MetLife Long-Term Disability Denials

Aggressive Legal Help for Group ERISA and Individual Disability Policyholders

Receiving a denial letter from MetLife for your long-term disability (LTD) claim is more than frustrating; it is destabilizing. You paid for protection. Now, when you need it most, the insurance company is refusing to uphold its end of the agreement.

MetLife, one of the largest and most established disability insurers in the country, has a long history of rejecting valid claims. It has faced disputes over claim denials, rescissions, and policy rescission actions. The company frequently leans on ambiguous policy language, biased medical evaluations, or technical exclusions buried deep in your policy.

To make matters more complex, MetLife has operated under various individual disability insurance (IDI) product names, including:

• Income Guard
• OMNI Advantage
• OMNI Essential
• Business Overhead Expense
• Buy‑Sell

Many claimants do not even realize their policy falls under one of these sub-brands, a confusion that MetLife may not be in a rush to clarify.

At Sandstone Law Group, we understand how important these benefits are when your health, career, and stability hang in the balance. Our attorneys are deeply familiar with MetLife’s denial strategies and know how to counter them with sharp, focused legal action. If you have been denied, this is not the time to go it alone.

With Sandstone in your corner, you have a team that listens, strategizes, and fights. Contact Sandstone Law Group today at (602) 932-6592 for a consultation.

MetLife’s Legal History

As one of the largest and most profitable insurance companies in the world, MetLife has built its empire on the trust, and premiums, of working Americans. Through its vast network of subsidiaries, including Metropolitan Life Insurance Company, American Life Insurance Company, and others, MetLife collects billions each year in disability and life insurance payments. But behind the brand’s familiar name lies a long pattern of broken promises, financial maneuvering, and aggressive claims denials.

MetLife has come under intense scrutiny for its handling of long-term care and long-term disability claims. In the notorious class action lawsuit Newman v. Metropolitan Life, policyholders who paid higher premiums under a “Reduced-Pay at 65” rider were promised lower costs in retirement. Instead, they were hit with shocking premium increases, some over 100%, just as they reached an age where affordability mattered most. The resulting settlement forced MetLife to cap premium hikes and refund a portion of the excess payments.

MetLife has consistently been called out by regulators and plaintiffs alike for:

• Unreasonable claim denials based on technical policy language.
• Sudden, steep premium increases after years of stable pricing.
• Failing to deliver on retirement planning promises marketed to consumers.

Tactics MetLife Uses to Deny Disability Claims

MetLife’s profit is built on its ability to limit payouts, even on legitimate LTD claims. If your benefits were denied, there is a good chance it was not just a clerical oversight. MetLife uses calculated tactics to delay, diminish, or outright deny claims, knowing most policyholders do not have the resources or knowledge to fight back effectively.

Here are some of the most common strategies MetLife employs to avoid paying LTD benefits:

How to Appeal a MetLife Disability Claim Denial

If MetLife has denied your LTD claim, your next steps are critical, and they depend heavily on the type of policy you have.

Understand Your Policy Type

• Employer-sponsored LTD plans are almost always governed by ERISA, a federal law that imposes rigid rules on how claims and appeals must be handled.
• Individual policies are governed by state law, not ERISA, and offer broader legal remedies.

Appealing a MetLife Disability Denial Under ERISA (Group LTD Policy)

If you obtained your policy through an employer, your claim likely falls under ERISA (Employee Retirement Income Security Act). If your policy is covered by ERISA, you must file an internal appeal with MetLife before taking any legal action. This is not a step you can afford to take lightly.

• This is your one opportunity to submit supporting evidence. Once MetLife issues a final denial, any lawsuit you file will be based solely on the information you provided during the appeal.
• No new documents or testimony can be added later. If you do not submit a medical record, physician letter, or vocational assessment during your appeal, it likely will not be considered by the court.
• You are working against the clock. Federal law requires that appeals be submitted within 180 days of receiving the denial.
• MetLife will not tell you the whole truth. They will not explain the strategic importance of the appeal or the long-term legal consequences of submitting an incomplete file. In fact, many denials are issued with the hope that claimants will not fully understand their rights—or the stakes.

To make matters worse, most ERISA policies grant MetLife discretionary authority, which means a court will uphold the denial unless it was “arbitrary and capricious.” That standard gives the insurer the benefit of the doubt unless your appeal is airtight.

