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If I am already receiving long-term disability benefits, what actions can I take to help prevent denial of disability benefits?

In order to help avoid denial by a disability insurance company here are a few actions a claimant can take:

  • See your treating physicians at least once every 3 months;
  • Make sure your treating physician is documenting all of your restrictions and limitation in detail. It is not enough for your doctor say that you cannot work. Your medical records should be reviewed regularly.;
  • Complete any diagnostic test which are recommended by your doctor. If your doctor has not performed any objective diagnostic testing, you should ask your doctor to have objective testing completed so that you can further document your disability. Be aware that if the test results do not support your disability, then the insurance company may use this information against you. If it has been more than 2 years since conducting diagnostic test, then the test should be repeated.;
  • Keep a daily or weekly journal of activities that cause pain.;
  • Take photographs of any swelling or videotape yourself on days you are experiencing disabling pain.

Attorneys Dell & Schaefer represent claimants with the monthly claim handling of their long-term disability insurance claim.

There are 6 opinions so far. Add your comment below.

CB:

Do insurance companies pay bonuses/commission to case managers if they can find a way to discontinue an LTD claimant’s benefits? Do you find lesser effort/scrutiny on the part of case managers after the “any occupation investigation” phase is over and the claimant’s benefits have been extended?

Attorney Greg Dell:

CB,

Thank you for your great questions. Please see our replies here and here.

Tony M.:

My long-term insurance company stopped paying me at the end of July 2015. The insurance company told me that they are reviewing my claim. Can they stop paying me while reviewing my claim?
Thank You,

Tony

Attorney Stephen Jessup:

Tony,

It is not uncommon for an insurance company to stop payment while conducting a review of a claim, but the amount of time that has passed since your last paycheck is somewhat unusual. Please feel free to contact our office to discuss your case in greater detail.

Dean:

If someone is already collecting LTD via an ERISA policy, can they change the policy which in effect would deny continued benefits to that person? Is the employer beholden to the policy that was in effect when the person was working or can they change the language/policy at will?

Attorney Stephen Jessup:

Dean, if you are already currently on claim for disability, then the policy language that was in force at the time of your disability would be in effect throughout the life of your policy. Any subsequent changes to a disability policy by your employer at a later date would not change the language used to evaluate your claim. If you have additional questions regarding your claim/policy please feel free to contact our office to discuss same.

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