Why Medical Evidence Matters in Long-Term Disability Claims

If you’re seeking long term disability benefits from an insurance company, you may be concerned that you’re facing an uphill battle. Fortunately, the stronger your medical evidence, the greater the odds that your claim will be approved. On the other side of the coin, one of the most common reasons for denial of long term disability benefits involves too-weak medical evidence. What should you do to boost the quality of the evidence in your claim file (and, as a result, your chances of disability approval)?

You must try to get as much objective medical proof as possible to get your long term disability claim approved.

It can’t be stressed enough: your medical evidence is the most important factor in getting your disability claim approved. This means having medical evidence that supports your disability claim and is supported by all your treating doctors. If one or more of your treating physicians isn’t supportive of your disability claim or refuses to cooperate when it comes to creating the medical records you need, you may need to find a new doctor.

There are many medical conditions that only have subjective evidence of disability. Your doctors must document everything in your records.

So, what medical evidence does a claimant need to get past the disability company’s arguments? There are a variety of different medical conditions that can cause disability, so, whenever possible, it’s important to have objective medical evidence that supports your diagnosis. Often, this can be test results like an MRI, CT scan, or bloodwork, or a diagnosis of a chronic illness like cancer or rheumatoid arthritis.

The strongest claims will combine this objective evidence with the claimant’s subjective complaints. Doctors should document these complaints as much as possible, building on test results with complaints of pain, limited movement, fatigue, and other subjective symptoms.

But in some cases, testing may not come back with much objective medical evidence at all – yet the claimant may still be dealing with pain and symptoms. If this is the case, you’ll need to tell your doctor exactly what’s going on physically and emotionally. You also can keep a pain journal, send yourself emails, or make other contemporaneous records of what your day-to-day life is like. You’ll then be able to submit this documentation to the insurance carrier as evidence.

How does a disability claimant continuously satisfy the medical proof burden?

Many disability claimants assume that once their claim has been approved, that’s the end of the road. However, claims are generally handled on a month to month basis, which means that there needs to be enough medical proof of disability to re-approve the long term disability claim each month. This means making regular doctor’s appointments and ensuring that the doctor’s notes reflect the symptoms and limitations you’re experiencing at the time.

It sounds simple, but if your complaints are not documented then it’s as if they don’t exist.

It’s vital for doctors to document every aspect of your disability, including how it affects your ability to work. But doctors are primarily focused on treating patients, not documenting insurance claims; when they fill out medical records, they’re making notes for themselves as part of an overall treatment plan. It can take some effort to teach your doctors to create your medical records in a way that is useful both for the treating physicians and the disability insurance company.

Always ask for a copy of your medical records so that you can verify the information in your records.

If your doctor’s office isn’t already in the habit of printing out or emailing a treatment summary after every appointment, it’s a good idea to get this process started. By reviewing your medical records as soon as they’re generated, you can quickly spot and correct any errors or omissions, ensuring that the insurance company is getting complete and accurate information.

At Dell Disability Lawyers, our long term disability insurance attorneys have extensive experience in working with claimants and their doctors to ensure that all symptoms and limitations are thoroughly covered in the medical file. No matter where you are in the claims process, you likely can benefit from some professional help. Just give us a call today to schedule a FREE consultation with a member of our legal team.