Long-Term Disability for Bone Marrow Transplant Recipients

A bone marrow transplant, also known as a stem cell transplant, can be lifesaving. But it can also be life altering. For many recipients, the road to recovery is long, uncertain, and filled with complications that can make returning to work impossible. If you’ve received a bone marrow transplant and can no longer work, you may qualify for long-term disability (LTD) benefits. Unfortunately, insurance companies don’t always make the process easy.

Common Conditions Leading to a Bone Marrow Transplant

Bone marrow transplants are most often used to treat serious, and often life-threatening, diseases, including:

• Leukemia (e.g., acute myeloid leukemia, chronic lymphocytic leukemia)
• Lymphoma (e.g., Hodgkin’s and non-Hodgkin’s)
• Multiple myeloma
• Aplastic anemia
• Myelodysplastic syndromes (MDS)
• Sickle cell disease
• Immune deficiency disorders
• Some solid-tumor cancers (in rare circumstances)

How a Bone Marrow Transplant Can Affect Your Ability to Work

Undergoing a bone marrow transplant usually requires a high-dose of chemotherapy or radiation to destroy diseased marrow, followed by the infusion of healthy cells. You may have both chemotherapy and radiation or just one of these treatments as part of your conditioning treatment.

Recovery can take months—or even years—and many recipients experience long-term or permanent complications. Some common issues that can prevent a person from working include:

• Graft-versus-Host Disease (GVHD): A common and often debilitating complication in allogeneic transplants that can affect the skin, liver, intestines, and other organs.
• Chronic Fatigue: Chronic exhaustion that doesn’t improve with rest.
• Frequent Infections: Due to weakened immune function.
• Organ Damage: Especially liver, lungs, or heart.
• Chronic Pain: Pain related to mouth sores and gastrointestinal (GI) irritation is a common side effect of high doses of chemotherapy and radiation.
• Emotional and Psychological Effects: Depression, anxiety, PTSD, or adjustment disorders.

These symptoms can make it impossible to maintain a regular work schedule, meet deadlines, or handle physical or mental demands required in most jobs.

What Medical Evidence Do You Need to Support Your Claim?

To be approved for LTD benefits, you must show that your condition prevents you from performing the duties of your occupation—or any occupation, depending on the terms of your policy. Strong medical evidence is crucial. This may include:

• Transplant Records: Including pre- and post-transplant treatment summaries.
• Reports from Your Transplant Team and Specialists: Such as oncologists, hematologists, and immunologists.
• Documentation of Complications: Like GVHD or chronic infections.
• Immunological Tests and Blood Work: To show suppressed immune function.
• Neuropsychological Evaluations: If you’re experiencing cognitive issues.
• Statements from Treating Physicians: Describing your restrictions and limitations.
• A Personal Journal or Symptom Log: Detailing how your condition affects daily functioning.

Challenges You May Face in a Long-Term Disability Claim

Insurance companies often deny or terminate claims—even for something as serious as a bone marrow transplant. Some of the most common issues include:

• Minimizing Recovery Time: Insurers may assume you should be back at work within a few months.
• Disregarding Complications: Like GVHD or cognitive dysfunction, especially if they’re not well-documented.
• Lack of Objective Evidence: Subjective symptoms like fatigue or pain can be hard to “prove” without detailed medical support.
• Misapplying the “Own Occupation” or “Any Occupation” Standard: Especially if your job was physically or cognitively demanding.
• Requiring You to Return to Work Prematurely: Based on generic recovery timelines, not your personal situation.

RELATED POST: Own Occupation vs. Any Occupation in LTD Claims

How a Long-Term Disability Attorney Can Help

If your long-term disability claim has been denied or terminated after a bone marrow transplant, you don’t have to fight the insurance company alone. An experienced disability attorney can help:

• Review your denial letter and policy
• Gather and submit the right medical and vocational evidence
• Work with your doctors to provide persuasive reports
• Handle all communications and deadlines
• File an appeal or, if necessary, a lawsuit

Nick Ortiz and the Ortiz Law Firm focus exclusively on disability claims and appeals. Even if you’re not in Florida, our team represents clients nationwide with ERISA-governed group LTD claims.

Need Help After a Claim Denial?

If your long-term disability claim was denied after a bone marrow transplant, contact us for a free case review. We’ll evaluate your situation and help you understand your options. Call (888) 321-8131 today to get started.