Top Five Things Long-Term Disability Insurance Companies Examine
Top five things long-term disability insurance companies look at when reviewing your claim
Oftentimes, the long-term disability insurance company says there is not enough medical information. Sometimes, it seems like a delay tactic by 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 know what they want regarding information to approve your disability claim.
These are the top five things the insurance company will look at in determining if you can work:
- Your job description. Usually, this is provided by your employer as part of the employer’s portion of the disability insurance application.
- 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.
- Information about the medical treatment, past, present and future. They need to know if treatment is available, and if there is, they want details of that treatment. They will need to know you follow your doctor’s advice and comply with treatment recommendations. Medial treatment is evidence and proof of 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.
- Information as to how the medical condition affects your ability to function and your ability to work. A diagnosis is not enough. A diagnosis is a medical label. Some people with the same diagnosis can still 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?
- Depending on the definition of disability in the insurance policy and whether your claim is for “any occupation” type benefits, they will want information about 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 disagrees, ask him to write 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, appeal the denial of long-term disability insurance benefits. Our law firm can help remove the stress if you want us to. Call us today to discuss your situation. We can be reached at 403-670-0070 or toll-free at 1-855-670-0070.
Bayda Disability Law Firm
serving Alberta & Saskatchewan
Calgary Disability Lawyer
Suite #9, 1915 – 32 Avenue NE
Calgary, Alberta, T2E 7C8
Tel: 403-670-0070
Fax: 403-670-0071
Toll free: 1-855-670-0070