Five Tips for Winning a Disability Claim

Becoming disabled as a result of an on-the-job injury can be a frightening prospect. Worker’s comp or short-term employee benefits may cover the immediate cost of the injury and hospitalization. Some states offer temporary benefits to enable injured workers to get back on their feet. But if the doctor decides you are permanently disabled, your options are suddenly limited.

Filing a disability claim for long-term coverage is time-sensitive, and if you have suffered an injury that will affect your ability to return to work, you need to get started right away. Here are some steps to take to improve the outcome of your case and get the best result.

1. Contact a disability benefits attorney right away. The language of disability insurance is deliberately complex and legalistic, and at a minimum, you will need help understanding what you need to do and what documentation you need to provide. Some insurance companies have differing requirements for what doctors may be seen, and where paperwork must be sent, and this is where a skilled attorney can help.
2. File your claim immediately. In most states, there is a 60-day window to file your claim following an injury. If you miss the deadline, the insurance company can reject your claim immediately. If you are not certain that you have a claim, or it is unclear if you will be disabled long-term, you should ask your attorney and your doctor. Whether or not your worker’s comp or short-term disability claim will carry over into your long term disability claim depends on the language in your company’s insurance policy. In some cases, it will, and in some cases, it will not.
3. Read your disability insurance policy carefully. This is where the services of an attorney are especially helpful. The policy should define what “disabled” means for the purposes of the policy, what constitutes proof of your claim of disability, and what the key deadlines for submission of information are. If you do not understand any of this, get a clear explanation before proceeding.
4. Keep detailed records. Your disability case should have two types of records.
   • Your medical records. Your doctors will have these, of course, but you should get and keep copies of every record made each time you have contact with your doctors, physical therapists, pharmacists, and other medical personnel as your case progresses. You may not need all of it, but it is better to have it than to have to track it down months or years later.
   • Your communications records. Even in today’s electronic communications age, messages get lost, and phone calls don’t get recorded. Get into the habit of noting every contact you make with the insurance company, whether by phone, email, or text. This is one great advantage to having an attorney: once you have legal counsel, the insurance company must communicate with them, rather than you regarding your case and treatment.
5. Be prepared for the claim to be denied. Nearly all disability claims are denied after the first submission. The reasons for the denials are so varied it is almost impossible to list them all. They can include:
   • Improperly completed forms, such as filling out the wrong paperwork, or using the wrong forms.
   • Missed deadlines, including filing after the 60-day window or other statutory deadlines.
   • Missing medical records, such as tests or radiographs, incomplete doctors’ files, or unclear notes.
   • Conflicting diagnoses or improper treatment, such as a referral from a chiropractor when the insurer requires a neurologist.

Many of these denials do not require a case to be appealed if you have been otherwise fully compliant with the insurance company’s requests, but this is another reason why it is better to have a skilled disability attorney on your side. For instance, improperly completed forms can easily be remedied by submitting the correct form, but the insurance company would prefer to refuse to let you do that. Having your attorney make the call can greatly improve your chances of getting that small error corrected.

Get the Help You Need

The insurance companies have teams of lawyers on their side in these cases, so the best thing you can do to get your claim approved is to have a good lawyer representing you. The team at Capitan Law has been handling disability claims for many years, and we specialize exclusively in employment disability claims. This ensures we know the best way to handle your case, and get you through the insurance company’s hoops.

Capitan Law offers a free initial consultation for your disability claim questions and concerns. Call us at our offices at (267) 419-7888 today.