Appealing (or Suing) Under an IDI Policy with MetLife

If your LTD policy was purchased independently and is not tied to your employer, it likely falls outside of ERISA. That is good news, because California law provides far stronger protections.

• You may be able to sue MetLife directly in state court without appealing first, depending on your policy terms.
• You may be eligible to pursue damages for bad faith, emotional distress, and even punitive damages, remedies that are often off-limits under ERISA.
• You have the right to a jury trial, a broader discovery process, and a far more level playing field.

However, some IDI policies still contain internal appeal language or other procedural hurdles. A careful review of your specific policy is essential before moving forward.

Whether your claim falls under ERISA or IDI rules, one fact remains constant: MetLife is counting on you to make a mistake. They hope you will miss a deadline, leave out critical evidence, or appeal without legal help. We do not let that happen.

We Are Ready to Take Your Case to Court

MetLife counts on you giving up. On accepting their denial. On not knowing your rights. But at Sandstone Law Group, we prepare from day one as though your case will go to federal court, or state court, if you hold an IDI policy.

Under ERISA, we understand how to challenge “abuse of discretion” reviews, build airtight administrative records, and push for favorable rulings in the Ninth Circuit. For IDI denials, we go further, leveraging every available legal remedy California law allows.

Why Choose Sandstone Law Group to Fight MetLife?

When MetLife denies your long-term disability benefits, it is a betrayal of the trust you placed in your insurance policy. At Sandstone Law Group, we fight to restore not only your income, but your peace of mind, your dignity, and your sense of control.

We understand that our clients would give anything to feel well again, to return to work, to regain normalcy. But when MetLife refuses to honor its promises, we step in with conviction, clarity, and relentless legal resolve.

• We Know MetLife’s Tactics: MetLife has a well-documented pattern of minimizing valid claims through tactics like:
  • Discrediting treating physicians.
  • Downplaying symptoms using biased reviewers.
  • Exploiting surveillance footage out of context.
  • Misapplying policy language to limit or terminate benefits.
• We have seen it all: Our attorneys have successfully challenged these strategies across both ERISA-governed and IDI policies. We handle every stage of the process, including:
  • Appealing internal denials with robust medical and legal documentation
  • Challenging biased IMEs, peer reviews, and vocational assessments
  • Litigating MetLife denials in federal or state court
  • Using procedural violations and bad faith conduct to shift leverage in your favor.
• We Are Courtroom-Ready: While many firms quietly settle or avoid litigation, we take the opposite approach: we prepare every case as if it will go to court. That mindset forces MetLife to take our clients seriously, and it shows in our track record.
• We Win Because We Care: We do not treat cases like files or numbers. We treat them like the deeply personal battles they are. Our clients are people whose lives have been upended by disability and corporate denial—and we treat their stories with the respect and legal firepower they deserve.

Our team brings a rare combination of legal aggression and personal compassion. We have seen the damage done by disability denials, and we fight like it is personal, because in many ways, it is.

How Our LTD Insurance Claim Denial Lawyers Can Help

When MetLife denies your long-term disability (LTD) benefits, you are left facing an uphill battle against a multibillion-dollar insurer armed with its own legal and medical teams. Our attorneys understand that behind every denial is a person whose life has been upended.

• We Will Listen. You will not be rushed through an intake form or handed off to a faceless case handler. At Sandstone, our attorneys listen deeply. We want to understand the full story behind your disability, the obstacles MetLife has placed in your path, and what this denial has cost you. From there, we build tailored, legally sound strategies based on your lived experience, your medical realities, and your long-term goals.
• We Will Lead the MetLife Appeals Process: For claims governed by ERISA, your appeal is your one and only chance to present the evidence that may ultimately decide your case in court. We take that responsibility seriously. Our team prepares each appeal with meticulous attention to medical records, expert opinions, functional assessments, and any other materials that can reinforce the legitimacy of your claim. If your policy falls outside of ERISA, such as with an individual disability insurance plan, we assess the most strategic path forward, which may include appeal or immediate litigation, depending on the circumstances.
• We Will Take Your Case to Court: Our attorneys have extensive experience litigating LTD denials in both federal and state courts. Whether the standard is de novo review or abuse of discretion, we are prepared to present a compelling case backed by facts, law, and a deep understanding of insurance company tactics.

You do not have to fight this alone. Let Sandstone Law Group fight for you aggressively, relentlessly, and without compromise. Contact Sandstone Law Group today at (602) 932-6592 for a consultation.