Telehealth services have seen an explosion in recent years, coming into play for the management of everything from minor infections to mental health support. Often individuals applying for, and ultimately receiving, long-term disability insurance (LTD) benefits have questions about the potential telehealth impact on long-term disability claims, particularly for gathering the documentation of medical evidence they will need to support and renew their claims. Some insurance companies may consider virtual doctor visits for LTD claims valid, while others may reject long-term disability benefits telehealth records and require documentation of in-person benefits.
Many may accept records from telehealth appointments for some types of evidence but not others. Individuals navigating LTD benefits and telehealth services may wish to review the terms of their policies with a benefits specialist at their old employer, if they had employer-sponsored LTD plans. Consulting a disability attorney can also help you make sure you have adhered to all the terms of your long-term disability benefits’ telehealth requirements.
Potential Benefits of Telehealth for Long-Term Disability
Telehealth services can significantly reduce the practical difficulties many people applying for or receiving long-term disability benefits experience in navigating healthcare systems. While personal challenges do vary widely depending on condition, for many people who have to leave work for an extended period due to injury or illness the simple physical demands of traveling to and from medical appointments can take a substantial toll.
Long-Term Disability Challenges in Medical Care: Physical Medical Environments
Individuals with limited mobility may have to go through time consuming detours to attend in-person medical appointments. This process increases the hours they must spend moving through often uncomfortable surroundings and managing assistive devices that can sometimes be cumbersome, as well as in some cases socially stigmatizing. People suffering from chronic fatigue syndrome or other conditions characterized by intense post-exertional malaise may find that they take days or weeks to recover even from a routine office visit, let alone more elaborate procedures.
Telehealth Impact on Long-Term Disability Recipients: Travel Concerns for In-Person Office Visits
For those whose conditions impose limitations on their driving ability, finding a driver to bring them to the appointment, potentially wait several hours, and then drive them home again, can be extremely challenging. Hiring cabs, even in urban areas where these are widely available, can create a significant financial burden that adds to an already difficult situation. Asking friends and family for rides may rapidly strain relationships, even if an individual on long-term disability is fortunate enough to have close friends or family members in good health living nearby. All of these disadvantages and challenges to traditional healthcare environments present opportunities for telehealth services to improve healthcare access for people with long-term medical challenges.
Advantages of Virtual Doctor Visits for LTD Claims
Telehealth services can reduce or eliminate much of the burden individuals with serious medical conditions experience in accessing healthcare. Eliminating travel time and hours spent in waiting rooms can greatly reduce the worsening of symptoms many people with fatigue issues experience after attending in-person medical appointments. The ability to discuss their conditions with a healthcare provider from home, where the layout, furniture, and other surroundings have often been adapted to meet their needs, can greatly reduce the physical discomfort many people with mobility restrictions unfortunately experience when trying to navigate healthcare environments. For many individuals with challenging health concerns, telehealth services can function as a type of disability accommodation, reducing the barriers between these vulnerable patients and the compassionate, effective care they need and deserve.
LTD Benefits and Telehealth Services
Although individuals with health challenges can often find many advantages in combining LTD benefits and telehealth services, the telehealth impact on long-term disability can also prove to be a double-edged sword in the context of long-term disability applications for benefits. The potential advantage is that telehealth appointments can make it much easier for disabled individuals to gather the documentation of medical evidence they will need to prove their disability. On the other hand, a virtual doctor visit for LTD benefits may make it harder for a physician to assess the true severity of an individual’s condition.
Telehealth Impact on Long-Term Disability Applications
This potential gap between patient symptoms and provider perception can be especially significant when it comes to the independent medical examination (IME). Most long-term disability insurance companies will require an IME as part of their review process prior to approving a claim. Many may not accept virtual doctor visits for LTD benefits approval in any case, but even if your LTD provider does allow a telehealth option, you may want to think twice before using that method if you are presented with a choice.
Long-Term Disability Benefits Telehealth Appointments
Consider carefully whether a physician who does not know you and how you respond to pain, fatigue, and other challenges will be able to develop an accurate impression of your condition and the impact your symptoms have on your daily activities, just from seeing you on a screen that may be no larger than a typical digital tablet. In the event that you feel you are being pushed toward virtual doctor visits for LTD benefits approval when a face-to-face examination might better convey the true nature and severity of your condition, be prepared to advocate strongly on your own behalf and do not hesitate to seek professional legal support.
What Does Long-Term Disability Not Cover?
Many individuals getting approved for the first time have questions about what is covered under their long-term disability insurance policies. For a majority of people who have LTD insurance, the disability policy has been part of a larger employee benefits package. These packages will almost always have included health insurance, and since short-term disability insurance (STD) is slightly more common than LTD, many will have included coverage for short-term injury or illness, as well. In addition, most LTD policies require anyone filing a claim for benefits to also submit their application for Social Security Disability Insurance (SSDI). SSDI is like LTD in that it does not cover anything more than partial income replacement, but individuals going through the SSDI application process are often also evaluated for their potential eligibility for other programs that may offer other types of coverage. Meanwhile, anyone who files a long-term disability claim due to a work-related injury or illness will more than likely be receiving workers’ compensation benefits, which at a minimum are designed to cover the costs of any medical care needed as a result of the work-related injury.
Long-term disability benefits are like SSDI in that they do not offer any form of coverage beyond a partial replacement of the individual’s income. They are unlike SSDI in that the amount of income they replace is calculated as a percentage of the recipient’s pre-disability income specified in the terms of the policy. Often this percentage may be similar to, or a little greater than, the amount replaced by workers’ compensation disability benefits, particularly under an employer-sponsored plan. However, LTD is available regardless of whether an individual’s disability is caused by a work-related activity or incident. The important thing to know, for people trying to manage LTD benefits and telehealth services, is that a long-term disability policy may have specific requirements about the types of documentation the company will accept as medical evidence; to have your claim covered, you will need to meet the medical documentation requirements of the specific policy. When it comes to your personal healthcare and medical visits not directly related to your claim, however, coverage for any telehealth services will generally be determined by your health insurance policy, not by your long-term disability insurance provider.
Long-Term Disability Benefits: Telehealth Challenges and Advantages
Virtual doctor visits for LTD claims can often ease the application process for exhausted and overwhelmed long-term disability claimants. At the same time, navigating LTD benefits and telehealth services is not always easy, especially during sensitive, high-stakes periods such as the initial application and any periodic renewals. The telehealth impact on long-term disability claims is still taking shape, and will likely continue to evolve as technology changes and as the people who use it adapt to take advantage of its possibilities. Long-term disability benefits’ telehealth challenges and opportunities alike depend for the moment on an individual’s level of access, both to physical spaces and to internet-enabled services, and on the documentation requirements set by their long-term disability policy. Reviewing those terms with a disability attorney or other experienced advocate for disability rights may help you to clarify any potential risks and identify strategies for making your own life easier.
