Giving Your Long Term Disability Claim the Best Chance Of Success
When you apply for long-term disability (LTD), you have the burden of proving that your condition prevents you from working. The most convincing evidence is objective proof of your disability through medical records and statements from your physicians. However, how you answer certain questions in the application could also impact your application for long-term disability benefits.
Working with a long-term disability lawyer will give you the best chance of success. An experienced ERISA-trained, LTD attorney will understand what evidence is required to win a long-term disability claim or appeal. Your attorney can also help you avoid some of the most common mistakes people make when they file for disability benefits.
Obtaining Objective Medical Evidence
Your claim for long-term disability benefits is strongest when you have objective medical evidence to back up your claim. Insurance companies have a more difficult time arguing against objective medical evidence. The company may send you to a doctor of its choice for an evaluation, but if you have substantial objective medical evidence, it makes it harder for the insurance company to deny your disability claim.
Examples of objective medical evidence include, but are not limited to:
- Clinical statements from physicians and other medical providers stating they observed signs of a medical condition. Signs are not the same as the symptoms you claim when answering questions. Medical signs are observed by medical providers during examinations and appointments. They include fever, restricted range of motion, rashes, swollen glands, and other visual signs of a condition or disease.
- Laboratory results include blood tests, urine tests, and other chemical tests. They may also include various imaging tests, such as CT Scans, X-rays, MRIs, hearing tests, vision tests, electroencephalograms, and electrocardiograms. In cases involving mental or psychological conditions, it may also include an array of psychological tests.
- Functional capacity evaluations may also be performed to determine if you can perform certain physical activities. For example, can you lift a box over your head, remain on your feet for several hours, or sit for several hours. The activities tested during a functional capacity evaluation depend on the type of job you are qualified to perform.
Subjective evidence is also essential. Your self-reports of symptoms are subjective evidence. Subjective evidence also includes observations and statements from friends and family members.
Can Insurance Companies Use Medical Records Against You?
It would seem that if you have substantial medical evidence in the form of tests and medical records that back up your claim for disability, you will win without a problem. However, that is not always the case. An insurance company searches through your medical records for any small notation that it can use to deny your long term disability claim.
For example, progress notes are one area that many insurance companies focus upon when reviewing medical records. Progress notes are the quick notes typed or handwritten by the doctor in your chart as you talk with your doctor.
Your doctor might ask how you are feeling today? You may reply that you are feeling better or that the pain is not as severe. You are not stating that you are healed and can work. You simply answer the question based on how you feel at that moment. You could leave the doctor’s office and double over in pain. However, the insurance company may attempt to take the statement out of context.
The insurance company also searches for lists of symptoms in your medical records. If the list of symptoms changes or this list is missing one or two key symptoms, it is another issue that the insurance company may raise.
The problem with doctor’s notes is that the notes are never complete. You may need to ask your doctor to write a statement clarifying some of the notes. It is not a good idea to allow the doctor to speak directly with the insurance provider. The insurance company may summarize the conversation in writing. If the doctor does not respond within a specified period, the letter states that the doctor agrees with the summary. Summaries of conversations prepared by insurance companies are always drafted in the insurance company’s benefit.
Likewise, providing a statement to the insurance company without an attorney’s guidance can hurt your chance of success. It is easy to become confused and frustrated when trying to make a statement. Insurance adjusters are skilled at phrasing questions in certain ways and eliciting responses that could be harmful to your claim.
Instead, it is best to let your long-term disability lawyer handle these matters for you. Your attorney reads through the medical records, lab results, and doctor’s notes to identify red flags that could hurt your chance of success. Addressing these issues early in your cause can increase your chances of being approved for disability benefits.
Work With an Experienced Kansas City Long Term Disability Lawyer
At the Law Office of Kevin J. McManus, we fight for the rights of individuals to receive the long-term disability benefits they deserve. We have extensive experience dealing with disability insurance companies. Let us help you with your long-term disability claim or appeal.
If you were recently denied long-term disability benefits or had your benefits terminated, contact our office by calling 816-203-0143 to request a free denial letter review with our Kansas City long-term disability lawyer. We would be happy to review the denial letter and provide you with a free, no-obligation strategy on how to fight back.