The Challenges Nurses Face When Applying For Long-Term Disability

As a nurse, you are the medical professional closest to patients. You may spend 12 hours or more a day helping patients and doctors. Medical facilities could not survive without you. So why does the insurance company make it so hard to file for long-term disability when you become disabled?

In this article, we will explore:

• Why it’s so hard to file a long-term disability claim as a nurse
• What you can do to help build a strong claim

Why It’s So Hard to File a Long-Term Disability Claim as a Nurse

Outdated Data

The nursing profession has evolved over the years. The most recent Dictionary of Occupational Titles was published in 1991, but insurance companies still use it today even though it’s based on clearly outdated information. The duties of a nurse have changed drastically since the 1990s, and nurses now specialize in different areas. To prove your disability claim, you (and your attorney) will need to provide the insurance company with an updated list of job responsibilities.

Current Salary

According to the Bureau of Labor Statistics, nurses earn a median salary of $70,000, with some specialized nurses earning more than $100,000 a year. The insurance company knows that a long-term disability claim could cost them, so they will try to find ways to deny your claim.

Pre-Existing Conditions

The majority of nurses claims are related to back and neck injuries. Nurses are required to lift and move patients on a daily basis, and years of this will take a toll on your body. The battle comes in proving that your chronic pain is not a pre-existing condition. An experienced attorney can help you navigate this issue.

What You Can Do to Build a Strong Claim

Read Your Policy

The first thing that you need to do before you start the claim process is to get a copy of your long-term disability (LTD) policy. How you get a copy of your policy depends on the type of policy that you have: individual or group.

If you have an individual policy, you will need to contact the LTD company directly and ask for a copy. If you have a group policy through your employer, you will need to contact the administrator of the policy, usually the human resources department. They are required to provide you with a copy within 30 days of receiving your request.

If possible, be sure to request a copy of your long-term disability policy in writing so you have documentation in case your employer or LTD company gives you the runaround.

Gathering Evidence to Support Your Long-Term Disability Claim

Filing a long-term disability claim can be a meticulous and time-consuming process. One of the most critical stages is gathering the documentation to support your claim. While this guide serves as a good starting point, understand that each claim is unique, and additional evidence may be required for your particular situation.

Documentation You May Need:

1. Your LTD Policy: A copy of your policy to refer to for terms and guidelines.
2. Insurance Correspondence: Copies of all letters exchanged with your insurance company, including those sent by you.
3. Proof of Disability: This includes documentation detailing why you can no longer perform your job duties (usually supported by medical records).
4. Medical Provider Statements: A compilation of statements from all medical providers seen for your condition, with each provider confirming that your condition prevents you from working.
5. Communication Summaries: Written summaries of all meetings with insurance representatives, medical professionals, and your employer. Sending copies to all parties by certified mail ensures proof of receipt.
6. Income Verification: Proof of your monthly income.
7. Proof of Continued Medical Care: Proof of ongoing medical treatment for your condition.
8. Additional Medical Documentation: This includes, but isn’t limited to, your medical records, lab reports, x-ray and MRI reports, doctor’s notes, and lists of surgeries with related medical reports.

Anticipate Surveillance

Large monetary claims, such as one for a nurse, may require video surveillance, which is legal. Private investigators may observe the claimant’s home, interview neighbors about daily activities, and potentially use this information against the claimant. That’s why it’s important to avoid strenuous activities during the claim period is vital.

Be Careful with Social Media

In the digital age, it’s common for insurance investigators to monitor social media accounts. Even if you’re someone who doesn’t normally engage with social media platforms like Facebook, Twitter, Instagram, LinkedIn, or Snapchat, you may be tempted to do so during your recovery period. We recommend avoiding social media altogether during the claim period, as your posts could be used to deny your claim.

Seek Legal Representation from an Experienced Long-Term Disability Attorney

Nurses can face challenges when applying for long-term disability. The insurance company will try to save as much money as possible by finding reasons to deny your claim. Building a strong administrative claim will help you win your case. If you need professional help, hiring an experienced disability attorney can be a smart move to protect yourself from the insurance company. The Ortiz Law Firm, based in Florida and serving clients nationwide, offers free case evaluations for those who feel their LTD claim has been wrongfully denied or terminated. Call (888) 321-8131 to schedule your case evaluation today.