Making a Disability Claim as an Apple, Inc. Employee

In November 2025, Apple initiated layoffs across its salesforce, the majority of which — but not all — are located in California. Apply also has a significant white collar employee presence in New York, Seattle, Oregon, Pennsylvania, Texas, Boston, and Colorado.

For Apple employees, including those affected by these layoffs, it’s crucial to understand your rights under the Employee Retirement Income Security Act of 1974 (ERISA), especially concerning disability benefits. ERISA provides protections for employees participating in employer-sponsored benefit plans, including the right to appeal denied claims and to file lawsuits for wrongful denial of benefits. Apple employees need to understand that if they can demonstrate they were disabled before their last day of work, they are covered under Apple’s short and long term disability plans even if they have already left Apple or been notified of termination.

Many workers have health issues that are significant enough to qualify as a disability, but the workers push through them because they love their career, or need the money, or both. The fact that you worked while disabled does not disqualify you from making a claim now, it simply demonstrates your commitment to working and the effort you exerted to keep your employment as long as you could.

The Apple Short and Long Term Disability Plans

Apple’s short term disability plan is administered by Sedgwick, while the long term disability plan is administered by Lincoln Financial Group. Apple pays the benefits for the short term disability, while Lincoln pays the benefits for long term disability.

Under the short term disability plan, employees can receive up to 25 weeks of paid leave after a one-week elimination period. During the first 12 weeks, Apple will pay 100% of an employee’s weekly pay under a short term disability claim. After 12 weeks, the benefits drop to 70% of weekly pay for up to another 13 weeks. If you live in a state that offers paid disability, Apple will require you to apply for that disability benefit from the state, and will deduct the amount paid by the state from what Apple pays you. Coverage begins on your first day of employment. To qualify for disability benefits, the insured must be able to provide “objective medical evidence” of the inability to perform “your regular and customary job because of injury, illness, or pregnancy” as confirmed by the insured’s treating provider. Apple does not accept naturopath providers as treating providers, and requires that an insured be treated by an MD or DO, NP, chiropractor, dentist, podiatrist or psychologist. The “objective medical evidence” required by Apple is defined as being “verifiable through a test or an analytical tool such as blood tests, MRIs, and X-rays and other assessment tools that can bolster or prove a diagnosis of a specific illness or medical condition. All observations and tests must be assessed by a qualified provider. Objective medical evidence does not include a provider’s opinion based solely on acceptance of subjective complaints of the patient.” This means that even for mental health claims or claims based on fatigue or pain, formal assessments must be performed by the treating physician in order for the claim to be approved. When calculating the insured’s salary, Apple does not include overtime or bonus income. For commissioned employees, Apple considers base pay and on-target variable. If benefits are approved, after the first twelve weeks of payment an insured can choose to keep the payment at 100% of salary by supplementing it with earned sick or vacation pay. Contributions to the insured’s 401(k) plan, Health Savings Account, Employee Stock Purchase Plan ,and Flex Spending Accounts will continue to be taken from the disability payments during the short term leave. Sick pay and vacation pay will not accrue. If you attempt to return to work and are unsuccessful, you can go back out on disability within 60 days without needing a new waiting period if the disability is the same.

The long term disability plan takes over at 26 weeks. To qualify for benefits under the long term disability (“LTD”) plan, employees must be able to demonstrate that they were disabled throughout the “elimination period,” which is 180 days, and ties to the 180 days of the short term disability policy. The Plan pays 50% of the employee’s monthly predisability earnings up to either $12,500 or $26,000 per month depending on the insured’s annual salary. Apple offers its employees the ability to sign up for a “buy-up” option covering an additional 20% of salary, for a total of 70% per month. As with STD benefits, LTD benefits do not include overtime or bonuses in the calculation of the monthly benefit. Commissioned employees again receive base pay and on-target variable. Benefits are potentially paid up to age 67. Lincoln may require you to apply for Social Security Disability Insurance benefits and offset them against what it owes you.

If you become disabled in your first year of employment with Apple, your LTD coverage is subject to a pre-existing exclusion. That means that if the insured claims a disability “caused by, substantially contributed to by, or results from a pre-existing condition or medical or surgical treatment of a pre-existing condition” that began in the first twelve months after the employee’s effective date, and the insured received or was recommended to receive treatment for the symptoms of that disability in the six months prior to being covered under the policy, the coverage is excluded.

For most disabilities, LTD benefits are potentially paid to age 65. For the first 12 months of long term disability, the employee has to prove the inability to perform the material and substantial duties of their “own occupation.” After 12 months the employee must demonstrate the inability to perform the duties of any gainful occupation for which the employee is reasonable fitted by education, training, station in life, or experience.

The long term disability plan includes limitations of 24 months of coverage for any disability related to Mental Health or Substance Abuse.

What do you need to demonstrate disability, especially if you were working full time at the same time you are claiming disability? You need to demonstrate that your treating physician agrees that you had restrictions and limitations that kept you from performing the materials duties of your own occupation as of your last day of work, and you have to have been treating for the symptoms causing those restrictions and limitations as of your last day of work. Under the Apple Short and Long Term Disability Plans, you need to demonstrate “regular” treatment by a medical professional for the condition that keeps you from working.

Courts understand that many people push through disability and try to work anyway because they love their job, or they need the income, or both and have routinely held that the fact that an employee was working does not bar them from claiming disability at the same time. Employees can also make claims for disabilities that arose after they learned of the termination of their position but before their last day, if they have medical support. That includes depression and anxiety, if an employee is diagnosed with and actively treating for such a condition before their last day of work.

