You cannot work. But you still drive to the doctor, buy groceries, make dinner, and maybe take a trip to see family. Can your long-term disability insurance company use that to stop your benefits?
It can try. Insurers look at daily activities, surveillance video, social media, and the answers on their own questionnaires to argue that you can do more than you report. Occasional activity is not the same as working eight hours a day, five days a week. But an inconsistency between what you say and what someone sees can do real damage. Here is how to protect yourself.
Surveillance
Insurers sometimes hire investigators to watch claimants, during the initial claim or while benefits are being paid. Investigators can record what you do in public: driving, shopping, carrying things, walking, yard work, recreation. The insurer compares the footage with your statements and your medical records.
Example: a man with severe lumbar spine problems reports he cannot lift more than ten pounds. An investigator films him lifting a 40-pound bag of mulch into his car. The insurer uses the video to question everything he has said.
The video does not show whether he was in severe pain afterward, whether he spent the next day in bed, or how often he does it. Footage of one moment is not proof of full-time work capacity. But if what you reported is “I never lift anything,” a single clip can make you look untruthful.
Be accurate about your limits. Do not describe yourself as completely unable to do things you sometimes do. Explain how often you do them and what happens afterward.
Driving
Insurers ask whether you drive because driving suggests you can sit, use your hands and feet, concentrate, and react. But driving 15 minutes is not the same as sitting at a workstation for hours.
Example: a woman with lumbar spinal stenosis drives about 15 minutes to her doctor. She leaves early so she can stand and stretch when she arrives. When she gets home, she lies down for an hour. The insurer focuses on the fact that she drives. The complete picture shows a serious limit on sitting.
When asked about driving, explain how often you drive, how long you can drive comfortably, whether you have to stop, whether someone else drives longer distances, and whether you need to rest afterward.
Shopping, cooking, and housework
Insurers ask about groceries, cooking, cleaning, and laundry, and may treat any “yes” as proof of physical or mental capacity. But you do housework at your own pace. You can take breaks, split a job into pieces, sit down, or stop when it hurts. A job requires predictable attendance and steady output.
Compare two answers to “Do you shop?”
“Yes.”
“I usually shop once a week for about 20 minutes. I lean on the cart, avoid heavy items, and often need to rest after I get home.”
The second answer tells the truth more completely. Describe not just what you do, but how you do it.
Vacations and travel
Most policies do not forbid vacations just because you receive benefits, though your specific policy and situation matter. But insurers do investigate travel, and photos of hiking, swimming, or sightseeing can raise questions.
Example: a woman receiving benefits for chronic back pain flies to Florida, stays at a resort, and spends time at the beach. The insurer finds the photos. What the photos do not show: she needed wheelchair help at the airport, spent most of the trip resting, and needed days to recover. On the other hand, photos of strenuous activity that contradicts her reported limits would be a real problem.
If you travel, follow your doctor’s advice, be accurate when you describe the trip, and keep records of the accommodations you needed.
Social media
Insurers may review public photos, videos, posts, and comments. A photo captures a moment, not your whole day: one picture of you standing and smiling at a family reunion proves little. A video of you doing prolonged physical activity is different.
- Assume anything you post may be seen, even posts you think are limited to friends and family.
- Be accurate in everything you say about your activities.
- Do not delete or change posts to hide them once you have a claim. Concealing evidence creates a far bigger problem than the post itself.
Activity questionnaires
This is where many problems start. Insurers send periodic forms asking whether you drive, shop, exercise, travel, or do chores. A bare “yes” can be read as more capacity than you have. An absolute “I never lift anything” can backfire if you are ever seen carrying a light bag.
Detailed, accurate answers are better than either. For each activity, explain how long you can do it, whether you need breaks or help, and what happens afterward. Keep a copy of every questionnaire you send, and check that your answers match your medical records and your earlier statements.
How this differs from Social Security
In both systems, daily activities can be used to question your limits. In an LTD case, though, the insurer is also looking for evidence that you can do your own occupation or another occupation under the policy’s definition. The real question is not whether you carried groceries. It is whether that activity contradicts your reported limits or shows the capacity your occupation requires.
If your benefits were cut off because of surveillance or activities
- Get the evidence. Request your claim file, including the surveillance report, the video itself, and any statements or questionnaire answers the insurer says are inconsistent.
- Look at exactly what it shows. How long was the activity? How often? Does it really contradict what you reported, and did the insurer describe it accurately?
- Give context, truthfully. Explain what happened before and after: the pain, the rest, the help you had. Do not offer explanations the video contradicts.
- Get your doctor’s input. Your treating physician can explain why the observed activity is consistent with your limits.
- Appeal on time. If ERISA governs your plan, you generally have at least 180 days, and the appeal is usually your chance to put this context into the record.
Did your insurer use surveillance or social media against you? Call 770-351-0801 or request a free case evaluation.
Related: Mistakes that sink LTD claims · What to expect at an IME · My insurer says I can do sedentary work