If a chronic illness, severe pain, or another debilitating medical impairment is keeping you from working, you may be eligible for long-term disability benefits. To get approved for long-term disability, a claim must be filed. Your case will be reviewed. Unfortunately, insurance companies can sometimes be challenging to work with. They may even keep watch on a claimant’s social media before (and after) approval for benefits. At The Law Office of Paul J. Dombeck, PLLC, our Phoenix long-term disability attorney can help you with your disability claim in Arizona.
Functional Capacity is Key in Most Long-Term Disability Claims in Arizona
A long-term disability claim is not simply a dispute over whether a person has been diagnosed with a serious medical condition. While that can be an issue, there is often a different question that needs to be answered directly:
- Whether the claimant’s condition causes functional restrictions that prevent him or her from performing the work required under the policy’s definition of disability.
In other words, a person is disabled only if they cannot actually reasonably “work” due to their medical condition. With that in mind, an insurer will often carefully examine all of the evidence presented to determine what a claimant actually can (and cannot) do.
Know the Term: In the context of a long-term disability claim, functional capacity is broadly defined as a person’s ability to perform physical and mental activities on a sustained basis. It can include the ability to sit, stand, walk, lift, concentrate, follow instructions, and maintain a consistent work schedule.
Insurance Companies May Use Surveillance to Challenge Reported Restrictions
A long-term disability insurer may hire an investigator to conduct surveillance of a claimant. Surveillance commonly focuses on activity occurring in public, such as driving, shopping, walking, doing yard work, attending events, exercising, or carrying objects. Among other things, the insurer may compare recorded activity with statements in claim forms, medical records, functional capacity questionnaires, or interviews.
Notably, surveillance can have a major impact when it reveals a genuine inconsistency. Indeed, this is not merely an “academic” matter. It is very important in long-term disability claims. For example, in the case of Aluisi v. Unum Life Insurance Co. of America, for example, the Ninth Circuit upheld the insurer’s decision where surveillance contradicted the claimant’s reports that sitting, standing, or walking for more than 15 minutes caused unbearable pain.
Social Media Reviews Have Become a Common Form of Disability Surveillance
How does an insurance company surveil a disability claimant? There is not one specific answer. It can happen in a wide range of different ways. With that being said, social media reviews are becoming increasingly common. If you have applied (or are planning to apply) for long-term disability benefits, you should be aware that your social media accounts may be evaluated.
For that reason, a person who is pursuing long-term disability benefits in Arizona should generally avoid posting about physical activities, travel, exercise, hobbies, home projects, social events, or other activities that could be taken out of context. Insurers can review publicly accessible Facebook, Instagram, TikTok, LinkedIn, and other accounts. A photograph, video, caption, check-in, or comment may then be compared against the limitations described in the disability claim.
The danger is that social media naturally presents an incomplete picture. A photograph from a family outing does not show that the claimant spent the next day in bed because of pain. A vacation photograph does not reveal accommodations, rest periods, medication use, or assistance from family members. Yet an insurer may still argue that the post is inconsistent with disability.
Privacy Settings Do Not Necessarily Keep Social Media Evidence Out of the Case
Making an account “private” can limit what an insurance investigator can view without permission, but privacy settings do not create an evidentiary privilege. Courts addressing civil discovery have repeatedly recognized that relevant non-public social media material may be discoverable even when the user has restricted access to friends or followers. Courts generally will not permit an opposing party to rummage through an entire private account without regard to relevance, but private status alone does not make responsive material immune from discovery.
Takeaway: If you are applying for or receiving long-term disability benefits, you should protect your social media accounts with strong privacy settings. Beyond that, you should be very careful about what you post. It is often safest to limit what you are sharing about your life.
You Can Challenge a Denial or Loss of Benefits
If an insurer terminates or denies benefits based in part on surveillance, social media evidence, or conclusions drawn from that evidence, a claimant should directly address those issues rather than simply resubmitting the same medical records. A strong response may explain the duration and frequency of the observed activity, symptoms experienced during or afterward, accommodations that were not visible on video, and why isolated activity does not translate into sustained occupational capacity. Treating physicians can also address whether the activity is medically consistent with the claimant’s restrictions.
How Our Arizona Long-Term Disability Lawyer Can Help
Long-term disability claims are complicated. Facing surveillance from the insurance company, whether through your social media or otherwise, can make things all the more challenging. At The Law Office of Paul J. Dombeck, PLLC, we put clients first. Our firm is here to help you navigate all aspects of a long-term disability case, from your initial claim to an appeal. To set up a free consultation with a top-rated Arizona disability attorney, please contact our Phoenix office today.
Schedule a Free Case Review With Our Phoenix Long-Term Disability Lawyer Today
At The Law Office of Paul J. Dombeck, PLLC, our Phoenix long-term disability attorney has the knowledge and experience that you can trust. If you have any questions or concerns about the long-term disability claims process and social media surveillance, we can help. Contact us to arrange your free, no-obligation case review. With an office in Phoenix, we handle long-term disability claims in Maricopa County and beyond.