The Apple Severance Agreement

If you are laid off by Apple, Apple will require you to sign an agreement to obtain a severance package. If you have any intention of making a disability claim under the Apple policy, or if you already are on disability at the time of the layoff, it is important to have an attorney review your severance agreement prior to signing it. Most employees do not realize that depending on the language used in the agreement, a court may interpret it to waive your right to pursue disability benefits. The severance agreement will include a section releasing your claims against Apple. Apple will be a defined term involving “Released Parties” or “Releasees.” If that definition includes Apple’s insurers, then a court may decide that you released your claims against Lincoln as well. If the claims released includes claims under ERISA, a court could decide that you released your claims for disability benefits, which are governed by ERISA. It is important to have counsel review this for you before you sign. There is nothing your counsel can do for you after you sign it. If you consult with counsel before signing, it may be possible to request specific language to be included based on any current or pending disability claim, and to carve that claim out of any waiver.

All Apple Employees Can and Should Pursue Their ERISA Disability Insurance Claims in California Federal Courts

The Apple long term disability plan is governed by ERISA. Lincoln routinely denies many disability claims, especially those involving mental health or “self-reported” symptoms such as pain, migraines, or fatigue. Insureds are required under ERISA to appeal a denial, but after one appeal, there is no further option for reconsideration under the long term disability plan. The next step is litigation. Lincoln, like most insurers, is often interested in buying out the value of the insured’s claim at litigation. This enables some insureds to obtain a lump sum settlement. Lincoln looks at the total claim and the litigation, including the court where the litigation is filed and the judge assigned, when making determinations about settlement.

While under ERISA an insured can technically bring suit anywhere in the US, Lincoln will push back on most suits if there is not a specific connection, arguing successfully that the court should not bear the cost of the litigation without a clear connection. Under ERISA, there are three locations where the insurer cannot dispute the venue of the lawsuit – if it is filed where Lincoln is headquartered, if it is filed where the insured lives, or if it is filed where the disability plan is administered. Apple administers the Plans in the Northern District of California in the Ninth Circuit. This is arguably one of the most favorable districts in the country for disabled plaintiffs.

Many insurers include language in their disability policies that grant them “discretion” in deciding claims. Courts interpret that language to mean that the court must accept the insurer’s decision unless it is clearly “arbitrary and capricious.” The Apple policies include this language. But discretionary clauses have been banned in several states, including California, Oregon and Washington, and are not enforceable in those states, and courts have uniformly held in the Northern District of California that the ban applies to the Apple disability policies. That means that the court will consider the claim objectively on its merits, rather than giving Lincoln the benefit of the doubt.

California state also embraces the doctrine of notice prejudice. This means that unless the insurer can demonstrate actual prejudice from a late-filed claim, the insurer must accept and consider that claim. Many states will allow an insurer to deny a claim as late-filed automatically. Where insureds often do not have a diagnosis for medical issues in a timely period and only receive a diagnosis after they leave employment, insurers in many states have been able to avoid responsibility for those diagnoses by pointing to the fact that they were late-filed. When suit is filed in California, the insurer cannot escape its responsibility for the claim even if it is filed late.

If you are an Apple employee in a state other than California, you can still file suit in California and take advantage of the more favorable laws and courts for your litigation – if you have an attorney admitted to the California bar.

What Do You Need to Make a Late-Filed Claim?

For any claim, the support of your treating physician is paramount. You cannot make a successful disability claim if your doctor or therapist does not believe that you are disabled. Your treating physician does not need to be a medical doctor. Under the Plans, you need to be seeing a medical doctor or doctor of osteopathy, nurse practitioner, psychologist, chiropractor, or podiatrist. If you are an Apple employee who has received notice of termination but you are still employed, a claim will not be considered late-filed. If your doctor agrees that as of your last day of work you had restrictions and limitations, whether mental or physical, that precluded you from performing the material duties of your job, you can apply for disability benefits at Apple.

If you are making a claim after you have already left work, you need to demonstrate that you were treating for the symptoms that disabled you on or prior to your last day of work. You do not need to show a diagnosis, but you do need to demonstrate that you were experiencing symptoms of the disability and that you sought treatment for those symptoms, so medical records need to show treatment. Your treating medical practitioner will also have to be willing to complete paperwork confirming your disability and that it began on or prior to your last day of work. With that information, Lincoln will be required to accept and review your claim even if you last worked at Apple months or even years ago.

Obtaining Legal Counsel During the Appeal

Many insureds appeal the denial of their benefits themselves. Unfortunately, if the appeal is denied and litigation is required, your attorney will not be able to improve your position. Under ERISA, there is usually no discovery in litigation. A judge rules on the claim, and the judge is limited to the information in the claim file. That means that the appeal is the insured’s only chance to get all information into the file that would benefit the judge. This includes declarations under penalty of perjury from witnesses, additional medical records, letters from the treating physicians, independent testing to support the disability, issues with Lincoln’s doctors, and medical literature to educate the judge about the insured’s disability and diagnosis. The appeal isn’t just for Lincoln- it is the insured’s one chance to strengthen the file for litigation.

An appeal within 180 days of denial is required. The insured cannot bring suit if there is no appeal and cannot appeal again or refile the claim. As soon as a denial is received, an insured should contact counsel for assistance to give counsel time to perfect your appeal.

Where Monahan Tucker Law has attorneys and offices in Washington, California, Arizona, Oregon, and Nevada, it can assist Apple employees anywhere in the country and if necessary bring suit for its clients in the Northern District of California, because our attorneys are admitted to the court. We have deep and broad experience with the Apple disability policies and with Lincoln, and can help you through this difficult and stressful time and provide you the strongest tactical advantages in your claim or litigation.