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Long Term Disability for Prostate Cancer: What You Need to Know

Disability Wiki.

Medical Tablet with the Diagnosis of Prostate Cancer on the Display and a Black Stethoscope on White Background.

Prostate cancer is a life-changing diagnosis that affects not only your health but also your ability to work.  The physical symptoms, cognitive challenges, and side effects of treatment can make it difficult—or even impossible—to maintain your job.  Long term disability benefits are designed to provide financial stability during this difficult time, but securing those benefits isn’t always straightforward.

Insurance companies often scrutinize claims, requiring detailed evidence to prove that your condition prevents you from working.  They may deny claims based on insufficient documentation, disputed symptoms, or overly optimistic assessments of your recovery.  Navigating this process while managing your health can feel overwhelming.

Below, we’ll answer common questions about long term disability claims for prostate cancer, helping to increase your chances of a successful outcome.  Whether you’re considering exiting work or facing a denial, understanding your rights and how to strengthen your claim can help you secure the benefits you deserve.

Can I get long term disability benefits for prostate cancer?

Yes, you may be eligible for long term disability benefits for prostate cancer if your condition or its treatment prevents you from performing the essential duties of your occupation.

Most long term disability policies define “disability” in one of two ways:

For high-wage-earning professionals, such as executives, attorneys, or physicians, the “own occupation” definition is especially important.  These roles often involve complex cognitive tasks, long hours, or high stress, which can be severely impacted by the side effects of prostate cancer and its treatment.

For example:

    • Cognitive Impairment: Hormone therapy and other treatments may lead to memory issues, confusion, or reduced focus, making it difficult for a CEO to make strategic decisions or for an attorney to prepare for trial.
    • Physical Limitations: Side effects like fatigue, pain, or urinary incontinence can prevent a physician from enduring long shifts or standing for extended periods during surgery.
    • Emotional Strain: The emotional toll of a cancer diagnosis and treatment can also interfere with roles requiring high levels of interpersonal engagement or decision-making under pressure.

Understanding how your policy defines disability and documenting how your specific condition impacts your ability to work is crucial to securing benefits.  If you are unsure how your situation aligns with your policy, consulting an experienced long term disability attorney can help clarify your rights and options.

 

What symptoms of prostate cancer qualify for long term disability?

Symptoms of prostate cancer that qualify for long term disability benefits are those severe and frequent enough to prevent you from performing the essential duties of your job.  Whether the symptoms are physical or cognitive, the key is demonstrating that they interfere with your ability to work on a consistent basis.

Common Disabling Physical Symptoms of Prostate Cancer

Prostate cancer itself, as well as its treatments such as surgery, radiation, hormone therapy, or chemotherapy, can cause debilitating physical symptoms, including:

    • Chronic Fatigue: Persistent exhaustion can make it impossible to sustain the energy needed for even routine tasks, let alone a full-time job.
    • Chronic Pain: Pain in the pelvic area, lower back, or other parts of the body, especially if the cancer has spread, can limit mobility and focus.
    • Urinary Issues: Severe incontinence, frequent urination, or difficulty controlling bladder function can disrupt your ability to perform duties in a professional setting.

Common Cognitive Symptoms of Prostate Cancer

Cognitive impairments can also qualify you for long term disability if they make work impossible.  These can arise from hormone therapy, chemotherapy, or the psychological toll of battling cancer.

Examples include:

    • Memory Issues and Confusion: Prostate cancer treatments, particularly hormone therapy, can lead to cognitive decline, making it difficult to concentrate or remember important details.
    • Difficulty Focusing: Tasks requiring sustained attention, such as analyzing data or conducting meetings, may become unmanageable.
    • Mood Changes: Depression, anxiety, or emotional instability, often tied to the stress of the diagnosis or side effects of treatment, can interfere with interpersonal relationships and workplace productivity.

Ultimately, any symptom of prostate cancer—whether physical or cognitive—can qualify you for long term disability benefits if it prevents you from working.  The key is to present strong evidence that links your symptoms to your inability to perform your job.  A well-supported claim increases your chances of approval and helps ensure you receive the financial support you deserve.

 

How does prostate cancer treatment affect my eligibility for long term disability?

Prostate cancer treatment can significantly affect your eligibility for long term disability benefits by introducing physical and cognitive challenges that prevent you from performing the essential demands of your job.  Treatments such as surgery, radiation, chemotherapy, and hormone therapy often result in side effects that can disrupt your ability to meet the demands of your job.  The severity and duration of these side effects play a crucial role in determining whether you qualify for benefits.

For example, surgery, such as a prostatectomy, frequently causes:

    • Fatigue and weakness, which may persist for weeks or months;
    • Pain or discomfort that limits mobility or focus; and/or
    • Urinary incontinence, which can create ongoing challenges in professional settings.

Radiation therapy often brings additional complications, including:

    • Severe fatigue that worsens over time;
    • Bowel or bladder dysfunction, such as frequent urination or diarrhea; and/or
    • Localized pain or irritation that can interfere with sitting, standing, or other work-related activities.

