Long-term disability (LTD) insurance is meant to replace income when illness or injury prevents you from working. Many policyholders expect that, if approved, benefits will last until retirement age. Unfortunately, insurers are increasingly rewriting policy language to limit benefits to just 24 months for a wide range of conditions.
What began as restrictions only for mental health claims and self-reported symptoms has now expanded to include musculoskeletal disorders, chronic fatigue conditions, chemical sensitivities, and soft tissue injuries. This growing trend can leave disabled workers without the protection they thought they purchased.
Traditional 2-Year Limitations
For years, LTD insurers have placed two-year caps on certain claims:
- Mental Health Disorders: Depression, anxiety, and related psychiatric conditions are often restricted to 24 months of benefits.
- Self-Reported Symptoms: Insurers may limit claims that rely primarily on the claimant’s reported symptoms, such as fatigue, pain, or dizziness, when objective medical evidence is limited.
These limits have long been controversial, since many of the affected conditions can be severe and life-long.
New Categories Subject to Two-Year Caps
In recent years, insurance companies have broadened their definitions and added more exclusions. Common examples include:
- Soft Tissue Disorders: Conditions affecting muscles, ligaments, or tendons, such as strains, sprains, and repetitive motion injuries. Policies often require “objective proof,” such as imaging or surgery, to extend coverage.
- Chronic Fatigue Conditions: Chronic Fatigue Syndrome and similar illnesses are increasingly classified under fatigue-related limitations.
- Chemical and Environmental Sensitivities: Claimants disabled by mold, fumes, or other environmental triggers may be capped at two years.
- Musculoskeletal Disorders: Some policies only cover back, neck, and joint conditions beyond two years if strict criteria are met, such as evidence of nerve root compression or spinal cord involvement.
These limitations apply even when the condition prevents full-time work.
Why Insurers Are Expanding Limitations
The trend toward broader limitations is primarily driven by cost savings. Limiting claims to two years reduces the insurer’s long-term liability, especially for younger claimants. These limits transfer the financial risk back to disabled workers and their families — the very people LTD insurance is supposed to protect.
Steps to Take if Your LTD Policy Has a 2-Year Limitation
If your policy includes a two-year limitation, there are strategies to strengthen your claim:
- Review your policy in detail to identify restrictions and any exceptions.
- Gather objective medical evidence (imaging, lab tests, specialist reports) to support your diagnosis and limitations.
- Document all disabling conditions, as some may not be subject to the same limits.
- Seek legal advice early, especially if your insurer signals it will cut off benefits after two years.
Protecting Your Rights Against 2-Year Limitations
Two-year limitations are no longer confined to mental health and self-reported symptoms. Insurance companies are extending them to soft tissue disorders, chronic fatigue, chemical sensitivities, and musculoskeletal conditions.
If your insurer relies on a two-year cap to deny or terminate your benefits, you can appeal the denial. At the Ortiz Law Firm, we help clients across the country challenge unfair limitations and fight for the benefits they deserve. Call (888) 321-8131 to schedule a free case evaluation today.
