In recent months, we’ve seen a growing number of clients reaching out with questions about lump sum buyouts of their approved LTD claims…

Sometimes they’ve received an offer from their insurance company; other times, they’re wondering how to start the conversation themselves. While we typically advise against buyouts, the rising cost of living has made it harder for many people to manage on monthly LTD payments alone. For some, a lump sum feels like a lifeline—offering the chance to pay off debt or invest in their future. But these decisions carry serious risks, especially when paired with the kind of short-term symptom relief many people experience in the summer.

Summer often brings a renewed sense of hope and energy for many people living with disabilities or chronic health conditions. The warmer weather, longer days, and a break from the usual routines can sometimes ease symptoms and improve mood. For those receiving long-term disability (LTD) benefits, this seasonal uplift can understandably lead to thoughts about returning to work once fall arrives. 

While hope is a powerful and necessary part of healing and managing disability, it is crucial to approach these feelings with caution—especially when it comes to your LTD claim. Speculating about your ability to return to work after the summer, even in casual conversations with your healthcare providers or your insurance company, can have serious consequences. In this blog, I’ll explain why optimism about working in the fall can sometimes backfire, how insurance companies interpret these signals, and share practical tips for communicating with your LTD insurer during the summer months to protect your claim. 

Why Summer Optimism Can Be Misleading

Many of my clients report feeling better during the summer. The combination of sunshine, fresh air, and a change of pace often helps reduce pain, fatigue, and depression. This improvement is real and valid, but it is important to understand that it may be temporary and seasonal. 

Chronic conditions and disabilities often fluctuate. The relief you experience in the summer might not last once the weather changes, stress increases, or your daily routine becomes more demanding. Returning to work is not just about feeling better for a few weeks or months—it requires sustained functional ability to meet the physical, cognitive, and emotional demands of your job. 

When you share hopeful statements like, “I think I might be able to return to work in September,” or “I’m feeling good now, so maybe I’ll be ready soon,” insurance companies can interpret this as evidence that you are no longer disabled or that your condition is improving enough to return to work. This can lead them to terminate your LTD benefits or push you into rehabilitation programs prematurely. 

How Insurance Companies Use Optimistic Messaging 

LTD insurers are businesses with a financial interest in minimizing claim payouts. They closely monitor claimant communications and medical updates for any indication that a claimant might be ready to return to work. Optimistic statements, even if made with genuine hope, can trigger: 

• Claim Termination: Insurers may decide that you no longer meet the definition of disability and end your benefits. 

• Rehabilitation Referrals: You might be referred to insurer-sponsored vocational rehab programs designed to prepare you for returning to work, which can be stressful and may not align with your actual health status. 

• Increased Surveillance: Insurers may require more frequent medical evaluations or functional capacity assessments to verify your ability to work. Because of this, it is critical to manage how you communicate your condition and outlook during the summer months. 

Tips for Communicating with Your LTD Insurance Company in the Summer 

Here are practical strategies to help you protect your LTD claim while maintaining honest and accurate communication: 

