In the video above, we explain the first steps in filing a group disability claim. But what’s the secret to filing an initial LTD claim that is successful?
Most people find the process of applying for disability insurance benefits — and actually getting the monthly payments they need — to be far more difficult and distressing than they ever expected.
The complex nature of the application process, and the documentation required to prove you are disabled, is overwhelming. Many have turned to our disability law firm for help with their initial long term disability application.
What’s the Secret to a Winning Initial LTD Claim?
What does it take to get an application for LTD insurance benefits approved on the first try?
Because certain issues hold true with every claim, no one can guarantee an initial claim will be approved. For example,
- disability insurance policies vary significantly
- no two disabling conditions, and no two disabled individuals, are alike
- each insurance examiner or adjuster is different
- insurance is big business and LTD insurance companies seek to protect profits
Filing the initial claim for long term disability benefits can instantly become confusing. What seems like a simple or straightforward question is anything but.
Yet even if it seems the deck is stacked against you, there are specific steps you can and must take to avoid the pitfalls that undermine most claims — under both privately purchased and group (ERISA) disability insurance policies.
This article will help you and your family understand what it takes to improve your chances of filing a successful initial LTD claim, including
- why you must know exactly what your policy actually covers
- how to prepare a clear and well-documented claim
- work with your doctors in a way that secures a most accurate and well-developed claim
- know what to do next—whether your claim is approved or denied. Denial does not mean a claim is finished.
It’s More than Filling Out a Form.
Starting a claim for disability benefits goes far beyond completing application forms. What you do in advance of submitting the requested documentation is very important.
Step 1: Request the Proper Claim Application Forms
For an individual disability policy you have purchased privately, request the disability benefit forms directly from your insurance provider.
If you are covered by a group disability policy through your job, request the disability benefit forms from your employer’s Human Resources department.
Generally these forms include:
- Disability claim forms
- Attending Physician Statement
- Employer’s statement (for a group claim)
- Authorization for Release of Medical Information
Step 2: Read Your LTD Insurance Policy!
All successful long term disability claims begin with understanding what’s in your policy.
This sounds simple but it is the key to your claim. The procedure for submitting an initial LTD claim is explained in your insurance plan. Read your policy from front to back, and find out the specifics about what your insurer or your employer require as far as procedures to follow, forms to submit to the claims administrator, and time requirements and deadlines to meet.
Your policy sets the terms and provisions related to your actual benefit provisions and limitations. Interpreting the terms in your policy can be tricky; and may lean in favor of the insurer. You especially want to avoid incomplete or inaccurate information that the insurer can use to deny the claim.
So claimants beware! Remember, the insurance company writes the policy, and usually the same company decides whether you are disabled. Policies may be written in such a way as to allow, or enable, the insurance company to deny legitimate initial claims or terminate a claim in the future.
Step 3: Submit a Complete, Well-developed Claim
As you fight to endure a disabling condition, it should not be your station to battle a burdensome claim process. But unfortunately this is the case most of the time.
To win the disability benefits on the first try, in most cases one must be proactive and include information that is not specifically implied or stated in the policy. In fact, there is often little room or no helpful instructions on the claim forms, which puts a damper on any extra efforts and proactive thinking on a claimant’s part.
Winning Your Initial LTD Claim Is about Proving You’re Disabled.
Your doctor says you are disabled. You have submitted the medical files and other paperwork as stated in you policy. Even so, it is common for insurance companies to deny initial claims.
How can you avoid this? Every successful initial disability claim is written from the point of view that insurance companies really do not want to pay the claim. The insurer is going to be skeptical about whether you are truly disabled. It is up to you to prove that you are.
The insurance company may investigate your claim, or resort to shrewd denial tactics to avoid paying benefits. You or your disability attorney must be prepared for such actions, and submit a carefully honed claim that will withstand these pressures.
Solid, objective evidence of disability in the initial disability claim can be a game changer. Examples might include:
- additional, highly relevant medical and vocational testing
- complete description of your actual job duties, functions and requirements, and other “factual” employment information
- a narrative description of your impairment and symptoms, giving a detailed picture of how your disabling condition affects your daily life at both work and home.
As disability attorneys assisting claimants in their initial application, we fortify every initial claim with the proper evidence and legal arguments that can defend against an insurer’s denial tactics.
We coordinate with doctors, vocational experts, employers, fellow workers and accountants, to provide the insurance claims examiner the most accurate medical, vocational and financial information to support your claim.
We Make Filing an Initial LTD Claim Easy
We can help you file a rock solid long term disability application for both individual LTD claims and group (ERISA) claims. See how we make it easy.
Ask Us About Your Claim Today.
If you were denied long term disability benefits, Social Security Disability or Veterans’ Disability Compensation, we are prepared to help you now. 1-800-562-9830