Protecting Your Long Term Disability Benefits | 5 Do's and Don'ts

Here are 5 do's and don'ts that will help protect your long term disability benefits from being terminated by the insurance company.

DO'S

1. Start Early. We will work with you to prepare and obtain the information necessary for your updates upon receipt of the disability insurance companies’ request.  The early start will provide us with a buffer to account for unforeseen delays.

   

2. Be Courteous to Your Physician. This is common sense, but remember to be courteous to your physician and his/her staff.  Keep in mind no doctor went to medical school so that he/she could fill out insurance company update forms.  Because your doctor will not view update writing as part of his/her job description, we recommend that you offer to pay your doctor for his/her time in completing the insurance company paper work.  In our disability lawyers’ experience, most doctors will not accept payment and greatly appreciate the offer.  Remember the time your doctor spends working on your file equates to time lost on another patient.

3. Keep a Diary. We will instruct you to keep a diary of your condition.  For instance, many of our clients suffer from chronic conditions, such as migraine headaches.  In the diary, the client will record, the date and time of the headache, what happened right before the pain started, the intensity level of the pain, the location of the headache, and how long the pain lasted.  Having this information will help prove to the disability insurance companies that your condition is disabling.  Our disability lawyers in New York will also will instruct you to give a copy of your diary to your doctor each visit, so that your doctor can use the information for treating your condition and explaining why your condition is disabling.

4. List of Symptoms. We will instruct you to keep a running list of your symptoms since your last appointment with your doctor, and then to give the list to your doctor at each subsequent appointment.  We do this because the insurance company will scrutinize your doctor’s treatment notes to determine whether they support disability.  If in January you complained of hip pain, back pain and shoulder pain, but in May you only complained about shoulder pain, the disability insurance companies will interpret the May note as showing that your hip pain and back pain have resolved.  This often is a misinterpretation of what actually happened.  Most likely what happened was the patient talked only about the shoulder pain in May because that was pressing and did not mention the hip and back pain because he/she was focusing on solving the shoulder pain.  The list of symptoms will help avoid this situation.  The list will inform the doctor of all of your symptoms, so that the insurance company will not exclude symptoms because they are not discussed with the doctor.

5. Tell Us Everything. You need you to be transparent with our firm regarding any changes in your disability and other related issues (e.g., work and/or financial status).  What you may perceive as a non-issue may in actuality be an issue our disability lawyers in New York need to preemptively address, as opposed to being accused by the insurer of “hiding” information relevant to your claim.  We will review the complete update package for accuracy, including information from your physician’s office as it can contain mistakes.  The insurer will compare your physician’s statement, your statement, and medical records, to ensure that the information is corroborative.  Disability insurance companies will interpret inconsistent statements or omissions as red flags, which will prompt an investigation with more scrutiny.  We strive to preserve your credibility.

DON'TS

1. Adversarial to the Insurer. We will not be adversarial to the insurer.  There is a time to be adversarial and a time not to.  When you are receiving benefits and want to continue receiving them is not the time to be adversarial.  We will be firm with the insurer and will protect your rights, but our goal is to establish a rapport with the representative assigned to your claim and have him/her understand your disability and why it prevents you from performing your occupation and/or any occupation.  You will receive more this way than engaging in contentious and uncooperative behavior, which just results in the need for an unnecessary lawsuit (with all the attendant costs and delays).

2. Direct Communication with the Insurer. Do not communicate directly with the Insurer.  You have retained our disability lawyers in New York to take care of this for you.  It is our firm’s protocol to correspond with disability insurance companies in writing and to document telephone calls.  This is because we want to ensure that what is being conveyed to the insurer is being accurately documented.

3. 

   Assume Your Physician Is Error Free. Due to the busy nature of a medical office, your physician and his/her staff can and will make mistakes.  We will review the forms completed by your physician and associated medical records to ensure that there are no errors and communicate with your physicians to have these issues resolved, if necessary.  Your physician has hundreds, if not thousands, of patients and may confuse your symptoms with the symptoms of another patient.  Also, do not assume that your physician and his/her staff is working on your request for updated information.  Medical offices often need reminders and cajoling to complete requests.  Sometimes, a reminder from the patient is more effective than one coming from an attorney’s office.

4. Irrelevant Information. We will not provide the disability insurance company with information that is not requested.  What you may perceive as critical information to your claim may in actuality be a non-issue.  We do not want to distract the insurer from the issues pertinent to your claim or clutter your claim file with information that is irrelevant to your claim.

5. Assume the Insurer is Working in Your Favor. Do not assume that the insurer is working in your favor no matter how personable or friendly the individual may be on the other end of the telephone.  This also is applicable to the representative or physician that is retained by the insurer to perform an interview or examination, respectively.  At the end of the day, these individuals are being paid by the insurer to look for ways to terminate your claim.