Chemotherapy may lead to:

    • Nausea and vomiting that make it difficult to concentrate or perform routine tasks;
    • “Chemo brain,” a term for memory lapses and reduced mental clarity; and/or
    • Extreme exhaustion that prevents sustained effort, even for sedentary roles.

Hormone therapy, another common treatment for prostate cancer, can result in:

    • Mood swings and emotional instability, making it hard to manage workplace stress.
    • Cognitive changes, including difficulty focusing or processing information.
    • Hot flashes and physical discomfort that can disrupt your ability to work comfortably.

The cumulative impact of these treatments can affect both your physical capacity and mental acuity, especially if your job requires sustained focus, physical stamina, or interaction with others.  Even if your symptoms fluctuate, the key is showing that they are severe and frequent enough to prevent you from consistently performing your job duties.

By demonstrating how treatment-related symptoms directly impact your ability to work, you can build a compelling case for long term disability benefits.  In the next section, we’ll discuss what types of evidence you can submit to your insurer to prove your prostate cancer disability.

 

How do I prove a long term disability claim for prostate cancer?

Female doctor holding notepad with blue backgroundProving a long term disability claim for prostate cancer requires thorough and specific evidence to demonstrate that your condition—or the side effects of treatment—prevents you from performing the essential duties of your job.  Insurance companies expect detailed documentation showing not only your diagnosis but also the impact on your ability to work.

The following types of evidence can help you build a strong claim:

    • Medical Records: Your claim should include comprehensive medical records documenting your prostate cancer diagnosis, including pathology reports, biopsy results, and imaging studies such as MRIs, CT scans, or bone scans.  These records should clearly outline the stage and progression of the cancer.
    • Treatment History: Provide details about the treatments you’ve undergone, such as surgery, chemotherapy, radiation, or hormone therapy, along with notes from your healthcare providers describing the severity and frequency of side effects like fatigue, pain, or cognitive issues.
    • Specialist Opinions: Supporting statements from oncologists, urologists, and other specialists involved in your care can strengthen your claim.  These experts can explain how your prostate cancer and its treatment affect your ability to work and whether these limitations are expected to improve or persist over time.

In addition to medical documentation, vocational and functional assessments can help demonstrate how prostate cancer impacts your job performance. These include:

To tie everything together, it’s essential to create a clear narrative connecting your prostate cancer diagnosis, treatment, and symptoms to your inability to work.  Insurance companies often deny claims based on gaps or ambiguities in the evidence, so consistency is key.

For example, if you experience fatigue and cognitive difficulties that prevent you from working, your doctor’s notes should reflect these symptoms, your FCE should support physical limitations, and your neuropsychological evaluation should validate cognitive impairments.  Statements from coworkers or supervisors about your reduced productivity or inability to meet deadlines can further support your case.

Building a successful long term disability claim for prostate cancer requires a comprehensive approach.  Collecting strong medical, vocational, and functional evidence will help establish the legitimacy of your claim and increase the likelihood of approval.  Consulting with an attorney experienced in long term disability claims can provide valuable guidance on how to gather and present this information most effectively to your insurer.

 

How do I prove that fatigue, pain, or cognitive issues from prostate cancer prevent me from working?

Proving that fatigue, pain, or cognitive issues from prostate cancer prevent you from working requires a combination of subjective documentation and objective evidence.  Insurance companies may view these symptoms with skepticism because they are not always visible on imaging or lab tests, so it’s crucial to build a strong case that ties these limitations directly to your inability to perform your job.

To document subjective symptoms like fatigue and pain:

    • Symptom Diaries: Keeping a detailed symptom diary can help you track how your fatigue, pain, or other symptoms fluctuate daily.  Record the severity of your symptoms, their duration, and how they impact specific activities or job tasks.  For example, note if fatigue prevents you from completing an 8-hour workday or if pain makes sitting or standing for long periods impossible.
    • Medical Records: Ensure your medical records reflect your symptoms.  Regularly report fatigue, pain, or cognitive difficulties to your doctors so they can document these issues in their notes.  Ask your treating physician to describe how these symptoms affect your functional capacity and job performance.
    • Supporting Statements: Statements from family members, coworkers, or supervisors can corroborate how your symptoms affect your ability to work.  For instance, a coworker might attest to your increased absences or difficulty focusing during meetings.

Objective evidence is especially important for cognitive issues, as insurance companies often require proof beyond your self-reports. You may consider undergoing the following:

    • Neuropsychological Evaluation: This comprehensive test assesses various cognitive functions, such as memory, attention, problem-solving, and executive functioning.  If you experience “chemo brain” or cognitive impairments from hormone therapy, the results can provide measurable evidence of your limitations.  For example, testing might reveal significant deficits in concentration or information processing speed, which could explain why you can no longer perform tasks requiring sustained focus or quick decision-making.
    • Functional Capacity Evaluation (“FCE”): While typically focused on physical abilities, an FCE can also document cognitive fatigue or reduced stamina over an extended period.

When filing your LTD claim, it’s essential to connect the dots between your prostate cancer symptoms and your job requirements.  For example, if you work in a physically demanding role, describe how pain or fatigue limits your ability to lift, stand, or move efficiently.  If your job requires multitasking or managing deadlines, explain how cognitive impairments, like memory loss or reduced concentration, interfere with these tasks.

