Filing a long-term disability (LTD) claim can be a daunting process, but having the right documents in place is essential to ensuring your claim is as strong as possible.
Insurance companies often look for any gaps or inconsistencies in your submission to deny or delay claims. To avoid these pitfalls, it’s crucial to gather and organize the key documents that demonstrate your eligibility and the extent of your disability.
The Basis of Your Application
Your medical file forms the basis of your LTD application. Medical evidence needs to be comprehensive regarding diagnosis, prognosis, and limitation caused by the condition. Comprehensive medical records include test results, radiology studies, physician notes, and summaries of all treatments and consultations relative to your disability.
Most, if not all, insurance providers rely on this type of evidence a great deal. Without detailed medical documentation, your case will suffer accordingly. This will entail working with your healthcare providers to make sure that they provide full and timely records.
Writing an Effective Attending Physician Statement
The attending physician statement, or APS, is perhaps the most important piece of evidence that will directly support your claim for LTD. The APS is usually completed by your physician and describes the nature of your disability, the severity of your disability, and the functional impact on your ability to work.
It should specifically address the limitations that prevent you from performing your job or any other type of work. A LTD lawyer can help you ensure the APS is completed correctly and contains the required information to meet the insurance carrier’s criteria. This document is often the most influential in a decision.
Proving Your Work History and Duties
Your employment records are another important component of your LTD claim. This would include job descriptions, performance appraisals, and documentation of accommodations your employer made on your behalf because of your condition.
Of particular importance is a complete job description because it gives an outline of the occupational duties that include both the physical and mental demands. Combined with your medical records, these documents will assist in defining how your disability interferes with your performing your job.
Evidence of Income for your earnings
Insurance carriers have to have proof of your earnings for an appropriate calculation to calculate how much you are eligible under your LTD policy. The pay stubs, recent year tax returns, and W-2 forms are records to show your income level pre-onset of the disability.
This financial history allows your earnings not to differ which may affect what the individual receives in terms of benefit. Organizing these documents in advance will make the process much easier and eliminate potential delays.
Understanding Your Coverage
You will want a copy of your LTD insurance policy for the purposes of understanding the terms and conditions of your coverage. It will outline what constitutes “disability,” the waiting period, and the duration for which benefits are payable.
This document will also provide an opportunity to determine any specific requirements or exclusions that may impact your claim. If you are not certain how to interpret the policy language, consulting with a professional who understands disability law can be invaluable.
Your Description of the Impact
While medical and work records are considered objective evidence, your statement is an opportunity to describe-to a lay audience-how your disability impacts your daily life and ability to work. This can be a compelling element of your claim because it puts a face and emotional content to the technical evidence.
Be candid and elaborate on the difficulties faced by an individual, whether physical, emotional, or social. An entertaining personal statement can enhance the case and humanize the claim.
Additional Medical Evidence
In some other instances, additional evidence could support your claim. This would include letters from colleagues and supervisors that testify to one’s decline in performance for reasons of the condition one has, and documentation of the efforts one has made on vocational rehabilitation.
If modifications in the home or particular equipment are needed because of the condition, receipts and invoices for these expenses can also support your claim by showing the functional effects of your disability in real life.
Organizing and Submitting Your Documents
Once you’ve gathered all the necessary documents, it’s crucial to organize them in a logical and easy-to-follow manner. Create a checklist to ensure that no critical evidence is overlooked. When submitting your claim, consider including a cover letter summarizing the enclosed documents and highlighting key points. This demonstrates your thoroughness and professionalism to the insurance company.
It may be a very complex process, but by collecting these identified herein documents, you will go a long way in strengthening your long-term disability claim. Preparation and attention to every detail will make a great difference in getting approved. If the going gets tough, be sure to seek the right experts to walk you through it.
