• Applying for short or long term disability insurance benefits should not be done alone
  • When is the best time to file for STD or LTD disability insurance benefits?

Individual or Group Disability Insurance Policy

Whether you have an individual long-term disability policy that you purchased from an insurance agent or a group disability policy provided by your employer, the application process requires the same attention to detail.

An application for disability income benefits must contain specific information and be supported by the proper documentation. The application process involves a collaboration between the applicant, the treating physicians, possibly an accountant and any co-workers at the time the applicant became disabled. The disability application requires an applicant’s occupational duties to be specifically broken down into categories and the amount of time spent performing each duty must be established. The manner in which this is determined can make the difference between receiving total or only partial disability benefits. In order to verify occupational duties, an insurance company will want to analyze the applicant’s tax returns, pay-stubs, profit and loss statements, appointment books, monthly and annual CPT code production reports (physicians only) and any other documentation that shows the work the applicant has performed during the three years prior to filing a claim and the time period after filing a claim.

Next the insurance company will require the applicant’s treating physicians to submit Attending Physician Statements, which must state whether or not the applicant can perform either the duties of his or her occupation or in some instances, the duties of any other occupation. In addition, the insurance company will either call or meet with the treating physicians in order to discuss the applicant’s claim for disability benefits. We regularly consult with an applicant’s treating physician, so that the treating physician can properly evaluate an applicant’s restrictions and limitations in conjunction with the applicant’s daily occupational duties. In most cases, disability should not be addressed in a generic sense, but in relation to the applicants own occupation. Disability insurance claim examiners are trained to look for specific information in the medical records, and if information is missing they will rely on a lack of information to deny or delay claim approval.

While evaluating the applicant’s claim for benefits, the insurance company will usually send out a company field representative to interview the applicant and review any financial documentation in the applicant’s possession. Field representative interviews should never be conducted without the presence of an attorney. How you phrase a response will follow you throughout the claim’s process. In addition, the applicant may be required to appear for an independent medical examination (IME) and a functional capacity evaluation (FCE). In order to protect the rights of the applicant and ensure legitimate testing, we always recommend that these so-called independent medical exams are videotaped and a copy of the report is provided to the applicant upon completion.

Lastly, without the applicant’s knowledge or consent, the insurance company will usually have a private investigator follow the applicant and conduct video surveillance for several days. The insurance company will then send the video surveillance to the independent medical examiner or the claimant’s own doctors in order to determine if the observations in the video are consistent with the applicant’s stated inability to perform the duties of his or her pre-disability occupation. We always ask the insurance company for a copy of the surveillance video and to give the applicant’s treating physicians an opportunity to review the surveillance video before any claim decision is made.

The insurance companies are not entitled to every piece of information they request, and an applicant must be aware of the legal implications of every communication and document requested by the insurance carrier. Insurance companies have a lot of discretion under the terms of a disability insurance policy. They are required to focus on the limitations and restrictions which prevent an applicant from performing his or her occupational duties at the time the disability started. Determining the date of disability is often difficult, yet it must be selected in coordination with the supporting medical records. The playing field is not equal. Unfortunately, the insurance carrier is the wolf in sheep’s clothing.

If you are considering applying for benefits or are waiting for a decision, contact Attorneys Dell & Schaefer for a free evaluation of your claim for disability benefits.

Questions About Hiring Us

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

Dell & Schaefer Client Reviews   *****

Juan C.

Extremely satisfied. I’m a physician/surgeon who got rheumatoid arthritis when I least expected. Attorney Dell and everybody else in his firm made the claim, transition and final successful resolution, quickly, expertly, painless and very cost effective. Mr. Dell exceeded my expectations by a long margin and I am forever grateful for his services.

***** 5 stars based on 202 reviews

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