1. Focus on Your Current Functional Limitations, Not Future Possibilities 
   • When updating your insurer or healthcare providers, describe your present symptoms and how they affect your ability to perform work-related tasks. Avoid making predictions or speculative statements about your future work status, even if you feel hopeful. 
   • For example, instead of saying, “I think I might be able to return to work in a few months,” say, “Currently, I am unable to perform the essential duties of my job due to [specific symptoms or limitations].” 
2. Document Symptom Fluctuations Thoroughly
   • If your symptoms improve during the summer but worsen at other times, make sure this pattern is clearly documented by your healthcare providers. Ask them to include detailed notes about how your condition varies with seasons or activity levels. This documentation can help counter insurer assumptions that summer improvements mean you are ready to return to work year round. 
3. Be Mindful in Medical Appointments and Reports 
   • Healthcare providers often communicate directly with insurers through medical reports. Before appointments, discuss with your doctor the importance of accurately reflecting your functional status without overstating improvements. If you feel pressured to express optimism, remind your provider that your goal is to provide an honest and balanced picture of your health. 
4. Keep a Symptom Journal 
   • Maintain a daily or weekly journal detailing your symptoms, treatments, and how your condition impacts your daily activities. This record can provide concrete evidence to support your claim if your insurer questions your disability status after summer. 
5. Respond to Insurer Requests Carefully 
   • If your insurance company asks for updates or functional assessments during the summer, respond with factual, current information. Avoid volunteering speculative information about your ability to return to work. If you are unsure how to respond, consult your legal representative before submitting any statements. 
6. Consult Your Legal Team Before Making Statements 
   • Before communicating with your insurer, especially about your capacity to work, reach out to your disability lawyer. We can help you frame your updates to reflect your true condition while minimizing risks to your claim. This step can prevent misunderstandings that might lead to claim denial or termination. 

Understanding the Definition of Disability in Your LTD Policy 

Remember, LTD policies typically define disability based on your inability to perform your own occupation or any occupation, depending on the policy terms. This definition is medically and legally specific and requires consistent, objective evidence of impairment. 

Temporary improvements during summer do not necessarily mean you meet the policy’s criteria for returning to work. Your condition must be evaluated in the context of your overall ability to sustain employment over time. 

The Emotional Impact of Summer Hopefulness

It’s natural to want to feel better and to imagine returning to work. This hope can be motivating and uplifting. However, it can also lead to disappointment if your health does not improve as much as you expected or if your insurer misinterprets your optimism. 

Balancing hope with realism is key. Focus on managing your health day-by-day and communicating clearly and accurately about your limitations. This approach protects your benefits and supports your long-term well-being. 

How Mulqueen Disability Law Can Help 

Navigating the complexities of an LTD claim is challenging, especially when your health fluctuates and insurer expectations are high. At Mulqueen Disability Law, we specialize in advocating for clients with chronic and complex conditions, including post-concussive syndrome and other disabilities. 

If you’re concerned about how your summer improvements might affect your LTD claim or if you need guidance on communicating with your insurer, please contact us. We provide personalized advice and representation to help you protect your benefits and your future. 

Summary: Key Takeaways for Summer and Your LTD Claim 

• Summer symptom improvements are common but may be temporary. 

• Avoid speculating about returning to work in communications with insurers or providers. Focus on current functional limitations, not future possibilities. 

• Document symptom fluctuations and seasonal patterns. 

• Consult your legal team before making statements to your insurer. 

• Maintain honest, accurate, and consistent communication to protect your claim.Wishing you strength and clarity this summer, 

This blog is designed to provide you with clear, practical guidance rooted in experience and legal expertise. Protecting your LTD claim requires careful communication and understanding of how insurers interpret your statements. Let us help you navigate this process with confidence. 

Contact us for a Free Consultation

Mulqueen Disability Law specializes in hard-to-prove long-term disability claims for “Invisible Conditions” such as mental illness (depression, anxiety, PTSD) and chronic conditions (pain, neurological, immunological, concussion, post-COVID)  Contact us for a free confidential consultation.

Mulqueen Disability Law is a boutique law firm, focused on litigating long-term disability insurance benefit claims. Courtney Mulqueen and her team of legal professionals are Trauma-Informed Certified and have over two decades of experience exclusively in the area of long-term disability law. She and her team draw on their “insider” experience working for the insurance companies (including, Canada Life, Sun Life, Manulife, and OTIP), that they now sue for their clients.  

The preceding is not intended to be legal advice. This blog is made available for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog, you understand that there is no solicitor client relationship between you and the blog publisher. The blog should not be used as a substitute for competent legal advice from a licensed lawyer in your jurisdiction. If your disability claim has been denied and you require legal advice, please contact a lawyer specializing in disability law.