At Dell & Schaefer we’ve handled hundreds of long term disability insurance claims against Reliance Standard, and have learned a few things in the process. When you’re experiencing an injury or illness that makes it difficult (or impossible) to work, it can be tempting to file a claim as quickly as possible – but unless a claimant has all their ducks in a row, this could actually delay the ultimate resolution of the claim. Below are just a few of the tips we’ve discovered when negotiating long term disability insurance benefits with Reliance Standard.
#1: Medical Support is The Most Important Thing to Obtain a Reliance Standard Disability Approval
The single most important step in securing disability insurance claim approval is medical support from a claimant’s treatment providers. When you’re submitting a claim to Reliance Standard, it’s only as good as it looks on paper – which means there must be objective evidence, preferably medical records and physician statements, that you’re suffering from a condition that leaves you unable to work.
Most medical doctors aren’t prepared for the filter or spin the disability claims representatives will put on their comments. When your doctor is writing notes or filling out your chart, they’re focused on the pathology of your current condition and what will need to happen to get you better. They aren’t likely to provide details on how your condition affects you at work (or at home) or how long it’s likely to last. Because doctors’ notes don’t always line up with the information Reliance Standard is looking for, some otherwise worthy claims may be denied simply because the doctor’s notes don’t have the right verbiage.
#2: Your Treating Doctors Must be Prepared For A Phone Call With Reliance Standard Medical Experts
One way to overcome this common pitfall is to prepare your doctors for a phone call with one of Reliance Standard’s medical experts. Reliance Standard will be looking for direct evidence that your condition prevents you from performing one or more essential aspects of your current position. If your doctor isn’t sure what you do for a living or how much time you spend sitting, standing, lifting objects, or staring at a computer screen, they’re not going to be able to provide a valid opinion on how your condition affects you.
Furthermore, since doctors are busy and not always prompt about returning phone calls, a day or two of unsuccessful phone tag can mean Reliance Standard never hears directly from your doctor. Instead, set up a phone conference at a specific time as part of a medical appointment. This ensures your physician can connect with Reliance Standard and make sure it has a clear picture of what your condition means for you.
It’s also important for treating physicians to be educated on how a claimant’s Reliance Standard policy defines “disability.” For “own-occupation” policies, a claimant can be considered disabled if their condition prevents them from performing their current position. But in an “any-occupation” policy, a claimant will only be disabled if their condition prevents them from holding down any paid employment, which can be a much harder standard to meet.
#3: Occupational Experts Can Be Very Helpful in Establishing your Occupational Duties
“Own-occupation” and “any-occupation” policy definitions aren’t fixed, and many of Reliance Standard’s long term disability policies may begin paying benefits under an “own-occupation” standard and later switch to an “any-occupation” standard (often at the two-year mark). To continue receiving benefits, disability claimants may need to consult an occupational expert who can provide a roadmap to show exactly what the requirements are for a particular job.
#4: Know the Level of Review Your Claim File Will Receive
Reliance Standard can be anything but standard when it comes to reviewing a disability claimant’s file. In some cases, the insurance company will put the claim file through a fairly cursory internal review with a staff nurse or doctor who will recommend approving or denying the claim. Because the reviewer is directly employed by Reliance Standard, they have a vested interest in denying the claim – after all, the fewer long term disability claims Reliance Standard pays, the more profit it earns.
In other situations, Reliance Standard may send a file out for an “independent physician review,” where a physician employed by a different agency performs a review of your file. Because your file is only as good as it looks on paper at this point, it’s important to provide as much relevant information as possible.
#5: Your “Date of Disability” is Important
Determining your official date of disability can be more of a challenge than it may seem. This is even more true if your disability begins to cause problems during the “look-back” period of your long term disability policy. Most policies have a look-back period of anywhere from nine months to a year, which can mean that claims for any pre-existing conditions (or those that began to manifest before or during the look-back period) can be barred. To receive long term disability benefits from Reliance Standard, you’ll need to show that the onset of your disability occurred after the look-back period ended.
Regardless of where you are in your Reliance Standard disability claim, Dell & Schaefer can help. To get started, set up your FREE consultation with one of our attorneys today.