Sarcoidosis and Long-Term Disability

Sarcoidosis can create serious challenges for individuals trying to maintain steady employment. When symptoms such as fatigue, joint pain, or shortness of breath make it impossible to work, long-term disability (LTD) benefits should provide critical financial protection. Unfortunately, many legitimate sarcoidosis claims are denied by insurance companies that question the severity of the condition or demand “objective proof” that can be difficult to obtain.

If your LTD claim was denied or your benefits were terminated, you still have options. A focused appeal can turn the tide when supported by the right medical and vocational evidence. Understanding the medical aspects of sarcoidosis is an important first step, because your diagnosis, symptoms, and treatment history form the foundation of any long-term disability claim.

What Is Sarcoidosis?

Sarcoidosis is an inflammatory disease that causes clusters of immune cells, called granulomas, to form in various organs. The lungs and lymph nodes are most commonly affected, but the disease can also impact the eyes, skin, heart, liver, and nervous system. In some cases, sarcoidosis resolves on its own; in others, it becomes chronic and progressively debilitating.

Common symptoms include:

• Persistent fatigue and weakness
• Shortness of breath or chronic cough
• Joint or muscle pain
• Chest pain
• Vision problems or eye inflammation
• Skin lesions or discoloration

Because symptoms fluctuate and may not appear on imaging or lab tests, insurance carriers often claim that sarcoidosis is “subjective” or “in remission,” even when it continues to interfere with everyday functioning.

How Sarcoidosis Can Affect Your Ability to Work

Sarcoidosis can make it difficult to sustain regular attendance, focus, or physical activity. Shortness of breath, chronic pain, and severe fatigue can limit both physical and sedentary work. Those whose jobs require standing, lifting, or exposure to environmental irritants are often the first to experience performance issues.

Even in desk-based occupations, fatigue and “brain fog” can slow productivity and increase errors. Because these limitations are not always visible, insurers may downplay their impact or assert that the claimant can perform “light duty” or “sedentary work.” In an appeal, it’s critical to document how unpredictable flare-ups and cumulative exhaustion prevent consistent, full-time work.

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Why Long-Term Disability Claims for Sarcoidosis Are Denied

Insurance companies often deny sarcoidosis claims for reasons such as:

• Lack of Objective Evidence: Insurers may argue that imaging or pulmonary tests do not confirm functional limitations, ignoring how symptoms fluctuate.
• Inconsistent Medical Documentation: Gaps in treatment or varied symptom descriptions across providers can lead insurers to claim your condition has improved.
• Underestimating Fatigue or Pain: Adjusters may misinterpret “good days” or sporadic activity as proof that you can work full time.
• Reliance on Biased Medical Reviews: Many carriers use in-house doctors who review files but never examine the claimant. Their opinions often minimize real-world limitations.
• Vocational Misclassification: The insurer may classify your occupation incorrectly to argue you can still perform it or similar work.

Understanding the reason for your denial is key to building a targeted appeal.

Strengthening a Denied Sarcoidosis Claim

A successful appeal should directly address the insurance company’s stated reasons for denial. Consider the following evidence and strategies:

• Comprehensive Medical Records: Gather recent office notes, specialist evaluations, and test results showing how sarcoidosis affects your lungs or other organs.
• Residual Functional Capacity (RFC) Forms: Ask your treating providers to complete detailed RFC forms describing your limitations in standing, walking, lifting, and concentration.
• Objective Testing Where Possible: Pulmonary function tests, cardiac imaging, and laboratory results can help substantiate your diagnosis.
• Symptom Tracking: Maintain a log of fatigue levels, pain flare-ups, and missed workdays to demonstrate consistency over time.
• Vocational Evidence: A vocational expert can compare your limitations to the demands of your job and explain why you cannot perform it on a reliable, sustained basis.

These steps help create a complete administrative record—something the court will rely on if your case proceeds to litigation.

Common Challenges in Sarcoidosis LTD Appeals

Sarcoidosis presents unique legal and medical hurdles:

• Variable Symptoms: Because the disease may improve temporarily, insurers use these periods to justify denials.
• Invisible Limitations: Fatigue and pain are difficult to measure objectively, requiring strong narrative support from both claimants and doctors.
• Systemic Involvement: When multiple organs are affected, the insurer may minimize how those combined effects reduce functional capacity.
• Complex Treatment Regimens: Long-term use of corticosteroids or immunosuppressants can cause additional side effects—sometimes worse than the disease itself—yet insurers often ignore these impacts.

An experienced LTD attorney knows how to address these issues through targeted medical and vocational evidence.

Appealing a Denied Sarcoidosis Claim

Under ERISA-governed group policies, your administrative appeal is your last chance to submit new evidence before your case goes to court. Missing deadlines or failing to include critical documentation can permanently weaken your claim. An attorney familiar with ERISA procedures can help ensure:

• All medical and vocational evidence is properly included in the record
• The insurer’s reasoning is challenged with factual and legal arguments
• Treating physician statements directly respond to the insurer’s concerns
• Procedural violations—like failure to provide a full and fair review—are preserved for court

The appeal process is technical and time-sensitive. Having professional guidance can significantly improve your chances of success.

Get Help with a Denied Sarcoidosis LTD Claim

Filing an appeal for a denied sarcoidosis claim can be overwhelming, especially while you’re trying to manage your health. Having an experienced legal team on your side can make all the difference.

If your long-term disability benefits were denied or terminated, you don’t have to face the insurance company alone. The Ortiz Law Firm can review your denial letter, gather the medical evidence needed to prove your limitations, and prepare a detailed appeal that addresses the insurer’s reasons for denial. We focus on building the strongest possible record so your claim can stand up in court if necessary.

Call (888) 321-8131 or request a free case evaluation today to discuss how we can help you fight back and protect your right to benefits.