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For those grappling with stomach or gastric cancer, the impact on your daily life and work can be overwhelming.  From managing chronic pain to coping with severe fatigue, the symptoms of stomach cancer can make it difficult to perform even the simplest tasks, let alone maintain regular employment.  Understanding your eligibility for long term disability benefits can provide crucial support during this difficult time.

Navigating the process of obtaining long term disability for stomach cancer can be stressful and complicated.  This article answers common questions about qualifying for long term disability and shares strategies that can help substantiate your claim.  By understanding the key aspects of your policy and what evidence can prove your claim, you can increase your chances of securing the benefits you deserve.

Can I receive long term disability for stomach cancer?

Yes, you can receive long term disability benefits for stomach cancer if your condition prevents you from working and meets the eligibility criteria in your policy.  Stomach cancer, also called gastric cancer, occurs when malignant cells develop in the stomach lining.  It can spread to nearby organs and lymph nodes, making daily activities and work increasingly difficult.  The severity of your symptoms and the side effects of treatment play a key role in determining whether you qualify for benefits.

Stomach cancer can cause a variety of disabling symptoms, including:

• • Chronic abdominal pain and discomfort: Persistent pain can make it difficult to concentrate, sit for extended periods, or engage in tasks that require focus and stamina.
  • Nausea and vomiting: Frequent nausea and vomiting can be unpredictable, forcing frequent breaks and making it impossible to maintain a normal work schedule.
  • Difficulty swallowing (dysphagia): Trouble eating and drinking can lead to dehydration and malnutrition, causing weakness and reduced cognitive function that impair job performance.
  • Unintentional weight loss: Significant weight loss can lead to severe fatigue and muscle weakness, limiting endurance and the ability to handle demanding work tasks.
  • Severe fatigue and weakness: Extreme exhaustion can make even simple tasks overwhelming, reducing productivity and the ability to complete a full workday.
  • Loss of appetite and malnutrition: Poor nutrition can cause brain fog, dizziness, and weakness, making it hard to focus, problem-solve, or meet deadlines.
  • Gastrointestinal bleeding and anemia: Blood loss can result in dizziness, shortness of breath, and fainting spells, making it unsafe to perform physical tasks or operate in high-pressure environments.

Treatment for stomach cancer, including chemotherapy, radiation, immunotherapy, and surgery, can also lead to debilitating side effects, such as:

• • Extreme fatigue and weakness: Severe exhaustion can make it impossible to sustain focus, meet deadlines, or complete a full workday without frequent breaks.
  • Persistent nausea and vomiting: Ongoing nausea can make it difficult to remain in a professional setting, disrupt meetings, and require frequent absences.
  • Cognitive impairment (鈥渃hemo brain鈥�): Memory issues, difficulty concentrating, and slowed thinking can impair decision-making, problem-solving, and multitasking.
  • Neuropathy (nerve damage causing pain or numbness): Nerve pain, tingling, and numbness in the hands or feet can make it challenging to type, write, or perform fine motor tasks.
  • Increased risk of infections due to a weakened immune system: A compromised immune system may require isolation from coworkers, frequent medical appointments, and extended absences from work.
  • Digestive complications, especially after stomach surgery: Difficulty processing food, chronic diarrhea, and nutritional deficiencies can cause discomfort, frequent restroom breaks, and unpredictable work disruptions.

To qualify for long term disability benefits, you must meet the specific terms outlined in your policy. Most policies require that you were an active employee when you became disabled and that you satisfy an elimination period (a waiting period before benefits begin).  Your policy will also define disability, typically in one of two ways: 鈥渙wn occupation鈥� (unable to perform your current job) or 鈥渁ny occupation鈥� (unable to work in any job based on your education, training, and experience).  Many policies, especially group policies provided by your employer and governed by ERISA, will start with an 鈥渙wn occupation鈥� definition before transitioning to an 鈥渁ny occupation鈥� standard later on (usually 24 months).

Some policies have other provisions, such as pre-existing condition clauses, that can impact your long term disability claim.  Consider consulting with an ERISA attorney experienced in long term disability claims who can review your policy to interpret the eligibility criteria.

How do I prove my stomach cancer is disabling?

When filing for long term disability benefits for stomach cancer, your insurer will require substantial evidence showing both the medical severity of your condition and how it prevents you from working.  Insurers expect detailed proof that your symptoms and treatment side effects make it impossible to perform your job duties.

