When filing a long-term disability claim, one of the best things you can do is be proactive and well-prepared. The process is complicated and involves strict deadlines that you simply can’t miss. Plus, your insurance company is not on your side. It will find any excuse to deny your claim, despite your best efforts.
The more prepared and proactive you are, the more likely the outcome of your claim will be in your favor. The odds are even better if you have a long-term disability attorney on your side.
Here are five tips to keep in mind when filing your claim – but if you have any questions along the way, you can just reach out to our team for help.
5 Tips for Filing a Long-Term Disability Claim
1. Submit your claim promptly
First and foremost, submit your claim as soon as is practical.
Most claims give you a window of 60 days to file for your benefits after a diagnosis or injury that impacts your ability to work. You cannot miss this deadline or the insurance company can deny your claim for lack of timely notice. It is always better to file your claim early and then communicate additional information as you gather it rather than miss the filing deadline.
After your initial claim filing, it is common for insurance companies to delay their determination to perform a full and fair review of your claim. In reality, several pieces of the initial application might be hard to obtain promptly. And while you probably do not want a delay, whether you or your insurer cause it, it is better than not getting the benefits you have paid for at all.
2. Keep track of your communication
Communication with your long-term disability insurance provider could take place over the phone, through the mail, through email, or potentially through other means. However you are communicating with your insurer about your claim, keep detailed notes.
However you are communicating with your insurer about your claim, keep detailed notes.
- Phone calls: Keep a phone log. Track the time you received the phone call (or made the phone call), with whom you spoke, a description of the conversation(s), and action items that came from the conversations.
- Emails: Create a special folder to keep track of the emails. Alternatively, physically print them out and keep them in a file, if that is easier. Regardless, develop a consistent system for keeping track of the exchanges.
- All other forms of communication: Be detailed, and do your best to capture the who, what, when, where, why of the conversations.
Keeping track of these discussions will help you to communicate details to a long-term disability lawyer if you need one. Moreover, it will help you keep details straight in your own mind regarding your long-term disability claim.
3. Gather all medical records
Ideally, you will gather your medical records before filing your long-term disability claim, or along with it. Obviously, the illness or injury related to your claim is of high importance. However, other medical records may also come into play.
For instance, if you have a behavioral health challenge, it will make sense to seek out historical documents on the condition. This is because your behavioral health barriers likely didn’t manifest in the week before you filed your long-term disability claim. Whereas a physical injury, such as a back injury, will not likely require medical records from ten years ago.
The main point here is to get your medical records together in one place. Then make copies or even get them digitized so that you can provide digital (.PDF) copies to your long-term disability insurance company or long-term disability attorney.
One last note, obtain and keep records for any new medical attention that you require or appointments you attend after you file your long-term disability claim. They very well may also play a part in obtaining your benefits.
4. Read your long-term disability insurance policy carefully
If you do not already have a copy of your insurance policy, get one as soon as possible. If a policy covers you through your company benefits plan, your Human Resources representative should be able to provide you with this information.
Have an individually purchased policy? If so, you should be able to obtain the policy directly from your insurance company or the agent who sold you the policy.
If you do not already have a copy of your insurance policy, get one as soon as possible.
Once you have your long-term disability policy available, familiarize yourself with its terms.
The policy will explain the following:
- Timelines you are required to meet
- What information must be submitted to prove your claim
- What “disabled” means in the context of the insurance policy
Often the initial claim filing deadlines and other relevant information can be found in a section of the disability policy titled “Notice of Claim” or “Proof of Claim.”
Further, you will also want to have your policy ready to provide to a long-term disability insurance attorney if that becomes necessary.
5. Do not be afraid to disagree with a bad determination
Strong claims get turned down for a variety of reasons. Many of these reasons are easily corrected, but some require significant intervention.
If you receive a letter of denial, you should seek legal representation. In many cases where you have obtained your insurance through your employer as part of a benefit plan, the appeal process is governed by ERISA. Under ERISA, this is the last time you will ever be allowed to submit evidence to support your claim.
If your claim is governed by ERISA, you must appeal a claim denial within 180 days of receipt of the denial letter. Otherwise, you will have no further recourse to challenge the denial of disability benefits. This 180-day timeframe creates a hard deadline to which there are few exceptions.
Want some help with filing your disability claim? Don’t hesitate to reach out to the disability law experts at Roy Law Group.