Your Credibility When Applying for Disability and How the Insurance Company Assesses Your Complaints

Obviously, not all medical conditions are diagnosed with “objective” test results, which can make establishing a claim for long term disability with such conditions challenging. Take fibromyalgia, for example. You cannot take an x-ray of fibromyalgia and prove it with objective medical testing.

Yes, the “pressure point test” is a traditional method of testing for fibromyalgia, but this test is primarily subjective (not objective) in nature as it relies on the subjective complaints of the patient (i.e., it relies on the patient saying it hurts when the doctor presses a pressure point). As someone with fibromyalgia may not be able to produce traditional objective medical evidence of his or her condition, a claimant applying for disability for fibromyalgia may have a more difficult time proving that his or her condition is totally disabling.

The Difficulty of Proving Subjective Complaints

Another symptom that is difficult to prove with “objective” medical testing is impaired cognitive functioning. Most insurance companies will not accept a claimant’s self-reported memory loss or inability to concentrate. That is why it is essential for the claimant to speak with his or her treating physicians about such symptoms and – if possible – undergo neurological testing, psychological testing, or a mental status examination. These types of tests can help provide the insurance company with evidence describing the severity of the claimant’s cognitive impairments.

The Challenges of Mental Illness Claims

If you’re seeking long-term disability benefits due to mental health conditions like bipolar disorder or generalized anxiety disorder, it’s essential to furnish the following documentation:

• Details of any in-patient treatments or psychiatric facilities you’ve attended.
• A comprehensive list of prescribed medications, their dosages, and any side effects you’ve encountered.
• Your psychiatric evaluation, as outlined in the Diagnostic and Statistical Manual of Mental Disorders.
• A testimonial from your medical treatment facility detailing your interactions with others during your admission.
• Statements from both your psychologist and psychiatrist explaining their professional opinion on why you should be eligible for long-term disability benefits.
• A completed mental residual functional capacity form by both your psychiatrist and psychologist.

The Difficulty of Proving Migraine Headache Disorders

A migraine headache disorder is another medical condition that may not appear on objective testing. However, this condition can be recorded in a symptom log. When a claimant experiences a migraine, it is not always feasible to see the doctor immediately or necessary to seek treatment in an emergency room. That’s why the claimant should keep a migraine headache log to document the frequency, severity, and duration of his or her migraine headaches. A migraine headache claimant should also provide this completed symptoms log to his or her treating physician and ask that the symptoms log be added to his or her medical records. This will allow the treating physician to view the claimant’s symptoms and understand the severity of his or her condition.

Missing Medical Records

Long term disability insurance claims are often denied due to “insufficient medical evidence”. Many claimants are under the mistaken assumption that it is the insurance company’s duty and obligation to obtain all of your medical records. However, this is simply not the case. Most insurance companies will request medical records. However, it is the claimant’s “burden of proof”, which means the claimant should make sure the insurance company has all relevant medical records. For this reason, you should ask your disability carrier for a list of all of the records it has requested and a list of records it has actually received. If some medical records are missing, you should make sure that your insurer requests the appropriate records or even obtain those records yourself. Some persistence may be required.

Nationwide Long-Term Disability Insurance Claims Representation

Although headquartered in Florida, Ortiz Law Firm proudly serves clients facing unjust denials, delays, or terminations of their Long-Term Disability (LTD) claims anywhere in the U.S. If you suspect your LTD claim hasn’t been handled appropriately, call our office at (888) 321-8131 for a free case evaluation. We will assess your case and advise on the next steps to secure your rightful benefits.