A long term disability can impact your life in a number of ways, including your ability to work and earn an income. While many individuals suffering from disability breathe a sigh of relief knowing that they have insurance to cover it, that relief is quickly replaced by frustration over the complexity of proving that you are eligible for those benefits. If you’re wondering how to prove your long term disability, read on for more information.
The Evidence You Need to Prove for Your Claim
In order to prove that you have a long term disability, you must be able to show that you are disabled according to the definition of the term used by your policy. Different policies have different provisions and even provisions that change after you have collected benefits for a year, two years, or five years. Most policies begin by defining disability as an illness or injury that prevents an individual from doing his or her own job. After a time, disability can come to mean an illness or injury that prevents an individual from doing any job.
The most powerful form of evidence you have to prove your long term disability is the opinions of your doctor and the results of your tests.
How to Prove Long Term Disability
When applying for disability with the insurance company, you will generally be required to submit three forms. Each of these forms requires specific types of information.
The Claimant Statement
The claimant statement is a description of your disabling condition in your own words, why you feel the condition is disabling, and how the disability impacts your day-to-day life. When filling this out, it is important to be as precise as possible. Be sure that the information you are offering in your statement does not present an inaccurate view as to what you are able to do. Often, the forms provided by the insurance company offer only limited space for replies. If you are unable to fit a complete statement about your condition in the space provided, attach an additional page.
You will also have to provide additional information, including authorization for the insurance company to access your medical records and discuss your condition with any doctors who are providing treatment. You will be asked to fill out income statements. Again, provide as much information as possible, remembering to include sources of compensation from other benefit programs as well.
The Employer Statement
This information must be filled out by your human resources department or company supervisor and involves listing your job duties, your salary, the date on which you last worked and other details about your employment. Additionally, once your claim is approved, your employer will be required to furnish periodic updates as requested by your insurer to reevaluate your claim.
The Physician Statement
As stated, the opinion of your doctor and the results of diagnostic tests that your doctor has performed are among the most crucial pieces of evidence that can be provided. Your claim should include a strong combination of both subjective evidence — including the doctor’s view of how your illness or injury affects your daily life and ability to work — as well as objective evidence, such as MRI tests, X-rays, or lab work that reinforces the doctor’s opinion.
It is not unusual for an insurance company to provide forms in which the questions are misleading and can give answers that result in a denial or delay of benefits. Because the physician statement is such an important part of your claim, it is recommended that you schedule an appointment with your doctor around the time when you need to have the physician statement completed. This ensures that you not only have the opportunity to get the form filled out while you’re there, but the opportunity to go through the statement with your doctor to ensure that the information provided is clear.
In addition to the above three portions of your long term disability claim, your insurance company can also require you to undergo a functional capacity evaluation (FCE). This evaluation is a battery of tests performed in order to evaluate whether your condition prevents you from working. It is important that you speak with your disability assistance attorney to ensure that you are properly prepared for this evaluation as it is physically exerting and the results can be used to deny your claim.
Let Us Help
The process of filing a long term disability claim is complex, requiring an intense understanding of the legal requirements that the insurance company has to provide you with these benefits, as well as the requirements you have to prove your condition. If you have a disabling condition and you need assistance with your long term disability claim, we can help. Reach out today to schedule a consultation.