Ask the Lawyer: Long Term Disability Insurance Claim Questions

You have questions? We have answers. Navigating through the language of a long term disability policy can be confusing and overwhelming for so many people. In this blog, we answer everyday questions from people seeking advice about long term disability and insurance issues.

Question:

How do I get started if and when I decide I need to? I’m working part time, but it’s become more difficult each day.

Answer:

We understand how complicated this decision can be. Filling for disability benefits can mean a loss of career, a loss of income, and even a loss of identity. However, when your illness becomes disabling in a way that you can no longer work, it is often the only option. Here is how you can get started when you are ready.

Request a copy of your Long Term Disability Policy from your employer or your insurance company. You can refer to it for the specific claims submission procedures you must follow.

The steps for submitting a claim can vary depending on your employer. However, the process usually begins when you contact your employer, or insurer, to tell them that you need to submit a disability claim. You will then be provided with a number of forms to complete and sign for your claim. Make sure that you complete ALL required forms…failure to do so will most likely result in a denial for “failure of proof.”

Keep an eye out for:

Disability Claim Form: state the reasons that you are disabled and identify your treating physicians.

Attending Physician Statement: this will be completed by your treating physician. He/she will state your restrictions and limitations, which prevent you from performing the material duties of your occupation (and the expected duration of your condition).

Employer’s Statement: this will be completed by your employer, identifying your rate of pay and job responsibilities at the time of your ceased employment.

Authorization of Release of Medical Information: this form will allow the Claims Administrator to obtain your medical records.

Additional Information: take advantage of this opportunity to submit additional documentation in support of your claim. For example, records from your treating physician that support your diagnosis and disability, a detailed job description which describes your work duties (including the physical and mental demands and the working hours required), a letter from you describing the symptoms of your disability and how this impacts your functional capacity for work and daily living, and letters from family, co-workers, or friends describing their personal observations of your symptoms and how this has adversely impacted you at work and home. DON’T JUST RELY ON THE FORMS THEY PROVIDE! SUPPLEMENT WITH AS MUCH DETAIL AS POSSIBLE!

Unfortunately, it is not uncommon for insurance companies to deny a Long Term Disability Claim. Under the Employee Retirement Income Security Act (ERISA), you have a legal right to appeal the denial of disability benefits. If you encounter a long term disability denial, contact our office. We offer free consultations, and work on a contingency fee basis. This means that we do not collect a fee from you unless we get your claim paid.

For the full post, and more questions and answers, see our blog on Creaky Joints. If you have questions about your Long Term Disability Insurance claim, we would be happy to include your questions in our next “Ask the Lawyer” blog. Simply send your questions to rteicher@kantorlaw.net. Please note that we do not handle Social Security Disability Insurance (SSDI) claims, but can refer you to a reputable attorney that does.

Filing a long term disability claim, or dealing with a long term disability insurance denial, can be a time full of uncertainty and worry. We understand, and we can help.

www.kantorlaw.net (800) 446-7529

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