If you’re considering filing a long term disability insurance claim, you may wish you knew the answer to the question weighing most on your mind: will I be approved for long term disability insurance? Unfortunately, there’s no quick or simple answer to that question, and your odds of disability insurance approval will depend on factors ranging from the type of disability insurance policy you have (group or individual) to how often you see your doctor. Learn more about what goes into being approved for long term disability insurance and why it’s so important to seek regular treatment from your doctor.
Factors that Make it Difficult to get Approved for Disability Income Benefits
There are a few factors that can make disability insurance claim approval an uphill battle. One of the biggest factors is also one of the most basic – how the disability insurance policy defines disability. A disability insurance policy that provides benefits if the claimant can’t perform their current job will be far more generous than one that only provides benefits if the claimant can’t perform any job. Reading your LTD long term disability insurance policy carefully (and consulting a disability insurance attorney) can give you more information on what level of disability you’ll need to prove.
Group Disability Insurance Policy vs. Individual Disability Insurance Policy
Group disability policies, or ERISA policies, are generally provided by a claimant’s employer. Individual policies are purchased directly from the disability insurance company, usually through an insurance agent. With these disability insurance policies, the mantra “you get what you pay for” is in full effect – ERISA policies are far less expensive than individual policies and, correspondingly, have far stricter limits on coverage.
Under both ERISA and individual long term disability policies, claimants whose claims are denied disability insurance benefits may sue the disability insurance carrier. But with an ERISA policy, before you can file a disability insurance lawsuit, you’ll need to seek an administrative appeal – and once this disability insurance appeal has been decided, the record is closed. This means any information that didn’t make it into the record can’t be considered in deciding whether you’re entitled to disability benefits. Under an individual disability insurance policy, you don’t need to seek an administrative appeal, you have the right to request a jury trial, and your disability claim is subject to a less burdensome standard of review.
Why Medical Treatment is so Important in a Disability Claim
The timing of medical treatment can be a make-or-break moment in a disability insurance claim, particularly those involving chronic or degenerative conditions. If you can show that you’ve been visiting the doctor for years and your medical records establish that your condition has worsened, your disability insurance claim is far more likely to be approved than if you didn’t see a doctor until several weeks after you stopped working.
Every Month a Disability Insurance Claimant has a Duty to Get Medical Treatment Regularly
If you’re not regularly seeing a doctor, it’s time to start. Disability insurance carriers have a financial incentive to deny claims whenever they can, so seeing that you’re seeking medical treatment only intermittently may help the insurer argue one of two things: (1) your disability isn’t that serious (or you’d be seeing the doctor more often); or (2) you’re exacerbating your disability by not going to the doctor. Many disability insurance policies specifically provide, as a condition of the continued receipt of benefits, that claimants continue ongoing treatment until it is determined to no longer provide any benefit. But even if your disability insurance policy doesn’t specifically require ongoing treatment, maintaining regular appointments is still a good idea as it will help you continue to document your condition.
Contact the disability insurance Attorneys at Dell & Schaefer, give us a call or visit our website to get in touch with our team of experienced disability insurance lawyers, who can set up a free consultation to discuss your claim.