How to Win Your Long Term Disability Claim | 5 Do’s and Don’ts

Here are 5 do's and don'ts to help win your long term disability claim.

DO'S

1. Review Your Policy. You should review your policy to determine your time deadline to submit your LTD claim. If your claim is submitted late, the insurance carrier will treat it as a late claim. A late claim can be denied by the insurer. Don’t let this happen.  If you contact us early enough (e.g., before you stop working, or at the same time you stop working), we will ensure that your claim is filed in a timely fashion.

2. Answer All Questions Completely And Accurately.  When completing the Claimant Statement, be sure to attach a rider or addendum to provide full and complete answers.  Do not feel obligated to use the small space provided on the Claimant Statement.  When you retain Riemer Hess, we will do this for you.  We will concentrate on providing the most comprehensive answers possible, and on describing your information in the light most favorable to your claim.

3. Provide Detailed Information Regarding Your Job.  You must prove not only that you suffer from a medical condition that causes restrictions and limitations, but also that those restrictions and limitations prevent you from working in your own occupation. Therefore, you must explain both the physical and cognitive duties of your job. In other words, you must explain to the insurer exactly why you cannot perform the “Material Duties” of your own occupation.  When you retain Riemer Hess, our disability attorneys in New York will do this for you.  We will do a thorough analysis of your occupation.  We will consult with resources maintained by the United States Department of Labor. We will itemize the major duties of your occupation. We will then explain how each of your symptoms prevents you from performing each duty of your occupation.

4. Submit As Much Medical Documentation As Possible. When submitting your claim for LTD benefits, the APS form is often inadequate to prove your case.  Insurers often will require objective evidence of your disability.  When you retain Riemer Hess, we will marshal all of the objective and clinical information in support of the claim, we will send you out for appropriate testing such an a FCE and neuropsychological testing to objectify your impairments, and we help you support your subjective complaints of pain and fatigue.  Our disability lawyers are specially trained in all aspects of this process.

5. Always Tell The Truth.  Whether it be during a telephonic or in-person interview, or simply in answering the questions on the Claimant Statement, always be honest – particularly when discussing your activities of daily living.  It is much easier to explain away a certain activity, then to defend you if you are caught in a lie.  A lie affects your credibility. The disability insurance company and a judge will not believe your subjective complaints of pain and fatigue if your credibility is affected.

DON’Ts

1. Assume The Insurer’s Representative Or Nurse Consultant Is Your Friend. Your claim representative or the insurance carrier’s nurse consultant will often act very friendly towards you. That should not be an invitation to divulge too much information or talk “off the cuff.”  While a representative may act friendly, always remember that their goal is to try to find a reason to deny your claim.  When you retain Riemer Hess, our disability attorneys in New York will ensure that your insurer does not have any direct contact with you.  All communications will go through us, and if the insurance carrier needs to talk with you directly, Mr. Riemer will prepare you for the interview and attend the interview with you.

2. Focus Only On the Strength Requirements Of Your Job.  Insurers unduly concentrate on the physical aspects of your job (i.e., the amount of sitting, standing, walking, lifting, etc.).  This is unfair to professionals and executives because their occupations have significant cognitive requirements.  When you retain our disability attorneys in New York, we make sure the insurer is informed of the cognitive and stress demands of your job.  Likewise, if travel is required as part of your job duties, we make sure that the insurer knows about its frequency and special demands.

3. Allow Your Doctors To Speak Directly with the Insurer. Insurance carriers may try to contact your doctor to discuss your medical conditions and your ability to work.  Do not allow them to communicate with your doctor by telephone.  Often times, the insurer will misconstrue or misrepresent the statements of your treating physicians.  When you retain Riemer Hess, we will direct the insurance carrier to not to call your doctors and to correspond with your doctor only in writing.  While we will not put words in your doctors’ mouths, if they have any questions about the insurer’s inquiries, we will advise them accordingly.

4. Allow Your Doctors To Submit Documentation Directly To The Insurer.  Doctors are very busy people.  When they receive an APS or similar form, they often complete the form quickly and without fully reading each question. If the doctor then sends that incorrect information to the insurer, your claim could be permanently damaged.  When you retain Riemer Hess, we request that your doctor(s) send us all information before it is sent to the disability insurance company.  We will take the time to review the documents to make sure that they do not contain anything that will damage your claim.  If there is an issue with the form, we discuss the problem with your doctor. Our disability attorneys in New York are here to assist you every step of the way.

5. Have An In-Person Interview In Your Home.  If an insurance carrier requests an in-person interview, do not have it in your home.  Do not allow an insurer’s representative into your home as the interviewer will then be able to see how you live, what exercise equipment you have, where you spend most of your time, etc.  If you are wealthy or have a nice home, it invites jealousy and negative inferences.  Have it in a third party location. When you retain our disability attorneys in New York, we will insist that the interview takes place at our office.