Question: I am a licensed psychiatrist with long-term disability insurance. Why is the insurance company making it so hard to get my claim approved?
As a licensed psychiatrist, you are a specialist in psychology and medicine. Your expertise will provide you with a higher salary as well. In 2019, the average salary for a Psychiatrist was over $200,000 according to Zip Recruiter. A higher salary means a higher monthly benefit that the insurance company will have to pay if your claim is approved. In this article, we will discuss the following:
- Why is it so difficult to get a long term disability claim approved as a Psychiatrist;
- What information you need to get your claim approved;
- Suggested ways to stay organized; and
- How you can obtain a professional evaluation of your disability insurance policy.
Why Is It So Difficult to Get an LTD Claim Approved as a Psychiatrist?
One simple reason – money. Because the insurance company is looking at your case from a financial standpoint, they look at how much money it will cost them to provide you with benefits throughout your illness or disability. The longer it could potentially take you to get back to work, the less likely they will approve your claim.
In addition to your regular salary, you may have a residual rider that helps recover what you have lost during your disability period. If you own your psychiatrist practice, you can assume that while you are recovering, your current patients will need to seek treatment from another provider. When you return to work, you will have to work to replace the clients you’ve lost. This rider will help you offset the loss of these clients and help pay your bills while you rebuild your practice.
What Information Do I Need to Get My Claim Approved?
To get your claim approved, you will need evidence. Two types of evidence will be crucial: medical and financial. As a Psychiatrist, you may or may not be familiar with completing long-term disability paperwork for your clients. In addition to medical evidence, you will need to provide your financial information. This is probably the most tedious process of filing an LTD claim: gathering all the documents that will support your claim will take time.
Gather Your Medical Evidence
You need to provide proof that you are under the care of a physician for your condition. All medical documents from your physician regarding your condition including but are not limited to your official medical file, lab reports, X-ray and MRI reports, physician notes, list of surgeries including surgical reports. Be sure your doctors are noting your pain and any mental conditions you are facing like depression in the notes. Sometimes doctors do not make notes when the patient expresses pain concerns.
Gather Your Financial Information
As a Psychiatrist, unless you work for a hospital, you probably have your own practice. You will need to provide your practice financial information, especially losses that may be incurred due to your absence.
Suggested Way To Stay Organized
There is a lot of paperwork to keep track of when applying for Long Term Disability. Staying organized and saving all correspondence will help you if your claim is denied and you need to go to court. Create a binder or filing system for the following documents:
- Copy of your LTD policy;
- Copies of all letters from your insurance company and you to the insurance company;
- Why you can not perform your job duties (this will require medical documentation);
- A list of all medical providers that you have seen for this condition and a letter from each provider stating that your condition prevents you from working;
- Letters that summarize all conversations (by phone or in person) between you and the insurance company representatives, nurses, doctors, and your employer. Send copies to all parties involved in the communication via certified mail as proof it was received; and
- Keep everything chronological so that if your claim is denied, you have a complete record of how your claim was handled.
Request a Free Policy Evaluation
If you are considering purchasing a disability insurance policy or have recently purchased a policy, we will help you understand what you are entitled to and whether there are deficiencies in your coverage that could lead to a denied claim. It is easy for individual policyholders who are not trained to read insurance policies to misread or misunderstand the disability policy. As part of our evaluation, we will explain what everything means to you in your situation.
Some of the aspects of your policy we will review include:
- Total versus residual disability;
- Own occupation versus any gainful occupation;
- Mental and nervous disability benefit limitations; and
- Self-reported conditions benefit limitations.
A psychiatrist will find it difficult to get a long-term disability claim approved. Due to the cost of the payout, the insurance company will use lots of tactics to deny the claim. Gathering strong medical evidence and using our suggested way to stay organized will help you get your claim approved.
Using an experienced disability attorney will help you protect yourself against insurance investigators. The Nick Ortiz Law Firm is based in Florida but represents claimants across the country. Receive a free consultation by calling (888) 321-8131 with no obligation. We can help you evaluate your claim to determine if you will be able to access Long-Term Disability Benefits and how to move forward with the process.