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When Is The Best Time To File A Long Term Disability Benefit Claim?

Attorney Gregory DellAuthor: Attorney Gregory Dell

The answer to this question has a lot variables and it an issue that we help individuals determine on a daily basis. First, it is important to realize that each disability insurance company offers multiple long term disability policies containing different language. A close evaluation of the definition of “Disability” in relation to the activities a person is doing both in and out of work must take place. Every disability insurance policy defines “Disability” differently. Even if you have an “own occupation” disability definition, the interpretation of disability is a highly litigated topic. It is not as simple as saying, “I can’t do 50% of my responsibilities at work, therefore I am totally disabled”. The disability insurance company will conduct a quantitative vs. qualitative analysis of your work activities and determine if your reported medical limitations prevent you from working. In simple terms, the insurance company will try to say, “we think you can sit for more than four hours a day, therefore your restrictions and limitations do not support your inability to work.” This is typical statement we see in disability denial letters and it frustrates our lawyers every time. Fortunately our disability attorneys know what to do to put a claimant in the best possible position to obtain claim approval the first time.

Timing of a Disability Insurance Claim

Most long term disability policies require a person to be unable to work for at least 90 to 180 days before they are eligible for benefits. This is the “elimination period”. Many people suffer for months or years with a medical condition and they continue working without seeking medical treatment. These same people wake up one day in so much pain and want to immediately file a disability claim. This is a situation that will result in a claim denial 95% of the time. For people with chronic medical conditions, which is more than 75% of the LTD claims our lawyers see, it is essential to have a plan in place before even notifying the disability carrier. When it comes time to file an LTD claim, your disability claim is only as good as it looks “on paper”. The “on paper” I am referring to means medical record documentation of all your medical conditions. If you have a well documented medical history prior to filing a disability claim, then you have a high chance of claim approval. If you have very little medical documentation or poorly written medical records, then the chances of approval are more difficult.

When an individual contacts any of our disability insurance lawyers, we always want to know the medical history within the past 6-12 months and we want to see if your doctors have sufficiently documented your medical records. We work with you and your doctors to make sure that your medical records contain the information necessary for you to have the best chance for claim approval. This is a process that can take several months and unless you have a catastrophic medical condition, you must have strong historically documented medical support in order to get approved.

Our lawyers have worked with hundreds of claimants nationwide throughout the application process. We want to make sure our clients are doing everything possible to avoid a claim denial. The disability insurance companies have an advantage because the disability claimant has the burden to prove he or she is disabled. If you have poor medical support on paper, then you are giving the disability company the ability to deny you. Contact any of our long term disability lawyers and we will discuss how we could work with you and your doctors to obtain long term disability benefits.

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