to the office and you are considering a long term disability claim due to a medical condition that affects your ability to work in that environment, the legal grounds for filing can be based on several critical factors related to your health and job functions.
Here are the key points you should consider:
Medical Certification: Your condition must be medically certified as disabling by a healthcare provider. This documentation should detail how your condition specifically hinders your ability to perform your duties in an office setting, and potentially any job duties, depending on the specifics of your policy.
Duration of Disability: For a condition to qualify for long term disability, it generally needs to significantly impair your ability to work for a longer duration, typically extending beyond the short term disability period or any specified waiting period outlined in your policy.
Policy Definitions: Carefully review your disability insurance policy’s definition of disability. Some policies define disability strictly in terms of your inability to perform the duties of your “own occupation,” while others may extend this definition to include any occupation for which you are reasonably qualified based on your training and experience.
Impact of Condition on Work Ability: It’s crucial to document how your condition affects your daily functioning, particularly in a workplace environment. Detail how the requirements of working in an office exacerbate your symptoms or create new challenges that are not present when working from home.
Employer’s Accommodation Efforts: Document any efforts by your employer to accommodate your disability within the office environment. If your employer cannot reasonably accommodate your disability in a way that allows you to perform your essential job functions effectively and safely, this can significantly strengthen your claim.
These considerations form the basis of your right to file a long term disability claim when asked to transition from working at home to an office setting. Consulting with a disability insurance attorney is advisable to provide specific guidance tailored to your situation and ensure that your claim documentation is thoroughly and effectively prepared. This legal support can be crucial in navigating the complexities of disability claims related to workplace requirements.
What Is Not Legal Grounds for Filing a Long Term Disability Claim in This Scenario?
Inability to commute is not a legal ground for filing a long term disability claim. Commuting is usually treated as a logistical issue—separate from whether you can perform the actual duties of your occupation. Insurers typically focus on whether you can work in a functional sense (for example, sitting, concentrating, using a computer), not whether you can travel to your office or a specific job site. Even when a medical condition makes commuting difficult or unsafe, the long term disability insurer will say that you could still work remotely or in a different setting. To qualify, your medical limitations generally must prevent you from performing the material and substantial duties of your job—not just getting there.
How Should I Communicate My Disability to My Employer?
When preparing to file a long term disability (“LTD”) claim, it’s essential to approach communication with your employer carefully to protect your privacy while following necessary procedures. You are not required to disclose detailed medical information or the nature of your disability to your employer. Instead, focus on providing the information needed to initiate the claim process.
Here are some steps you can take:
Provide a Formal Notification: Draft a written notification, such as an email or letter, informing your employer that you are unable to work due to a medical condition and that you intend to file an LTD claim. This communication creates a record of your notification and ensures clarity.
Request LTD Claim Forms: Ask your employer or human resources department for any necessary LTD claim forms or instructions for initiating the claim. This step shows that you are taking proactive measures to begin the process.
Protect Your Privacy: You only need to state that you are unable to work; you do not need to disclose your diagnosis, symptoms, or medical records. Your medical privacy is protected, and these details are typically only shared with the insurance company.
Maintain Professionalism: Ensure your communication remains professional and focused. There is no need to elaborate beyond what is necessary to initiate the claim.
It’s also a good idea to consult with a disability attorney before reaching out to your employer. An attorney can guide you on how to communicate effectively while safeguarding your privacy and ensuring that your rights under your LTD policy are protected. They can also help address any questions or challenges that may arise during the process.
What Documentation Is Required to Support My Long Term Disability Claim?
To support your long term disability (“LTD”) claim effectively, especially when faced with a requirement to work in-person rather than remotely due to your disability, gathering comprehensive and detailed documentation is essential. Each piece of evidence plays a critical role in illustrating the extent of your disability and its impact on your ability to work in an office environment.
Here are the essential documents you should include:
Medical Records: Robust medical documentation is the foundation of any LTD claim. Collect all relevant medical records that pertain to your condition, such as detailed doctor’s notes, results from diagnostic tests like MRIs, CT scans, and blood tests, as well as records of any treatments you have received. These should document the onset of your condition, the progression of symptoms, and any medical interventions you have undergone, emphasizing how these issues affect your ability to work in-person.
Attending Physician’s Statement: A comprehensive statement from your physician is a pivotal component of your claim. This statement should confirm your medical diagnosis and elaborate on your symptoms, treatment attempts, their outcomes, and your prognosis. It should specifically detail how your medical condition impairs your ability to perform tasks in an office setting, potentially contrasting your capabilities when working remotely versus in-person.
Proof of Salary: Documentation of your earnings, such as recent pay stubs, W-2 forms, or tax returns, is necessary. These documents help the insurance company calculate the benefit amount you are eligible for, which is often a percentage of your average earnings.
Employment History: Provide a detailed job description that outlines your occupational duties and the skills required to perform your role. Include any evaluations or reports from your employer that discuss your job performance, especially noting any changes that correlate with the progression of your disability and its impact on your ability to work in-person.
Claim Forms: Accurately completed claim forms are essential. These forms, typically provided by your employer or your insurance company, must be meticulously filled out to detail the nature of your disability and its effects on your ability to perform your job in an office environment.
Personal Statement: A personal statement can profoundly impact your claim. Describe a typical day since the onset of your disability, highlighting the challenges you face with daily activities, particularly those exacerbated by working in-person. Explain any adjustments you’ve had to make to accommodate your disability, providing personal insights that can help the insurer understand your limitations.
Correspondence With Your Employer: Include any relevant correspondence with your employer regarding your condition, especially communications about your need for adjustments to work remotely or difficulties with in-person tasks. This documentation can be critical, especially if there are disputes about workplace accommodations or your capacity to perform your job in an office.
