Has your claim for long-term disability benefits been denied? A critical component of your appeal for long-term disability benefits is the information that we obtain from your treating physician. You may think that office notes and other records already submitted by your doctors would easily convince the insurance company that you deserve long term disability payments. However, the truth is much more complicated. In reality, it is difficult for your doctor to focus on your disability appeal with the type of approach that is needed to win the legal battle over benefits. Without a doubt, your doctors are busy with many patients, and they actually spend a good part of the day in their own battles with insurance companies as they simply try to get paid for the medical services rendered to patients.
In some cases, the documentation contained in medical records may be so sparse that the insurance company can deny your claim based on a lack of information. In other cases, your doctor may have a great deal of information in your medical record, but the disability insurance company picks and chooses unrelated bits of data and will deny your claim on that basis. Accordingly, it is imperative that your attorney speaks with your doctors to ensure that the correct information appears in your medical record and that incorrect or innocently misleading data is corrected and/or further discussed to give a clear and accurate picture or your medical situation for disability insurance purposes.
You also must be aware that the disability insurance company will probably send a questionnaire to your doctor about your health. Your doctor, busy with a hundred other issues, will hurriedly fill out the document simply to get it off his or her desk. What is not known is that the disability insurance company has taken a great deal of time to write the questions on that questionnaire so that the answers benefit the company and permit the disability insurance company to deny your valid claim.
For example, the questionnaire might ask the doctor to check off a sentence which best describes your ability to be employed. There are typically four or five different levels of abilities for the doctor to check off. The lowest level is often something like, “The patient can do sedentary work.” Your doctor may well think that, although you actually are so disabled that there is no job you can do, this “sedentary work” category is the level that best describes your situation. Of course, if the questionnaire had given the doctor the choice of, for instance, “The patient is not capable of any type of employment.”, then the doctor would have checked off that block to describe your disability status.
But since the doctor has checked off the “sedentary work” block, the disability insurance company may deny your claim by saying that your own physician has stated that you can perform “sedentary work” and therefore you are capable of working in any type of office anywhere in the country. You might feel that this questionnaire, written by the insurance company, is unfair and misleading. But this is the reality in the world of long term disability insurance, and you need to be aware of this situation.
Clearly, in order to deal with situations like this, you require the services of a lawyer who understands these and many other disability issues, so that your appeal for benefits is put together in such a way that your medical situation is accurately described in the documentation, and that will give you the best opportunity to be successful in obtaining your rightful benefits. At Walker & Hern, we have the experience you need to work with your doctors for records needed to maximize your chances for getting the disability benefits you deserve.
Our firm has significant experience helping people just like you retain or defend their Long Term Disability Benefits. Contact Walker & Hern for a free consultation.