Proving Medical Disability from Stomach Cancer

To demonstrate that your stomach cancer is disabling, you should obtain comprehensive medical evidence, including:

• • Diagnostic Test Results: Pathology reports, endoscopies, CT scans, MRIs, or PET scans confirming your diagnosis and cancer stage.
  • Oncologist鈥檚 Medical Records: Detailed treatment notes, prognosis, and reports on how cancer and its treatments affect your daily life.
  • Treatment Documentation: Records of chemotherapy, radiation, immunotherapy, or surgery, along with documented side effects such as nausea, fatigue, and neuropathy.
  • Blood Test Results: Evidence of anemia, malnutrition, or other complications that contribute to disability.
  • Physician Statement: A written opinion from your oncologist explaining how your symptoms and treatments limit your ability to function in a work environment can be valuable evidence to support your claim.

• • Neuropsychological Evaluation: If you experience cognitive impairment (鈥渃hemo brain鈥�), a neuropsychological evaluation from a neuropsychologist can objectively document memory, concentration, or processing difficulties that impact your ability to work.

Proving You Cannot Work Due to Stomach Cancer

Beyond medical evidence, you should also demonstrate to your insurer how your symptoms prevent you from performing your job duties. Vocational evidence can strengthen your claim by demonstrating that your physical and cognitive limitations make work impossible.

This may include:

• • Functional Capacity Evaluation (鈥淔CE鈥�): A test assessing your ability to perform physical tasks like standing, lifting, and sitting for extended periods.
  • Official Job Description: Your employer鈥檚 official job description should outline your key responsibilities and functions in your role.
  • Personal Statement: You may consider writing a personal affidavit to support your claim.  This statement can further explain the physical and cognitive demands of your role, the onset of your stomach cancer, and how your symptoms and treatment side effects have prevented you from performing the material duties of your occupation.
  • Employer/Co-Worker Statements: Statements from your employer or coworkers describing how your productivity and reliability declined due to treatment side effects.
  • Vocational Assessment: A report from a vocational expert explaining why your stomach cancer prevents you from working in either your own occupation or any occupation. This assessment considers your job duties, required skills, and how your symptoms鈥攕uch as fatigue, cognitive impairment, and physical limitations鈥攁ffect your ability to perform work tasks consistently. A vocational expert may also compare your functional abilities to the demands of other jobs to demonstrate that you are unable to work in any gainful employment.

By providing both strong medical documentation and clear vocational evidence, you can demonstrate to your insurer that your stomach cancer and its treatments prevent you from performing the duties of your job.  A long term disability attorney can be invaluable in obtaining evidence on your behalf. They can review your existing medical records for any missing information or red flags, refer you for additional medical or vocational assessments, coordinate with your providers to obtain medical records and statements, and ensure your evidence is organized and presented to your insurer in the strongest possible way.

Does the stage of my stomach cancer affect my long term disability claim?

Yes, the stage of your stomach cancer can significantly affect your long term disability claim.  Insurance companies evaluate the severity of your condition, its impact on your ability to work, and whether your disability is expected to be long-term.  Generally, more advanced stages of stomach cancer make it easier to qualify for benefits, but even early-stage cancer can be disabling depending on your symptoms and treatment side effects.

In early-stage stomach cancer (Stage 0 to Stage I), the cancer is often localized and may be treated with surgery, chemotherapy, or radiation.  While some individuals recover and return to work, others may experience debilitating side effects such as chronic pain, nausea, extreme fatigue, and digestive issues that make working impossible.  Disability insurers may closely scrutinize claims for early-stage cancer, requiring strong medical evidence that your symptoms and treatments prevent you from performing your job.

In mid-stage stomach cancer (Stage II to Stage III), the cancer has typically spread to nearby lymph nodes or deeper layers of the stomach, making treatment more aggressive.  Side effects from chemotherapy, radiation, or partial gastrectomy (removal of part of the stomach) can severely impact energy levels, cognitive function, and physical stamina, increasing the likelihood of qualifying for benefits.

In late-stage or metastatic stomach cancer (Stage IV), the cancer has spread to distant organs, such as the liver, lungs, or peritoneum.  At this stage, the disease is often considered terminal, and treatment focuses on slowing progression and managing symptoms rather than curing the cancer.  Individuals with advanced stomach cancer typically qualify for long term disability benefits more easily, as the prognosis and severity of symptoms make working impossible.

Regardless of the stage of your stomach cancer, your long term disability claim must be supported by strong medical and vocational evidence.  Navigating the claims process can be overwhelming, especially while managing a serious illness like stomach cancer, but a long term disability attorney can help gather the necessary evidence, communicate with your doctors, and ensure your claim is as strong as possible.  An experienced ERISA disability attorney can also protect you from common insurer tactics used to delay or deny claims, giving you the best chance of securing the benefits you need.

