Most disability insurance policies written by Mass Mutual are individual ones where professionals take out personal disability policies to cover them if they are unable to work in their own profession. This means that the policies are covered by standard contract law and unlike other types of disability policies, Mass Mutual can be sued for breach of contract if they deny your claim. You will also be entitled to a jury trial. This also means that ERISA laws applicable to employer provided disability insurance policies do not apply.
The top reasons why a disability insurance claim may be denied:
- Disability insurance claimants do not understand the term “own occupation” and do not adequately explain their specific job duties.
- Disability insurance claimants do not understand the terms of their policy regarding definition of disability.
- Disability insurance claimants medical records do not support their claim
Tips on How to Get a Mass Mutual Long-Term Disability Claim Approved
Mass Mutual has a reputation for being fair but thorough. You need to provide Mass Mutual as much documentation of your medical condition as possible.
You must know your Mass Mutual disability insurance policy language and what it says you can and cannot do. Do you have a policy that allows you to continue working in another occupation with no income limitation if you are unable to do the duties of your own occupation? Can you work at another job but with an income limitation? Are you prevented from working at all? These answers will be found in your policy.
Medical Support and a Coordinated Presentation of Information from All Treating Doctors is Essential
It is sometimes difficult to explain to your treating physicians what you require of them, but all your healthcare providers need to be consistent in their reporting. They must say more than that they support your claim for disability. They must be specific about how the disabling condition prevents you from working at your own occupation.
Often, our professional clients have had the disabling condition for some time. They may have been working through it for months or years, so Mass Mutual asks, “What changed? Why can’t you work now?”
We can usually show that you can no longer work like you used to. It may take you more hours to do the same amount of work. Your condition may have worsened. This requires more documentation than if you were injured in an accident or are suddenly faced with a catastrophic medical diagnosis.
Our clients generally do not want to stop working. They make far less money on disability, but they come to a point where they are just unable to perform their job duties any longer.
Establishing the Duties of Your Occupation is a Key Factor in Establishing Why You Cannot work in Your Own Occupation
Whether you are a physician, dentist, lawyer, business owner, or other professional, Mass Mutual will look at your financial documents to verify your loss. Mass Mutual will look at your state and federal personal and business tax returns. Mass Mutual will review your profit and loss statements. If you are a doctor, they will review your CPT billing codes. Dentists will need to provide their ADA codes. Mass Mutual uses all of this to verify your occupational duties.
Mass Mutual wants to know the procedures you were doing and why you can no long do them. They will look at your calendars, and for lawyers, they will look at their docket schedules. Business owners will need to provide their calendars and meeting schedules.
How Disability Insurance Attorneys Dell & Schaefer Can Help
When our disability insurance attorneys at Dell & Schaefer prepare your disability insurance claim, we take charge, and all communications go through us. Mass Mutual will generally ask you to sign releases like a HIPAA release so they can call your doctors directly. We suggest you tell your doctors not to speak to anyone without speaking to you first. We then work with the doctors to guide them through that interview.
Mass Mutual will likely want to interview you. This is an important part of having your disability insurance claim approved. Think of this as a job interview where everything you say will be scrutinized. You want to be honest, but you do not want to downplay your medical condition. We will guide you through this interview so you will know what to expect.
We offer a free consultation where we first review a copy of your policy, then discuss with you how we think we can help and what our fees or costs will be. If we do not collect benefits for you, you pay us nothing.
Our clients are located all over the country, so no matter where you live, we can help. Call us at (800) 682-8331 for more information.