Dealing with the Insurance Carrier: Your Medical Records and Your Long Term Disability Claim
When you apply for Long Term Disability Benefits, your Long Term Disability carrier will ask for your medical records. However, the Long Term Disability carrier will not tell you what medical records are the most important in your disability claim. There are three types of medical records each of which can result in a denial of your Long Term Disability claim, or an approval.
1. Chart Notes
When you go to see your physician, a nurse or assistant will take information regarding your complaints, symptoms, medications and perhaps the difficulty of how you are functioning.
Chart notes are important because Long Term Disability carriers will first determine whether or not they can deny your disability claim on the basis that your condition is a preexisting condition excluded by the terms of your Long Term Disability policy.
A Long Term Disability adjuster will look to see whether or not you have received treatment for the disabling condition, during the pre-existing exclusionary period. If so, chart notes will be used to deny your claim for Long Term Disability benefits.
Chart notes can also be used to establish when your disability began and your diagnosis. Picking the right date of disability can be crucial and the Long Term Disability carrier will compare the chart notes with your disability application to determine whether or not your date of disability is consistent with the chart notes.
2. Narrative Notes
Narrative Notes are those written by your doctor and generally include information about your appearance, any changes since your last appointment, any changes in your medication, examination findings and the doctor’s comments regarding your diagnosis and prognosis.
The narrative chart notes are crucial to your disability claim because it will show how your condition may have worsened over a period of time. Unfortunately, most doctors do not write chart notes for the disability insurance companies and it is up to you to make sure that the narrative notes reflect accurately your complaints, difficulties in functioning and any changes that you have experienced between visits.
Some Long Term Disability benefits applicants think it is best to get a narrative letter drafted by your doctor addressed to a Long Term Disability carrier confirming that you are disabled and unable to work. Unfortunately, that letter is not worth the paper that it is written on.
What is important is to have your doctor accurately complete the Residual Functional Capacity questionnaires that the Long Term Disability carrier requires.
3. Residual Functional Capacity Forms
I have written extensively about the completion of Activities of Daily Living forms and their role in your Long Term Disability claim. I believe it is important that your doctor have your Activity of Daily Living forms to assist them in completing a Residual Functional Capacity questionnaire.
Unfortunately, there is no uniform functional capacity form and they do take a lot of time to complete. More often then not a nurse and not your doctor will complete these forms.
These forms will ask questions about how much you can lift, how often, how far, whether you need to sit or lie down, whether you are likely to miss work.
The doctor will fill out the forms circling the appropriate response and write notes clarifying their responses.
It is important that your doctor understands how to answer these questions properly. If your doctor writes that you can lift a lot, stand or sit for long periods of time and work in sedentary position, the Long Term Disability carrier will take the position that you are not disabled.
If your doctor does not understand how to fill out Residual Functional Capacity forms you should consider hiring a disability lawyer such as Nancy Cavey to educate your physician as to how to complete these forms.
If your doctor does not consider you to be disabled, you should strongly consider changing physicians.
It is important for you to be treated by a physician who is not only competent and qualified to treat your disabling condition, but is also willing to assist you with your disability claim.
If you have questions about medical records for your Long Term Disability claim, how your physician should complete a functional capacity form, ask Nancy Cavey, your Long Term Disability denied lawyer. You may feel overwhelmed in completing Activity Daily Living forms or dealing with your physician. A Long Term Disability attorney may be your best option, since they know what to ask the doctors and can educate them about how to accurately complete Residual Functional Capacity forms that will greatly increase your chances of success.