When you claim a long term disability, chances are good that you’re doing so under the advice of your doctor, who has probably already told you that you have a disability and may have even filled out paperwork for you to this effect. Basically, you’re acting on the professional advice of a medical expert.
Logic would follow that the opinion of such a person would have to be taken into account. After all, that’s how it works if you’re filing a disability claim with Social Security. They are required to treat your doctor’s findings with respect, and if they are to argue against them, they have to come up with enough evidence to the contrary with their own experts to call your disability into dispute.
But that’s not how it works if your plan falls under ERISA regulations.
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Insurance providers can simply call in their own disability doctors and ignore whatever your physician has said. There’s no need to prove him or her wrong or come up with an overwhelming amount of evidence in their favor – they just toss out the evidence that doesn’t agree with them. All your insurer needs to do is make sure that their disability doctors – people who are on their payroll! – provide evidence that calls your long term disability into question.
With this kind of completely legal policy in place, you need an experienced disability attorney who can request that vocational experts review your medical evidence and complete a report which will support your claim. Combining strong medical evidence and expert vocational reports in your administrative appeal will contribute greatly to the success of your claim for benefits. Remember, you only have a limited amount of time to file your appeal, so your first step should be contacting an experienced long term disability attorney.
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