What To Do Before Filing For Long Term Disability
First and foremost, get a copy of your long term disability policy from your employer. It's critical that you understand the definitions, terms and conditions in that policy before filing your claim for long term disability benefits.
Get a complete copy of your medical records from your physicians. Some doctor's offices will give you only the physician notes or reports, some will charge you or have some copy service charge you for this, some staff members don't want to deal with it. But whatever the situation, be assertive in getting everything in your medical chart - office notes, labs, orders, prescriptions, referrals, etc. You need to see these before the disability insurance company does, and you have to know what your doctors are saying about your condition or injury and your ability to work before you file for long-term disability benefits.
You're injury or condition is legitimate - you're not trying to hide anything. But remember, the insurance company is going to do everything they can to deny or stop your disability benefits, construe everything that isn't 100% clear in their favor.
Review Your Medical Records Before You File Your Claim
You would be surprised at how many people don't review their medical records.
There could be a mistake in the records (this happens frequently, and with electronic medical records and auto-fill on the computer, the mistake gets automatically repeated in every office visit). Examples of common mistakes we see in medical records could be what job you hold and the physical aspects of the job, how long you've had the injury or condition, what caused it, and what your limitations really are.
Your doctor may not know what "disability" really means under your long-term disability insurance policy - in other words as it is defined in your specific policy - not the common, dictionary, or medical definition. Remember, it is your job to educate your doctor regarding the terms and conditions of your policy! We do this for our clients and we work with physicians, experts and consultants all the time.
The records amay not be complete - there are visits, labs, tests, etc. that are not in your medical chart.
Your doctor may not be a specialist or doesn't have specific expertise with your specific injury or condition and some of his notes could be misinterpreted by the insurance company. It's not that he doesn't understand your condition and that you can't work, but that his notes are vague, general, or not very specific.
Long term disability insurance companies will try to use your medical records against you.
Keep in mind that none of this really matters as far as your medical treatment goes - and that is what your doctor is focused on. Many doctors are squeezed by health insurance reimbursements and view documentation as one more thing they have to do - but it's critical for your long-term disability claim. Obviously, you want a copy of your records so you can identify if you have any of these issues before you file your claim, and so you can take steps to correct them by talking to the doctor, getting a follow-up exam, a second opinion, etc.
In every case, the disability insurance company will review these records closely, looking for everything they can (any mistakes, inconsistencies, omissions, etc.) they can use to deny benefits. The insurance company will have their own medical consultants and experts review your records - and you can bet they are trained to look for every inconsistency, mistake, anything that is vague or doesn't specifically describe your injury, condition, and inability to work. Your medical condition and inability to work are real and legitimate, so make sure your medical records are good enough to satisfy the insurance company under the policy and qualify for benefits.
Our Experienced Long Term Disability Attorneys Can Help
If you don't understand your long term disability insurance policy or don't review your medical records and just send them to the insurance company, you may set yourself up for a denial of your claim - that's what your long-term disability insurance company is hoping for. Our experienced long term disability lawyers can guide you through the process so you can get your case off on the right track and avoid having your claim denied.
If you want more information on how to prepare for your ERISA long term disability claim, or want to talk it through, call us at (202) 393-3320 or chat with someone right now. We make it easy to get started. And we give you a plan.