Long-term disability insurance (LTD) is supposed to replace a percentage of an insured person’s income if the individual becomes unable to work due to injury or illness. All too often, however, filing long-term disability claims can become an additional burden in an already troubled situation. The frequency of claim denials can leave many individuals moving through the process wondering how to win a long-term disability claim, or whether filing successful LTD claim tips ever actually work. The reality is that the procedures for how to file a long-term disability claim will be set primarily by your insurance company, but insurance providers are bound to abide by their own rules, set out in the terms of each policy. Following a clear LTD application best practices guide can make it easier to see how those rules apply to each individual situation, and strategize filing long-term disability claims accordingly.
Is It Hard To Get On Long-Term Disability?
Many people find it extremely difficult to qualify for long-term disability, even when they clearly have a condition that makes them unable to earn a living. Companies offering insurance of almost any kind are obviously incentivized, as part of their business model, to take the least-generous, rather than the most-generous, interpretation of an individual’s eligibility for benefits in each case. This incentive structure does not mean that no one is ever approved for LTD benefits. After all, a company that never paid out benefits in response to claims would quickly gain an unsavory reputation, negatively impacting its competitiveness in the insurance market. What it does mean is that the exclusions and limitations written into a policy’s terms can often be used in ways broader than the individual filing long-term disability claim may expect, and that the medical evidence the insurance company requires during the review process can sometimes feel like something of a moving target.
Working with an attorney who is familiar with how to file a long-term disability claim may make the process easier and less stressful to navigate, but unfortunately even individuals working with professional support and the benefit of a comprehensive LTD application best practices guide are likely to encounter more than a few moments of frustration along the way. Most of the time, two of the most important filing successful LTD claim tips to follow are:
- Identify as many potential obstacles as you can, as early as you can, and remove them as soon as possible.
- Expect new obstacles to emerge along the way, and prepare yourself to address each one methodically as it arises.
These tips will not eliminate all frustration and discouragement for individuals filing long-term disability claims, but they may make it easier to take a measured, problem-solving approach to determining how to win a long-term disability claim in each particular situation.
How Can I Increase My Chances of Getting Disability?
Even though following an LTD application best practices guide may not be a shortcut to an easy approval, a few filing successful LTD claim tips can often help individuals filing their initial long-term disability claims to improve their chances of avoiding a denial. Consider the following steps as you prepare to file your application for benefits.
1. Know Your Own Case
Even before you begin the all-important process of reviewing your policy terms, take time to gather your thoughts and write down key details relevant to your disability claim. These details will depend on your specific condition and circumstances, but for many people an approximate start date for when they first began to notice bothersome symptoms, as well as when they sought treatment for those symptoms and the initial steps the medical professionals reviewing the condition went through in attempting to find a diagnosis, can be helpful. Make note of the timeline and ask yourself:
- How much time lapsed between medical appointments?
- Did your condition worsen over time?
- When did you first notice that your condition was interfering with your ability to work, and how?
- What treatments did healthcare professionals recommend for you, and what steps did you take to follow their advice?
- Were there any specific activities needed for your job that your doctor or other healthcare provider advised you to avoid?
- Did you attempt to access workplace disability accommodations in order to continue working in spite of your condition?
- If so, why did those accommodations fail?
- What limitations does your condition impose on normal daily activities that you would reasonably expect to be needed for any job?
Outlining the answers to all of these questions, even briefly, can set you up to review the terms of your policy more effectively, because the process of putting together a time-structured narrative of your disability puts concrete points of reference on paper for you to connect with the policy application requirements for how to file a long-term disability claim as you read through them.
2. Access and Review Your Complete Policy Terms
Very often the plan documents individuals are provided during enrollment, and which they are used to thinking of describing the terms of the disability insurance policy, are actually summaries of benefits. This scenario may be especially likely if you are on group plan LTD and much of the onboarding process was accomplished with the assistance of a benefit specialist from your employer.
