Litigating Subjective Disability Claims


Disability claims involving subjective (or “self-reported”) conditions present unique problems. In the typical scenario, the condition that is alleged to have caused the disability cannot be confirmed by objective medical findings. Likewise, the symptoms related to that condition cannot be readily verified by standard medical tests or procedures. As a result, the objective medical data suggests that nothing is wrong, and the insured’s own testimony may constitute the only evidence of the underlying disorder and related functional impairment.

To be certain, self-reported conditions can be real and often are very disabling. However, the insurer’s difficulty in verifying the presence of such conditions and the extent of the insured’s functional impairment presents an enormous potential for fraud and abuse. At the same time, the number of disability claims based on self-reported conditions has increased dramatically over the last several years. Disability insurers therefore have a compelling need for finding some way to distinguish legitimate disability claims based upon subjective disorders from those that are not.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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