A strong Long Term Disability (“LTD”) application will increase your chances of approval and help you avoid a costly appeal. Unfortunately, many unrepresented LTD applicants unknowingly submit weak or flawed applications. Below are the most common mistakes made by unrepresented LTD applicants.
Waiting too long to apply
Your policy may restrict the amount of time that you have to file your LTD claim. If you fail to file the application within the deadline provided in the policy, your claim could be automatically denied. This may be true even if your condition is extremely seriously or terminal.
You should also file a timely disability application to help preserve your eligibility for other protections and benefits, such as FMLA leave or state-provided disability benefits. An experienced disability attorney can identify the deadline for your application, as well as the deadlines for any other disability benefits and/or protections that you may be eligible for.
Not maintaining an organized disability file
The LTD application process involves a lot of paperwork, forms, and strict deadlines. Unrepresented disability claimants often become overwhelmed by the amount of paper-pushing involved.
Organizing all disability paperwork and insurance company correspondence in a "disability file" will help ensure that your claim is not missing information, that you are responding within the deadlines, and that you are responding to all of the insurance company’s requests. Keeping a file will also help ensure that all of your communications with the insurance company are documented. If it ever turns into a he-said-she-said game, you will want proof to support your position.
You should also document information relating to your condition and treatment so that you can provide accurate and detailed responses to the insurance company’s requests for information. You may wish to document: (1) your doctor visits (dates, contact info, purpose); (2) your medications (prescribing doctor, reason, dosage, side-effects); (3) your symptoms (the nature, severity, and frequency of your symptoms over time).
Hiring a long term disability attorney to maintain a file for your claim can be extremely helpful to reduce the stress caused by all of the paperwork.
Not telling your doctor that you intend to apply for disability
Your doctor will likely need to complete paperwork for your disability application and provide medical documentation of your disability. Failing to tell your doctor that you intend to apply for LTD benefits can result in paperwork delays and/or inadequate medical documentation of your disability.
If you tell your doctor that you are applying for disability, then he may take extra precautions to document your condition carefully. Talking to your doctor about it first may also help ensure that he/she completes the paperwork quickly.
Not requesting a detailed letter of support from your doctor
The insurance company will want your doctor to explain exactly when you became disabled and why. More often than not, a “no work” or “disabled” note from your doctor will be insufficient. Rather, the insurance company will want a detailed letter of support from your doctor that explains the specific work limitations caused by your disability. An experienced LTD attorney can help guide your doctor to make the letter as supportive as possible.
Not obtaining all of your medical records
Many applicants are surprised to discover that the insurance company will render a decision without obtaining the relevant medical records. In fact, one of the most common reasons for long term disability claim denial is “lack of sufficient medical evidence.” Thus, it is very important to gather and submit sufficient medical evidence in the form of medical records, opinion letters, diagnostic testing, etc.
Not treating consistently
The insurance company will want to see consistent treatment to substantiate your disability and resulting limitations. If you stop treatment while your application is pending, the insurance company is likely to assume make certain assumptions that can harm your claim. These assumptions may include: (1) that your condition is not severe enough to require treatment; (2) that your improved to the point where you no longer require treatment; or (3) that you are being non-compliant by refusing to receive treatment recommended by your doctors.
Moreover, many LTD policies require that you remain under appropriate medical care in order to be eligible for benefits. If you are not receiving treatment, the insurance company may deny your claim for failure to satisfy the policy terms.
Being unaware that the insurance company may be conducting surveillance
Many unrepresented claimants are unaware that the insurance company may conduct surveillance on you while your LTD application is pending. The insurance company will do this by hiring a third-party investigator to follow you around for days while record videos and photographs of you. The insurance company’s goal is to record or photograph you performing activities that are inconsistent with your allegation of disability. It will then use this as “proof” to deny your claim.
The policy terms may dictate whether the insurance company has the right to conduct surveillance. However, the insurance company may still conduct surveillance if your policy is silent on this topic. An long term disability attorney can advise you when the insurance company is most likely to conduct surveillance so you can be extra cautious.
Completing and filing forms without consulting an attorney first
The insurance company will carefully scrutinize the information that you provide on your claim forms. The insurance company will look for inaccuracies, inconsistencies, and any information that it can use to deny your claim.
Inaccurate responses may be seen as binding and ultimately lethal to an LTD claim. Responses that are too descriptive may lead to perceived inconsistencies in your application and allegations. Responses that are not descriptive enough can lead to an incomplete picture of your disability. Having an experienced long term disability attorney review the forms for accuracy, consistency, and effective presentation of your claim will help increase your chances of approval.