The school buses are rolling, the stores are filled with back to school sales. You’ve made it through the summer — maybe a slow season in your occupation, maybe you had time to rest or recover during vacation – but now it’s time to get back to work. Or is it?
Making the decision to file a claim for short term disability insurance or long term disability insurance benefits is not easy. Many people do everything they can to keep working, and often continue to work long beyond when they should, but at some point, it’s just not possible. How can you prepare to file a long term disability claim if this is your situation?
Read More: Top 5 Myths About The Disability Claim Process In New York
Review Your Long Term Disability Insurance Policy
Find the original policy or secure it from HR, as this is the document that guides the process. It’s a contract between you and the insurance company. We say it is the road map to the treasure chest, and must be followed.
Important issues to consider, when you are reviewing the coverage:
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- Do you meet the policy definition of disability – what is the standard?
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- What are the requirements to file a claim—do you have to be out of work for a certain amount of time (elimination period), or establish your disability with a doctor’s examination?
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- Are there exclusions or limitations to your claim?
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- Can medical treatment be mandated?
Build Medical Support for the Long Term Disability Insurance Claim
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- A diagnosis alone isn’t enough for a successful claim. Your treating physician will need to include specific details on how your diagnosis impairs your ability to perform the material and substantial duties of your claim.
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- Treatments, medications, therapies, radiology studies and tests providing objective evidence of your disability will be needed to substantiate your claim.
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- A diagnosis and medical records from a doctor who specializes in your disability is crucial. Having a general internist treating a complex or rare disorder may lead to questions about whether or not you pursued a proper course of treatment.
Talk With an Experienced Long Term Disability Insurance Attorney
The claims process is spring-loaded with pitfalls, as you will learn. Questions about when your disability began, defining your responsibilities at work, the treatment you’ve pursued for your disability, are evidence-gathering questions the insurance company will try to use against your claim. Jason Newfield has helped many people who thought their disability was so obvious and clear that their claim wouldn’t be challenged. Unfortunately, the insurance company does not think the same way. A conversation with Jason Newfield will include a frank discussion about your claim and what you can expect from your insurance company.
File your Claim
A few words of caution when filing your claim without the help of a disability insurance attorney:
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- Only send copies of documents unless you are required to send originals. If you are required to send originals, make sure to have copies made. Expect your documents to get lost, deliberately or otherwise, and prepare to send them more than once.
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- Make sure to get a signature on delivery of materials if they are sent by mail. We recommend using an express mail service that requires a signature. If via fax, secure confirmation or receipt.
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- If you send documents via email, use the option to request a “Received” and “Read” receipt. This is not as enforceable as a signature from a live human on a hard copy delivery, but it’s better than nothing.
Read More: How a Long Term Disability Law Firm Can Help You Secure Benefits?
Watch the Mail
Here is where a lot of people get tripped up. Once you file a claim, a series of third-party companies are involved in your life. This includes companies you’ve never heard of who manage claims, oversee physical examination, review financial materials, etc. Open and read all of your mail to be sure you don’t miss any notices. As unpleasant as this whole process may be, don’t toss any notices from the disability insurance company or their third-party companies into a pile awaiting your attention. You must address these matters promptly to protect your legal rights and your claim.
Who is Watching Me?
Many claimants are reporting instances of surveillance, and insurance companies often utilize this tool, and social media searches, to try to undercut the credibility of a claimant.
Be Prepared for a Denial
We like to tell clients, expect the worst and hope for the best. If your claim is accepted and benefits are paid, that is the best of all possible worlds –except be prepared for your claim to be reviewed, especially at the 24 month mark when your policy may switch from “own” occupation to “any” occupation. If you receive a denial, we invite you to call our office immediately. The sooner you speak with Jason Newfield, the faster you’ll gain the understanding of your claim and learn what your options are.