Why do insurers commonly deny stomach cancer disability claims?

Insurers have a financial incentive to deny or limit long term disability claims, even for serious conditions like stomach cancer.  While you may assume that a life-altering diagnosis automatically qualifies you for benefits, insurers often look for reasons to reject claims in order to protect their bottom line.

Common reasons insurers deny stomach cancer disability claims include:

• • Claiming You Can Still Work: Even if you are dealing with debilitating symptoms or grueling treatments, insurers may argue that you can perform a sedentary job, ignoring the reality of your condition.  They may selectively use medical records or hire their own doctors to downplay your limitations.
  • Insufficient Medical Evidence: Insurers often deny claims by stating that your medical records do not 鈥減rove鈥� your inability to work.  If your doctor does not clearly document how your symptoms and treatment side effects limit your ability to function, your insurer may use this as an excuse to deny benefits.
  • Ignoring Treatment Side Effects: While chemotherapy, radiation, and surgery can cause severe nausea, fatigue, cognitive issues, and pain, insurers sometimes dismiss these effects as temporary or manageable, despite overwhelming evidence to the contrary.
  • Using Surveillance or Social Media Against You: Insurers frequently conduct surveillance or monitor social media to find any evidence that they can twist to claim you are not truly disabled.  Something as simple as a photo of you at a family gathering could be used against you, even if it doesn鈥檛 reflect your day-to-day struggles.
  • Unreasonable Policy Interpretation: Your policy may define disability as being unable to work in your 鈥渙wn occupation鈥� or 鈥渁ny occupation.鈥�  Insurers often exploit vague language, arguing that you can work in a different field, even if your education and experience make that unrealistic.
  • Claiming Your Condition Will Improve: Even with a cancer diagnosis, insurers may argue that your condition is not expected to be long-term, especially if you are still undergoing treatment.  They may delay or deny benefits by claiming you should wait and see if your condition improves.

If your stomach cancer disability claim is denied, it does not mean you are not entitled to benefits鈥攊t means your insurer is protecting its profits.  A denial can be challenged through an appeal, but it requires strong medical documentation, clear evidence of how your symptoms prevent you from working, and sometimes legal action to hold the insurer accountable.  Whether you are filing a claim, facing an appeal, or litigating your long term disability benefits, it's recommended that you consult with an attorney who can provide insightful guidance through the process.

How can an attorney help me get long term disability for stomach cancer?

An experienced long term disability attorney will understand how to substantiate your stomach cancer long term disability claim and avoid common insurer tactics used to deny or delay benefits.  Riemer Hess has over 30 years of experience securing long term disability benefits for our professional and executive clients. 

Riemer Hess understands that when you鈥檙e dealing with a diagnosis as devastating as stomach cancer, you don鈥檛 want to worry about combatting your insurer for the benefits you need and deserve.  Our attorneys handle every aspect to make the claims process as smooth as possible while protecting your rights to benefits.

Below is an example of a client with stomach cancer who we helped secure long term disability benefits.

Riemer Hess Client Success Story

Dawn was a high-level executive manager at a global company when she received the devastating diagnosis of stage four gastric cancer.  The aggressive chemotherapy and radiation treatments left her exhausted, in pain, and struggling with cognitive difficulties.  Although she had been approved for short term disability benefits, she knew she would need long term disability as her treatments would continue indefinitely.  Adding to her stress, her employer announced they would be terminating her position while she was still on short term disability.  Uncertain about her future and needing to secure her financial stability, Dawn turned to Riemer Hess for help with her LTD application.

Riemer Hess immediately developed a strategy to ensure Dawn鈥檚 claim was approved as quickly and smoothly as possible. First, we obtained her full disability policy to understand all applicable provisions.  We also coordinated with her employment attorney to address her severance agreement and ensure her right to file for long term disability remained protected.

To build a strong claim, we worked with her oncologist to provide a detailed medical statement outlining not only her pain and physical symptoms but also the overwhelming fatigue, cognitive impairment, and immunosuppression that made returning to work impossible.  Additionally, we secured a comprehensive statement from Dawn herself, documenting the severe limitations she faced due to her gastric cancer.

With this carefully crafted approach, Dawn鈥檚 long term disability claim was approved without issue or delay.  Knowing the challenges that could arise in maintaining her benefits, she retained Riemer Hess for continued benefit protection and support.

If you鈥檙e looking to file a long term disability insurance claim for lung cancer, appeal a wrongful claim denial, or litigate your insurer, Riemer Hess can help. Contact us today at (212) 297-0700 or click the button below for a consultation on your disability case.