Do Medications Affect A Long Term Disability claim?

Insurance companies are required to consider not only the disabling medical conditions but also the side effects suffered by a claimant as a result of medications that have been prescribed. Do medications affect a long term disability claim?

The insurance company is required by governing case law to give consideration of the impact those medications have on the claimant’s employability.  The case of Smith v. Continental Cas. Co., 450 F. 3d 253 (6th Cir. 2006) specifically provides that the failure to do so renders any adverse benefits determination “arbitrary and capricious” and thereby subject to reversal on judicial review thereof.  The required “full and fair review” includes consideration of a claimant’s arguments and evidence concerning pain and complicating medications.  Anderson v. Nationwide Mut. Ins. Co., 592 F.Supp.2d 1113 (S.D. Iowa 2009).

By law, medications are considered objective findings.  White v. Eaton Corp. Short Term Disability Plan, 308 Fed. Apx. 713 (4th Cir. 2009).  This is important if the insurance policy requires objective findings, as some do.  The long term disability insurance company is required to fairly consider the side effects of those medications, Rabuck v. Hartford Life & Acc. Ins. Co., 522 F.Supp.2d 844 (W.D. Mich. 2007) Insurance companies will try to gloss over the side effects of medications but Courts refuse to allow them to “glibly” fail to consider the side effects of the medications.  Huberty v. Standard Ins. Co., 2008 WL 783407 (D. Minn. 2008).  In sum, as held by the Court in the case of DeGennaro v. Liberty Life Assurance Co. of Boston, 561 F.Supp.2d 811 (W.D. Mich. 2008), a Carrier that fails to consider the cumulative effects of multiple conditions, the impact of the medications prescribed therefor, and refuses to credit significant portions of the treating physicians’ reports concerning those issues is acting in an impermissible manner and its benefits determination will not be sustained on judicial review.

How Do Insurance Companies Respond To Medication?

“Do medications affect a long term disability claim?” is a question we often hear. Insurance companies will downplay the side effects of every medication, including significant pain killers and the like.  It seems even prescribing doctors are somewhat apprehensive to fully state the potential side effect of medications.  The best source is what is known as the “Physician’s Desk Reference,” now commonly referred to as the “PDR.”  We often make copies of the information concerning each medication our client takes to ensure the issue is fully addressed in connection with their claim.

 Do You Need Legal Representation?

If you have any questions about your Short Term Disability or Long Term Disability claim, please give Herbert M. Hill, P.A. a call and we would be glad to answer any questions you may have.   We are available at 407-839-0005 or, toll-free, 844-454-5995,  If you would like, after discussing your case, we can set a conference.  In most circumstances, that conference would be free of charge but in no circumstance would you be under any obligation to hire me nor would you feel any pressure from me to do so.

 Herbert M. Hill, P.A. is a law firm located in Orlando, Florida with a practice extending throughout the state of Florida.  While the vast majority of cases handled are for disability insurance benefits, areas of practice include employee benefit claims of all sorts.  The firm handles any claims arising under the Employee Retirement Income Security Act (“ERISA”) for disability benefits, medical benefits, retirement benefits of any sort, including pension, 401k, termination agreements, or the like as well as claims arising under private disability policies.