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When an injury or sickness prevents you from working, you may be entitled to disability benefits under a long term disability policy.
However, before you stop working, you should get out your disability policy and understand:
(1) how the policy defines occupation,
(2) what type of proof the policy requires.
It’s crucial that you understand the claims process before you stop working and apply for long term disability benefits.
What Is A Disabling Condition?
Most policies define a disabling condition as an injury or sickness that prevents you from doing the material and substantial duties of your occupation. How does your policy define disability condition and occupation?
What Medical Support You Must Have For A Long Term Disability Claim
Many policies require that you have the appropriate medical support for your claim. You’ll have to establish that you have a diagnosis and that there is objective proof of that diagnosis. For example, if you have fibromyalgia, it’s crucial that you have a physical examination that meets the American College of Rheumatology criteria for the fibromyalgia diagnosis. If you have positive lab work such as positive rheumatological signs, that’s even better. Before you stop working you should make sure that there is a diagnosis based on objective medical evidence.
Disability policies also require that you treat with a physician who has the training to make the specific diagnosis and treat the medical condition. For example, if you have been diagnosed with fibromyalgia by your family doctor, the disability insurance carrier isn’t likely to accept that diagnosis.
A rheumatologist is an appropriate doctor to diagnose and treat fibromyalgia. It’s crucial that you see the right type of doctor and are getting treatment that is specifically designed to treat your diagnosis. If you are denied a claim, you can contact a dedicated American United disability claims attorney.
The most important thing you need to know before you stop working is whether your doctor is willing to advocate for you. Disability carriers will ask your doctors to complete Attending Physician Statement forms which can make or break your claim. There are no uniform Attending Physician Statement forms and, in fact, the questionnaires are often designed to mislead physicians to opine that their patient can work.
The insurance company form is going to ask questions about:
- the diagnosis,
- the basis of the diagnosis,
- your physical limitations,
- your course of treatment, and
- your prognosis.
It’s crucial that your physician not only document in your medical records your symptoms but how your symptoms affect your functionality and that your physician be willing to complete Attending Physician Statement forms.
Better yet, we at Cavey Law modify Attending Physician Statement forms so that the right questions are asked about your medical condition. We don’t allow the disability carrier to snooker your doctor into saying you can work because the disability carrier hasn’t asked the right questions.
For example, in fibromyalgia cases, the disability carriers rarely ask the right questions about the common symptoms of fibromyalgia such as brain fog, fatigue, memory issues or gastrointestinal issues.
It’s crucial that you have medical support for your claim and that you’re represented by an experienced long term disability attorney who understands the games disability carrier will use in delay, denying, limiting or even terminating long term disability claims.
Need Help With Your Long Term Disability Claim?
Contact long term disability attorney Nancy Cavey who can help establish that you have the appropriate medical documentation to get you the benefits you deserve. Don’t make a crucial mistake that could result in the denial of your long term disability claim.
Call today at 727-477-3263 for your complimentary consultation. You owe it to yourself and your family to get help with your claim regardless of where you live in the United States.
