If you carry long-term disability (LTD) coverage as part of your benefits package at work and you have a claim, the first order of business is proving your disability, which requires a considerable amount of evidence to back it up. If this is the difficult position you find yourself in, one of the most important first steps you can take is securing the skilled legal guidance of an experienced long-term disability attorney.
The process begins with filing the application with the insurance company, and it generally includes the following three basic elements:
Every LTD insurance company has its own policies and its own preprinted forms that apply, but the basics in terms of supporting evidence don’t vary much.
Insurance companies are in the primary business of making money, which means that their preference is denying and limiting claims, and they employ tactics to help them get the job done. For example, many of the insurance forms they use require doctors to respond according to the multiple choices provided. This often leads to overly broad information that can be interpreted to mean that you’re doing far better than you actually are. The more specific your doctor is regarding the state of your health, the better.
Ultimately, the success of your claim will hinge on the strength of your medical evidence. For example, a note your doctor scribbles on the fly regarding the severity of your disability isn’t going to cut it. Instead, your medical history should be all inclusive and include objective medical evidence when possible, which means including all the following:
Often, obtaining the right medical records is challenging, and even if you are able to do so, they can be impossible to decipher. Generally, including highly detailed and well-considered reports and questionnaires is the surest path forward.
Test results serve as objective evidence of clinical symptoms, and you basically can’t have too many. Tests can play an important role in establishing your diagnosis, while others can play an important role in establishing your functional limitations, including those related to the activities of daily living. If your doctor wants to skimp on the testing, let them know that it’s important to your claim, which means it’s important to your overall recovery.
If your claim is denied, it’s important to know that – if your policy comes through your employer – the Employee Retirement Income Security Act (ERISA) is a federal law that is designed to help protect your right to benefits. The next step is filing an appeal, which is required under ERISA. You want to have an attorney involved at the appeal stage, as ERISA limits any future lawsuit to the information in the claim file at the time the appeal is denied. Thus preparing your appeal is not just an attempt to reverse the denial, it is a key step in preparing for litigation if needed. If the appeal is the denied, then you can file a federal lawsuit in which you address the matter. If you’ve had knowledgeable assistance in preparing the appeal, all the information you need to show a judge should be in your file and you should be well positioned to prevail in court.
The savvy long-term disability attorneys at Monahan Tucker Law dedicate their practice to helping clients like you file comprehensive claims that result in the benefits sought and to skillfully fighting for their complete legal rights in the face of claim denials. We’re here for you, too, so please don’t wait to contact us for more information today.
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