What MetLife Disability Insurance Covers

MetLife disability insurance is a private insurance product sold through employers, professional associations, or purchased individually. It pays a portion of your income if you become unable to work due to illness or injury. MetLife does not run a government program—it is a commercial insurance company that sets its own rules about what counts as disabled, how much it pays, and for how long.

The coverage you have depends entirely on the policy your employer bought or the terms you agreed to when you purchased it yourself. Some MetLife policies cover short-term disability (typically 3 to 6 months), others cover long-term disability (potentially to age 65 or 67), and some cover both. The monthly benefit amount is usually 50% to 70% of your salary, capped at a maximum dollar amount that varies by policy.

MetLife policies are separate from Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), which are government programs with their own definitions of disability and their own process processes. You can receive both MetLife benefits and SSDI at the same time, though MetLife may reduce your payment if you also receive workers' compensation or certain other benefits.

Key Takeaways

  • MetLife disability claims are filed directly with MetLife, not with Social Security or any government agency, and the company decides whether you meet its definition of disability.
  • You will need medical records, a statement from your doctor, and proof of your income to support a claim, and MetLife typically requires these documents within 90 days of your disability start date.
  • MetLife can deny a claim, reduce benefits, or stop paying if it believes you are no longer disabled, and you have the right to appeal any denial in writing.
  • If MetLife denies your claim and you believe the decision is wrong, a disability lawyer can review the policy language, the medical evidence, and MetLife's reasoning to determine whether you have grounds to challenge it.
  • MetLife disability benefits are taxable income on your federal tax return unless your employer paid the premiums with pre-tax dollars and you paid the premiums yourself with after-tax dollars.

How to File a MetLife Disability Claim

Contact MetLife as soon as you know you will be unable to work. Most policies require you to notify the company within a specific timeframe—often 30 days from the date your disability began. MetLife will send you a claim form and a list of documents you need to gather.

You will typically need to submit: a completed claim form signed by you, a medical report completed by your treating physician (MetLife provides the form), recent medical records related to your condition, proof of your income (recent pay stubs, tax returns, or an earnings statement from your employer), and a statement of your job duties. If you are claiming a mental health condition, MetLife often requires additional documentation, including psychological or psychiatric evaluation records.

Send all documents to MetLife's claims department. Keep copies for yourself and send by a method that provides proof of delivery—certified mail or email with read receipt. MetLife typically acknowledges receipt within 5 to 10 business days and will tell you if any documents are missing.

What MetLife Looks For When Reviewing Your Claim

MetLife uses its own definition of disability, which is written into your policy. Most MetLife policies define disability as the inability to perform the material duties of your own occupation during an initial period (often 24 months), then shift to a stricter definition—inability to work in any occupation for which you are reasonably suited by education, training, or experience—if benefits continue beyond that point.

MetLife will review your medical records to determine whether your condition prevents you from doing your specific job. The company may order an independent medical examination (IME) at its own expense, conducted by a doctor MetLife selects. This doctor will examine you and may request additional tests. You have the right to have your own doctor present during the IME, though MetLife is not required to pay for that.

MetLife also investigates whether you are actually unable to work. The company may contact your employer, review your social media, conduct surveillance, or request information about any work you are doing. If MetLife finds evidence that you are working or capable of working, it will likely deny the claim or reduce your benefits.

Timeline and What to Expect While Your Claim Is Being Reviewed

MetLife typically has 30 to 45 days from the date it receives a complete claim to make a decision. If documents are missing, the clock may restart once you provide them. During this time, you will not receive benefits—MetLife does not pay while the claim is under review.

Some policies include a waiting period (called an elimination period) of 7, 14, 30, or 90 days from the date your disability began. This means even after MetLife approves your claim, you will not be paid for that initial period. For example, if your policy has a 30-day elimination period and you became disabled on January 1, your first MetLife payment would cover February 1 onward.

Once approved, MetLife typically pays monthly, either by direct deposit or check. The payment is calculated based on your average income during a lookback period (often the 12 months before your disability began) and is subject to the maximum benefit amount in your policy.

Denial, Appeal, and When to Involve a Lawyer

MetLife may deny your claim if it concludes you do not meet the policy's definition of disability, if your medical records do not support your claim of inability to work, if you did not provide required documents, or if it finds evidence you are working. You will receive a written denial letter that explains the reason and your right to appeal.

