Top Five Things Long Term Disability Insurance Companies Examine

Top five things long term disability insurance companies look at when reviewing your claim

Often times, the long term disability insurance company says there is not enough medical information. Sometimes it seems like just a delay tactic on the part of the long term disability insurance company you receive a letter from them that the information is insufficient to approve your long term disability claim. You don’t really know what they want in terms of information to approve your disability claim.

These are the top five things the insurance company will look at in determining if you are able to work:

  1. Your job description. Usually this is provided by your employer as part of the employer’s portion of the disability insurance application.
  2. Medical diagnosis. Whether it is fibromyalgia, multiple sclerosis, heart problems, or chronic pain, the insurance company wants a diagnosis. They want to be able to know what the diagnosis is. If there is no diagnosis, they usually withhold benefits.
  3. Information as to the medical treatment, past, present and future. They need to know if there is treatment available, and if there is, they want details of what that treatment is. They will need to know you are following your doctor’s advice and complying with treatment recommendations. Medial treatment is evidence and proof both to the severity of your condition, and your wanting to return to work. Not following up on treatment leaves the impression that things are not that bad.
  4. Information as to how the medical condition affects your ability to function, your ability to work. A diagnosis is not enough. A diagnosis is a medical label. Some people with the same diagnosis are still be able to work and some aren’t. So the question is – What symptoms do you have? What limitations on your function are there? How does the medical condition affect your daily activities? Your recreational activities? Your social activities? Your relationships? Your personality?
  5. Depending on the definition of disability being used in the insurance policy and whether your claim is for “any occupation” type benefits, they will want information as to your education, training and experience. Can you do some other type of work? Can you be retrained? If so, what types of jobs can you be retrained for? How long would it take? Do you even need retraining? Sometimes the insurance company can decide that you don’t need retraining. And sometimes they come up with a list of potential jobs that they feel you should be able to do. Take that list and discuss it with your doctor. If he doesn’t agree, ask him to do a letter to the insurance company on your behalf explaining why, medically, you cannot do those types of jobs.

The key is not to give up. Either get back to work or if you can’t, then appeal the denial of long term disability insurance benefits. Our law firm can help take the stress off your shoulders if you want us to help. Call us today to discuss your situation. We can be reached at 403-670-0070 or toll-free at 1-855-670-0070.