Three Common Mistakes People Make When Filing A Long-Term Disability Claim And How To Avoid Them
Disability insurance covers a portion of your income in the event that you become disabled. Typically, claims are paid by your short-term disability policy first. Then, once you've surpassed the time frame of a short-term disability as stated in your policy, you file a claim through your long-term disability insurance policy. Filing a long-term disability claim is a detailed, ongoing process. Fortunately, you can make the process less stressful by reviewing some of the common reasons claims are denied so that you're prepared.
Failure to Meet the Policy's Definition of Disability
To ensure that your claim is approved, you need to make sure you meet your policy's definition of disability before filing your claim. Unfortunately, there isn't a standard long-term disability policy. There are actually two different kinds of policies: own occupation policies and any occupation policies.
If you carry an own occupation long-term disability policy, your insurance policy only covers you if you have a medical condition that has made you unable to do your job. Any occupation policies have more narrow coverage. If you have an any occupation policy, your disability must make you unable to work at all before your policy pays out. If you are able to do a different type of job, an any occupation long-term disability policy will not cover your disability.
Additionally, some long-term disability policies exclude certain disabilities. For example, medical impairments that results from substance abuse or conditions that you had prior to purchasing the policy might be excluded from coverage. There may also be stipulations in your policy regarding illnesses that are difficult to prove, such as chronic fatigue syndrome, ongoing depression, or anxiety disorders.
Not Enough Medical Evidence
In order for your long-term disability claim to be approved, you need to provide the insurance company with documentation regarding your condition. You need to make sure you supply your insurance carrier with your doctor's statement, statements from any specialists that you've seen, and documentation from all visits relating to your condition. Many insurance companies expect you to make regular visits to your primary care physician and to follow up with specialists within specific intervals, because it's common for a medical condition that causes a long-term disability to require regular treatment. You need to make sure you save any paperwork that your doctor and any specialists give you in case the documentation is needed to approve your claim.
Video Surveillance Doesn't Match Your Claim
It's common for insurance companies to hire investigators to look into a long-term disability claim. If an investigator records you doing activities that are inconsistent with your claim, the claim you filed could be denied. So, it's important that you follow all of your doctor's orders. If your doctor doesn't want you lifting anything heavier than a gallon of milk, don't carry several bags of groceries in from your car or take out heavy bags of trash. If you're supposed to walk with an assistive device, use it. If you're following your doctor's orders, you're less likely to be doing something that puts your health or your claim at risk.
There isn't anything that you can do to guarantee your long-term disability claim will be approved. If you have questions about filing a long-term disability claim or you think you need help with the process, you should consider talking to a lawyer, like Iler and Iler, that specializes in long-term disability claims.