You have the right to appeal a denial. Send a written appeal to MetLife within the timeframe stated in the denial letter (often 180 days). Include any new medical evidence, a letter from your doctor explaining why you remain unable to work, and a written statement explaining why you believe MetLife's decision was wrong. MetLife will review the appeal and issue a new decision, typically within 30 to 45 days.

If MetLife denies your appeal, you may have additional options depending on your policy and your state. Some policies allow a second appeal or external review. If your policy is governed by the Employee Retirement Income Security Act (ERISA)—which covers most employer-sponsored plans—you may be able to file a lawsuit in federal court. This is where a disability lawyer becomes important: the lawyer can review the policy language, the medical evidence, MetLife's reasoning, and applicable law to determine whether you have a case worth pursuing.

How a Disability Lawyer Can Help With a MetLife Claim

A disability lawyer who handles MetLife claims typically becomes involved after a denial or failed appeal. The lawyer will request and review your complete claim file from MetLife, including all documents you submitted, MetLife's internal notes, and the independent medical examination report if one was conducted. The lawyer will also obtain your full medical records from your treating providers.

The lawyer will then analyze whether MetLife applied the policy correctly, whether the medical evidence actually supports the denial, and whether MetLife followed the procedural rules required by ERISA or your state's insurance laws. If the lawyer finds that MetLife made an error—for example, ignored relevant medical evidence, misapplied the policy definition, or failed to follow required procedures—the lawyer may send a detailed letter to MetLife explaining the error and requesting reconsideration. Many denials are overturned at this stage without litigation.

If MetLife does not reverse the denial, the lawyer can file a lawsuit in federal court (if ERISA applies) or state court (depending on your policy and state law). The lawyer will present the medical evidence, informed testimony if needed, and legal arguments about why MetLife's decision was wrong. The goal is to obtain a court order requiring MetLife to pay your benefits, plus attorney fees and costs if you win.

MetLife Disability and Other Benefits

If you are receiving MetLife disability benefits and you also file for Social Security Disability Insurance (SSDI), you can receive both. However, MetLife may reduce your payment by the amount of your SSDI benefit—this is called an offset. Check your policy to see whether it includes an offset clause and how it is calculated.

MetLife disability benefits are generally taxable income on your federal tax return. However, if your employer paid the premiums with pre-tax dollars (deducted from your paycheck before taxes) and you did not pay any premiums yourself, the benefits are taxable. If you paid the premiums with after-tax dollars, the benefits are not taxable. If you paid part of the premiums and your employer paid part, a portion of the benefits is taxable and a portion is not. Your MetLife payment statement or a letter from MetLife should clarify the tax treatment of your specific benefits.

Frequently Asked Questions

How long does MetLife take to decide on a disability claim?

MetLife typically has 30 to 45 days from the date it receives a complete claim to make a decision. If documents are missing, the timeline may restart once you provide them. Some claims take longer if MetLife orders an independent medical examination or needs additional information from your doctor.

Can MetLife stop my benefits if I improve?

Yes. MetLife can stop your benefits at any time if it determines you are no longer disabled under the policy definition. The company may request periodic medical examinations or updated medical records to confirm you remain unable to work. If you disagree with a decision to stop benefits, you can appeal in writing.

What happens if I go back to work part-time while receiving MetLife disability?

Most MetLife policies allow you to earn a limited amount of income without losing benefits—this is called a work incentive or residual benefit. If you exceed that amount, MetLife may reduce or stop your benefits. Review your policy or contact MetLife to learn the exact income limit and how it is calculated.

Do I need a lawyer to appeal a MetLife denial?

You do not need a lawyer to appeal, and you can write an appeal yourself. However, a lawyer can strengthen your appeal by organizing medical evidence, explaining why the evidence supports your claim, and citing relevant policy language and law. Many people find a lawyer's involvement increases the chance of a successful appeal.

What if MetLife says I have to see their doctor instead of my own?

MetLife has the right to order an independent medical examination at its expense. You must cooperate with the examination or MetLife may deny your claim. However, you can have your own doctor present, and you can request a copy of the IME report. If you disagree with the IME findings, your own doctor can write a rebuttal letter for your appeal.