By combining subjective documentation like symptom diaries with objective evidence from neuropsychological evaluations and medical records, you can create a compelling case that fatigue, pain, or cognitive issues prevent you from working.  This thorough approach helps establish the credibility of your claim to your insurer and strengthens your chances of securing long term disability benefits.

 

Why do insurance companies deny prostate cancer-related disability claims?

Insurance companies often deny prostate cancer-related disability claims to protect their financial bottom line, not because the claims are without merit.  They frequently use tactics designed to minimize or dismiss your condition.

Here are a few common reasons insurers deny prostate cancer LTD claims:

    • Claiming your symptoms aren’t severe enough: Insurers may argue that early-stage prostate cancer or mild side effects from treatment don’t meet your policy’s definition of disability.  They often cherry-pick medical records that downplay the severity of your condition while ignoring evidence of more significant limitations.
    • Pointing to insufficient medical evidence: Prostate cancer often causes subjective symptoms like fatigue, pain, or cognitive issues, which are harder to measure with objective tests.  Insurers may claim your symptoms are exaggerated or unsupported if you don’t provide thorough documentation, such as medical records, symptom diaries, or specialist opinions.
    • Arguing treatment side effects are temporary: Insurance companies may assert that issues like post-surgical fatigue or cognitive impairments from hormone therapy will resolve quickly, even if your doctor has indicated that these problems are likely to persist or worsen.
    • Disputing your job limitations: For “own occupation” policies, insurers might argue that you can still perform sedentary or less demanding work, even if your symptoms make full-time employment impossible.  They may disregard the specific requirements of your job, such as sustained focus, long hours, or physical endurance.
    • Using surveillance or Independent Medical Exams: Insurers sometimes conduct surveillance or require IMEs to dispute your claims.  If they observe you performing basic activities—like driving or running errands—they may wrongly conclude that you’re capable of working, ignoring the significant differences between those activities and the demands of a full-time job.

By breaking down the reasons for denial, it’s clear that insurance companies often act in their own interests, rather than fairly evaluating your claim.  Understanding these tactics can help you anticipate challenges and prepare stronger evidence to counter their arguments.  Consulting with an experienced long term disability attorney can help you overcome these common insurer tactics and improve your chances of a successful outcome for your LTD claim.

 

How can an attorney help with my prostate cancer long term disability claim?

An attorney can provide invaluable assistance with your prostate cancer long term disability (“LTD”) claim by offering knowledgeable guidance, thorough preparation, and robust advocacy.  Riemer Hess, with over 30 years of experience helping executives and professionals secure their LTD benefits, has a proven track record of success, including numerous clients with prostate cancer. 

Our attorneys can help you navigate the complex claims process, from gathering comprehensive medical documentation to countering insurance company tactics designed to undermine your claim.  Our experience and high-touch client service ensures that every aspect of your condition is accurately represented and that you are fully supported during the process.

Riemer Hess Client Success Story

African American businessman tired in officeHere’s an example of how Riemer Hess helped secure long term disability benefits for a client with prostate cancer:

Our client “John,” a chief financial officer of a major tech company, was at the peak of his career when he received a devastating prostate cancer diagnosis.  He underwent surgery to remove his prostate and began hormone therapy as part of his treatment plan.  While the surgery was successful in addressing the cancer, the side effects of the treatment proved debilitating.  John began experiencing severe cognitive impairment and fatigue, making it impossible for him to keep up with the demanding responsibilities of his role.  Despite his best efforts to continue working, he eventually had to leave his position.

Unsure how to secure the long term disability benefits he needed, John turned to Riemer Hess for help.  Riemer Hess reassured him that his claim was strong, even without additional testing, but we wanted to ensure every aspect of his condition was thoroughly documented.  We explained the importance of obtaining a neuropsychological evaluation to objectively demonstrate the cognitive issues caused by his hormone therapy and recommended a Functional Capacity Evaluation (“FCE”) to quantify his fatigue.  Our attorneys laid out a clear plan for filing his claim, walking him through the timeline, relevant deadlines, and the steps required to gather all necessary evidence.  We coordinated with John’s doctors to obtain detailed supporting statements and ensured his medical records painted a comprehensive picture of his condition.

During the claims process, the insurer requested an interview with John to discuss his medical condition and his claim.  Our attorneys attended the interview with John to provide guidance and support.  We confirmed all of the information regarding his medical status, clarified key details about his date of disability, and ensured the insurer did not overstep or ask inappropriate questions.

Thanks to Riemer Hess’s careful preparation and advocacy, the interview went smoothly, and the insurer’s representative indicated they would approve the claim.  Relieved and finally able to focus on his health, John retained Riemer Hess to monitor his ongoing benefits and handle any issues that might arise in the future.

At Riemer Hess, our experienced ERISA attorneys understand the disability insurance claim process and what your insurer will look for, whether you’re filing a claimappealing a wrongful denial, or looking to litigate with your insurer.  To arrange for a consultation with lawyers at Riemer Hess, call us at 212-297-0700 or click the button below to schedule an exploratory call.

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