In a perfect world, anyone who suffers from a physical or emotional disability would have the resources to seek treatment and provide for themselves without supplemental income. But since we live in the real world, many people struggle with how to make ends meet during a period when they are disabled. Long term disability insurance is supposed to provide supplemental support for you, but insurance companies like to make it difficult for claimants to get approved. To help your chance of approval during the claims process, we have some tips:
Tip #1: Read Your Policy
Whether you have an individual policy or you are part of a group policy through your employer, you should read through your policy very carefully. Ask your policy provider for a copy – they must provide it to you. In the policy, you will see the exact terms and procedures you must follow during the claims process. Pay close attention to the deadlines written in your policy (Some policies state that you must file your disability claim within 30 days of the injury.)
Tip #2: Familiarize Yourself With Claim Forms
It’s smart to familiarize yourself with the claim forms before submitting your claim. The language can be tricky, but some of the things that will be requested are:
- Employee statement;
- Employers’ statement;
- Authorization to obtain medical information from your doctors; and
- Your doctors’ statement.
There may be additional documents required, so check your policy. Many claim forms do not leave enough room to write a complete statement. This is a tactic used by insurance companies to limit your response, but you have the right to attach additional sheets of paper to your statement. Just be sure to keep a copy and include page numbers at the bottom in case some pages get separated. Ex. (Page 1 would say “1 of 5”, page 2 would say “2 of 5”, etc).
Tip #3: Understand the Link Between Short Term Disability and Long Term Disability Policies
Check to see the connection between your short term and long term disability policies. Most insurance companies will require that you exhaust all of your short term disability benefits before you can apply for or otherwise qualify for long term disability insurance benefits.
Tip #4: Understand the Structure of Your Policy
Two types of periods govern most policies. The initial period (the first 24 months) and the continuation period (after the first 24 months). During the initial period, you will be disabled under “own occupation”. This refers to being unable to perform your current occupation. During the continuation period, you will have to be disabled under “any occupation,” which is just harder to prove than the initial “own occupation.” Claims that are considered a mental illness are terminated after 24 months with no continuation period. Benefits will also end if you reach retirement age during the claim period.
Tip #5: Check Your Policy For Medical Exclusions
When reviewing your policy, check for medical conditions that may exclude you from receiving benefits. Some of these issues are:
- Mental disorders;
- Pre-existing conditions;
- Diseases related to drug or alcohol abuse; and
- Impairments based solely on the patient’s complaints without medical evidence.
Tip #6: Make Your Doctor Aware of Your Intention to File for Disability
Your doctor will be your ally when it comes to your long term disability claim. Let your doctor know early on that you plan to file for long term disability if possible so they can prepare your case file properly. Most doctors have experience with patients who filed for disability benefits. They will know that even more information will be required to prepare for your claim. Information like:
- Comprehensive medical documentation of your diagnosed condition;
- A functional assessment completed by your doctor that outlines your limitations; and
- Detailed notes taken during routine visits to document your pain, daily life struggles, and mental health conditions caused by your disability.
Tip #7: You May Be Under Video Surveillance
It is common for the insurance company to put you under video surveillance during your claim process. Investigators are hired by the insurance company to stake out your house and take photos of you coming and going, moving around outside your home. The goal is to catch you doing something you aren’t supposed to do, like lifting a heavy bag of trash or cutting your grass. Be sure to follow all the limitations your doctor gives you even if that means your grass grows tall or your trash has to pile up for a while. Don’t overexert yourself.
The experienced disability attorneys at the Ortiz Law Firm can help you through every step of the process. They only get paid if you win your case. You can seek help without worrying about upfront costs or unexpected bills. Our law experts focus on your case so you can focus on your illness.
We offer free consultations with no obligation to use our firm. We will review your case and answer any questions you may have. The Ortiz Law Firm has successfully represented people in disability cases across the United States. To see how we can help you win your long-term disability case, call us at (888) 321- 8131.