Collecting and organizing these documents requires careful attention to detail. Working with a disability attorney can help ensure that your documentation comprehensively represents your case and adheres to the specific requirements of your LTD policy. An experienced attorney can significantly enhance the strength of your claim and increase the likelihood of a favorable outcome.
How Do I Prove I Cannot Work In-Person Due to Disability?
Proving that you cannot work in-person due to a disability involves presenting clear and comprehensive evidence to your employer and insurance company that demonstrates how your condition significantly impairs your ability to perform your job duties in an office setting.
Here are the steps and types of documentation that can help substantiate your claim:
Medical Documentation: Start by obtaining detailed medical records from your healthcare providers. This includes diagnostic test results, treatment records, and doctor’s notes. A comprehensive statement from your physician that explicitly outlines how your disability impacts your ability to work in-person will also be critical. This statement should describe your symptoms, treatment history, and prognosis, and explicitly link these elements to your incapacity to work in a traditional office environment.
Functional Capacity Evaluation (“FCE”): Consider undergoing a Functional Capacity Evaluation, which is an assessment conducted by a qualified healthcare professional to determine your capabilities and limitations in performing a range of work-related tasks. This evaluation can provide objective data about your physical or cognitive restrictions that can be directly related to the demands of in-person work.
Neuropsychological Evaluation: If your condition involves cognitive impairments, a neuropsychological evaluation can provide detailed insights into how your disability affects your memory, focus, problem-solving skills, and overall ability to meet workplace expectations.
Vocational Assessment: A vocational expert can evaluate how your limitations impact your ability to perform your specific job duties or transition to alternative roles. This assessment bridges the gap between your medical restrictions and workplace demands.
Correspondence and Communication Records: Gather any emails, letters, or records of conversations with your employer regarding your disability and previous attempts to accommodate your in-person work requirements. This documentation can support your claim by showing that you have actively sought solutions or discussed your limitations with your employer.
Personal and Witness Statements: Include statements from yourself and colleagues, supervisors, or others who have observed the impact of your disability on your ability to work, especially in-person. Witness statements can help corroborate your claims and provide additional context.
Consultation with a Disability Attorney: Given the complexities involved in proving an inability to work in-person due to disability, consulting with a disability insurance attorney experienced in ERISA can be invaluable. An attorney can help ensure that you have gathered sufficient and appropriate evidence, and they can assist in negotiating with your employer or insurance provider to recognize your disability and provide necessary accommodations or benefits.
Can My Employer Terminate My Employment If I File a Long Term Disability Claim?
Yes, your employer can terminate your employment even if you file a long term disability claim. However, there are legal protections that may apply depending on your circumstances, particularly if your termination is related to your disability.
Laws like the Americans with Disabilities Act (“ADA”) prohibit employers from discriminating against employees because of their disability. If you can perform the essential functions of your job with reasonable accommodations, your employer is generally required to provide those accommodations unless doing so would cause undue hardship. Similarly, the Family and Medical Leave Act (“FMLA”) may provide job protection for up to 12 weeks of unpaid leave if you are eligible, allowing you time to address serious health conditions without risking your employment.
That said, employers are not prohibited from terminating employment for reasons unrelated to your disability, such as company restructuring or economic concerns, as long as the reason is not discriminatory or otherwise illegal.
Because these issues can be complex and depend on the specific facts of your situation, it is highly recommended that you consult with an attorney experienced in employment and disability law. They can help you understand your rights, evaluate your employer’s actions, and determine the best course of action to protect yourself.
How Can The Maddox Firm Prove My Long Term Disability Claim?
When you’re considering filing a short or long term disability claim, especially under the pressure of an employer’s request to return to the office, The Maddox Firm is here to support and guide you through every step of the process. Our approach is thorough and tailored to ensure your rights are protected and your claim is successfully validated.
Here are a few ways we help prove your LTD claim:
We Examine Your Policy and Assess Your Claim: The first step in proving your disability claim is to thoroughly review your disability insurance policy. We analyze the specific terms and conditions, including the “active employment” requirement, which could be crucial if your employer has requested your return to the office. Understanding these details allows us to assess the strength of your claim based on your current employment situation and medical condition.
We Handle All Communications with Your Insurance Company: Dealing with insurance companies can be daunting and complex. We take this burden off your shoulders by managing all interactions with your insurer. This includes submitting the initial claim, negotiating terms, and handling any queries they might have. Our aim is to ensure that your communications with the insurer are clear, consistent, and effectively advocate for your needs.
We Help You Obtain Evidence to Support Your Claim: Gathering compelling evidence is key to proving your disability claim. We assist you in compiling comprehensive medical records, doctor’s statements, and any related documentation that outlines the severity of your condition and its impact on your ability to work. If your ability to return to the office is in question, we specifically focus on obtaining evidence that highlights why returning could exacerbate your condition or why your condition precludes full-time office work.
We Handle Appeals and Litigation: If your claim is initially denied or if there are disputes during the claims process, The Maddox Firm is prepared to handle appeals and, if necessary, proceed to litigation. We are committed to defending your rights through every legal avenue available, ensuring that you receive the support and benefits you are entitled to under the law.
A short term disability or long term disability claim can be a complicated process. If you need help during the claims process, with appealing a claim denial, or with litigating a final adverse short term or long term disability decision, The Maddox Firm can help. The experienced team at The Maddox Firm will examine your insurance policy, correspondence from your insurance company, medical records, and any other relevant documentation in order to give you personalized guidance on how we can help you win your short and/or long term disability claim. Our New Jersey and New York long term disability attorneys help clients nationwide.
