A self-reported symptoms limitation is a provision in some long term disability insurance policies that limits the amount of benefits that an insured individual can receive for disabilities that are based solely on self-reported symptoms, such as pain or fatigue, rather than on objective medical evidence, such as diagnostic tests or imaging studies. Medical conditions that are often considered self-reported include arthritis, chronic fatigue, fibromyalgia, Lyme disease, lupus, migraine headaches, and tinnitus.
Under a self-reported symptoms limitation, an insured individual may be eligible to receive benefits for a limited period, typically ranging from six months to two years, for disabilities that are based solely on self-reported symptoms. After this time, benefits may be terminated unless the individual can provide objective medical evidence to support their claim of disability.
The purpose of a self-reported symptoms limitation is to prevent individuals from claiming disabilities based solely on subjective symptoms without objective medical evidence to support their claim. However, this limitation can also make it more difficult for individuals with chronic pain or other subjective symptoms to receive disability benefits, as they may have difficulty providing objective medical evidence to support their claim.
It is important to carefully review the terms and conditions of a long term disability insurance policy, including any self-reported symptoms limitation, before purchasing the policy. Individuals with chronic pain or other subjective symptoms should also work closely with their healthcare providers to document their symptoms and to obtain objective medical evidence to support their claim of disability if necessary.