Hi warrio202105, I've actually heard from a few people that they almost without question most people get refused the first time. I would not say its automatic as every case is different. I for instance had a heart transplant and the work I was doing was very physical in as much as i needed to climb communication towers and because of that along with a heart transplant could not continue to climb towers. Now some companies could do what they say is an allowance to put me in a different position at the same pay and location as the job I had, and my company did not have a position available. So based on that and my age to retrain into something else (i was 58 at the time) would not be worth it as i was close to retirement age. So I got it mostly based on that. But i would not give up and resubmit. Also i might add that many people i have met with succsful transplant both heart and other organs were able to return to work with a leave of abssent of maybe 6 months to a year. Which also my give you a tempory disability which would allow you to recover and/or retrain into some kind of work you could do with a transplant. Ill be honest I really liked my career and many times in the past 5 years felt a strong desire to return. I know i cant physically but alo miss doing something I really loved. I hope you are succesful in what ever you decide.