There is nothing wrong with benefit summaries or enrollment assistance, but you need a copy of the full terms and conditions of your specific policy if you want to know how to win a long-term disability claim under that policy. Review the documents you already have in hand, check your customer portal with the insurance company if you have one, and if your plan was obtained through an employer, reach out to the benefit coordinator at that workplace to confirm whether there are any additional documents associated with your policy and coverage.
3. Compare Notes and Connect the Dots
Once you have a full copy of your policy terms, you can work your way through the document, step-by-step. Pay special attention to lists of excluded conditions, limitations on coverage, and types of documentation accepted as medical evidence. This is where the notes you prepared prior to beginning your review can be extremely helpful: Keep those notes with you as you conduct your review of the policy documents, and be prepared to mark up the margins of your policy or your notes or both. Any information in your own notes that resembles exclusion criteria can be a “red flag” that you need to dig deeper to confirm whether your condition is likely to be covered. Any qualification criteria or accepted documentation that you already know you can access because you already made a note of the qualification or the medical exam that produced a specific type of evidence works as a “green flag” that you know you will need to include in filing long-term disability claim support.
4. Consider Reviewing Your Plan With a Professional
Even before you set about the process of collecting the documentation your insurance company requires as medical evidence of your condition, you may want to consider reviewing your policy documents and notes with an attorney or disability rights advocate. This step can be especially helpful if your condition does not fall neatly into a category already clearly delineated in the terms of your policy, or if the comparison between your notes and the policy terms revealed several potential problem areas. An experienced professional who has dealt with multiple similar cases may be in a position to offer the benefit of a perspective that even the most painstaking reading of policy documents cannot realistically provide. That perspective often enables these professionals to provide filing successful LTD claim tips that can save individuals filing long-term disability claims significant time and trouble as they go through the application process.
5. Gather and Submit Your Evidence
Once you have clarified the terms of your policy and you are sure of the kinds of medical evidence you will need to submit in support of your claim, you can begin gathering the necessary documentation. This process can often take considerable time, so an LTD application best practices guide will usually urge you to establish a deadline tracker early on and begin the collection of medical documentation as soon as possible. When you are ready to actually file your claim, be sure that you follow all of your insurance company’s specific guidelines for submission. These guidelines can vary depending on the types of evidence submitted, so take your time and review the instructions for how to file a long-term disability claim thoroughly in order to save yourself preventable errors.
What Evidence Helps With a Disability Case?
You will likely find that most LTD application best practices guides advise individuals looking for successful LTD claim tips to collect substantial medical evidence to submit when filing long-term disability claims. Understanding the types of evidence that may be helpful can make following these recommendations for how to win a long-term disability claim much easier.
The most useful types of evidence to include when filing long-term disability claims will depend on the nature of the disabling condition in any particular case, as well as on the kinds of documentation accepted by the long-term disability insurance provider. Usually the types of documentation required and accepted are outlined in the terms of the LTD policy, so reviewing the plan documents is an important step in determining how to file a long-term disability claim in your specific situation. That said, some typical examples include:
- Attending Physician Statement (APS)
- Symptom/treatment log
- Results of diagnostic scans/tests
- Statements/testimony from others familiar with the impacts of your condition on your ability to work
Reviewing filing successful LTD claim tips with a disability attorney may help you to identify the specific elements that are most likely to prove helpful based on the terms of your insurance policy and the other factors present in your situation.
Filing Successful LTD Claim Tips: Laying the Groundwork for Smooth Sailing
Filing long-term disability claims is difficult, time-consuming, and complicated. Insurance providers have every incentive to deny claims, and to make the review process for LTD claims take as long as possible, in hopes that claimants may simply give up. Even the most carefully detailed filing successful LTD claim tips cannot give you control over the parts of the application process that lie with the insurance company. Few experiences in life are more frustrating than going through the steps knowing that the “secret” to how to win a long-term disability claim is to suffer from a life-altering impairment while somehow making sure that the impairment can be documented according to terms set by strangers. Following the insurance provider’s own instructions for how to file a long-term disability claim is one crucial step to setting yourself up for an approval. Following an LTD application best practices guide can make it easier to understand the kinds of documentation the instructions may be looking for, and establish a framework for how to prioritize the tasks necessary to filing long-term disability claims.
