As a nurse, you are the medical professional that works the closest with the patients. You rush in and out helping patients and doctors for 12 hours or more a day. Medical care facilities could not survive without you. So why does the insurance company make it so hard to file for long term disability when you are 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Outdated Data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Occupational Titles was published in 1991, but insurance companies still use it today even though it’s based on clearly outdated information.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 job responsibilities for a nurse have changed drastically since the 1990s and nurses now are specialized in different areas. To prove your claim of disability, you (and your attorney) will need to provide an updated job responsibility list to the insurance company.
Current Salary
According to the Bureau of Labor Statistics, nurses make a median salary of $70,000 with some specialized nurses making upward of $100,000 a year. The insurance company knows 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 claims by nurses 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 dispute comes in proving that your chronic pain is job-related and not a pre-existing condition related to something that happened before you had coverage. An experienced attorney can help you navigate this issue.
What You Can Do To Help Build A Strong Claim
Read Your Policy
The first thing that you need to do before you start the process of filing a claim is to get a copy of your long-term disability (LTD) policy. How you get a copy of your policy will depend on the type of policy that you have: individual or group. If you have an individual policy, you will need to contact the long-term disability 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 the request.
If possible, be sure to request a copy of your long-term disability policy in writing as documentation for you to have in case your employer or LTD company gives you the runaround.
Collect Evidence to Support Your Long-Term Disability Claim
Filing a claim for long-term disability (LTD) can be a meticulous and time-consuming process. One of the most critical stages involves gathering various documents that substantiate your claim. While this guide serves as a good starting point, understand that each claim is unique, and additional evidence may be necessary for your particular situation.
Documentation You Might Need:
- Your LTD Policy: A copy of your policy to reference the terms and guidelines.
- Insurance Correspondence: Copies of all letters exchanged with your insurance company, including any sent by you.
- Proof of Disability: This includes documentation detailing why you can no longer perform your job duties (usually backed by medical records).
- Medical Provider Statements: A compilation of statements from all medical providers seen for your condition, with each provider affirming that your condition hinders you from working.
- Communication Summaries: Written summaries of all conversations with insurance representatives, healthcare professionals, and your employer. Sending copies to all involved parties via certified mail ensures proof of receipt.
- Income Evidence: Proof of your monthly earnings.
- Proof of Continuous Medical Care: Evidence of ongoing medical treatment for your condition.
- Additional Medical Documents: This includes but isn’t limited to your medical file, lab reports, X-ray and MRI reports, physician 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 might observe the claimant’s residence, question neighbors about daily activities, and potentially use that information against the claimant. That’s why avoiding strenuous activities during the claim period is vital.
Be Cautious with Social Media
In the digital age, it’s common for insurance investigators to monitor social media accounts. Even if you’re someone who typically doesn’t engage with social media platforms like Facebook, Twitter, Instagram, LinkedIn, or Snapchat, you might be tempted to during your rest period. We recommend avoiding social media altogether during the claim period, as your posts could be used to reject your claim.
Seek Legal Representation by an Experienced Long Term Disability Attorney
Nurses may 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.
Should you require professional assistance, hiring an experienced disability attorney can be a wise move to protect yourself against 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.