A letter from your doctor or physician stating that you are disabled and unable to work will not guarantee that your long-term disability (LTD) claim will be approved. However, depending on the form and content of the letter, it can significantly improve your chances of being approved.
In most LTD cases, generic letters from doctors will have little impact on the insurance company’s disability decision. This is because, in most cases, doctors submit letters that are so short and lacking in detail that the value of the letter to a disability examiner is virtually non-existent.
For example, if all the doctor does is summarize your medical diagnoses and conclude that you are disabled and unable to work. This letter will not help the claims examiner understand why you are unable to work. Unfortunately, this type of letter is the most common from disinterested doctors.
So what makes a good letter? We know that a detailed statement from a physician who is knowledgeable about a claimant’s medical problems can make all the difference in whether or not a disability claimant is approved for disability benefits. A good statement goes beyond reciting the patient’s medical diagnoses; it provides an opinion as to the patient’s functional limitations.
This type of statement is called a “medical source statement” or “residual functional capacity” evaluation. These medical source statements aid in the evaluation process because most insurance company claims adjusters are not medical professionals. They rely on the medical professionals to determine the claimant’s level of impairment; therefore, adjusters give weight to the detailed opinions of medical professionals, particularly those directly involved in the claimant’s medical treatment.
The claims examiner should accept a treating physician’s medical source statement as true and accurate unless they have good reason to reject it (e.g., the physician is not credible or is not a specialist in the claimant’s particular illness or injury).
To help a long-term disability case, the doctor’s medical source statement should be:
- Detailed;
- Objective; and
- Assess the claimant’s physical or mental capabilities and the limitations resulting from the claimant’s medical condition and problems.
The statement should explain why the patient has certain limitations (e.g., the patient cannot bend because of a herniated disc in the back) and be supported by the medical evidence in the claim (e.g., include an x-ray or MRI showing degenerative discs).
There is a form that accomplishes these goals called an RFC form. (RFC stands for residual functional capacity.) To learn more about RFC forms and to download a free one for your doctor, visit our residual functional capacity forms page.
If your long-term disability claim has been denied, call us at (888) 321-8131 to schedule a free case evaluation with a national long-term disability attorney.
