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The following article was published in Your Health Magazine. Our mission is to empower people to live healthier.
Ben Glass, Esquire
More Mistakes That Can Cost You Your Long-Term Disability Case!
Benjamin W. Glass and Associates
. https://www.benglasslaw.com/

More Mistakes That Can Cost You Your Long-Term Disability Case!

Choosing the wrong date of disability.

The insurance definition of disability is contained in each policy, and each policy is different. Usually, it is a combination of an inability to work, coupled with an actual loss of wage-earning ability. This can be important in those situations where even though you may be cutting back your hours, your employer still pays you full salary. If you are still getting paid full salary, you may not be deemed disabled under your policy even if you have a substantial impairment.

It is important to identify the date of disability, because all other dates (e.g., when you must file proof of claim, where payments start, and when you can appeal your denial) are calculated from the date of disability.

Making your claim before you know what's in your doctors' records.

Insurance companies will only pay benefits if they are convinced that your medical records contain enough objective proof of disability. As soon as you file your claim, these companies will request records from your doctors (and from any doctors referenced in those records) and carefully scrutinize them.

You must get these records in your hands before you file your claim. Review them yourself. Are they accurate? Are they complete? Has the doctor recorded all of your complaints?

In one case, an insurance company denied benefits because the records of another person were included in the records sent by the doctor. Those records said all was well and the insurance company relied on those records.

(Great investigation, that was; wasn't it? The claims adjuster had so many files, she never even noticed that she was reading the wrong records.)

The claimant never knew that the records her doctor had sent had someone else's records in them, because she didn't get her doctors records first. It was only after she hired a lawyer and sued the insurance company that this was found out.

All of the expense and hassle was 100 percent avoidable by requesting the medical records before filing the claim with the insurance company.

Not understanding your policy before you file your claim.

Insurance policies can be hard to understand. You should obtain and review your policy before you file your claim. If your policy is an employer-sponsored policy, you should obtain both the Summary Plan Description and the insurance policy itself before you file your claim. Both of these documents should be available from your employer.

The Employee Retirement Income Security Act (ERISA) requires that these documents should be available upon written request to the plan administrator. If you have a private policy and cannot locate it, call your agent. You can obtain a replacement policy (usually for a small fee) from your insurance company.

Long-Term Disability is a tricky field, but you can maneuver it if you know to avoid costly mistakes like these.

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