Why Every Physician Seeking Disability Benefits Should Have an Attorney in the Disability Claims Process?
1. You need advice and assistance in completing your claims form and other insurance company requests. Accurately completing your application is the key to the successful claims process. This includes picking the right date of disability, making sure your disability condition is covered and is not excluded by a pre-existing clause, determining your pre-disability earnings. You should never complete anything, answer phone calls or written requests of the disability insurance company unless you have assistance. Each one of the contacts with the disability insurance company is an opportunity to destroy your claim.
2. Most medical professional believe they know how best to explain their personal medical condition. This unfortunately, is generally far from the truth. You need assistance to make sure that your claim forms are filled out correctly and that your disability is presented in a manner that is consistent with the law of your state so that you can receive your disability benefits on a continuing basis.
3. Long Term Disability carriers aren’t afraid to use independent medical evaluations, they are anything but independent. While you may have actually performed an independent medical evaluation in your practice, you’ve never been on the other side. You don’t know how to properly prepare for an independent medical evaluation or protections that can be put in place to ensure that your independent medical evaluation is video taped or other strategies that can be employed to combat carrier favored IME’s.
4. Long Term Disability carriers routinely deny Long Term Disability claims on the basis of a lack of objective evidence. Objective evidence is not exactly what you think it might be as a physician. Developing and establishing objective evidence of a diagnosis based on the terms of your disability policy is the key to defeating one of the first basis of Long Term Disability claims denials.
5. Long Term Disability claims are also denied on the basis that there is a lack of objective evidence supporting the diagnosis and that your claim is in fact, based on subjective symptoms or complaints. It’s important that you and your attorney work with your attending physician to establish not only an objective basis of a diagnosis but an objective basis of your disability. Many times Long Term Disability carriers use their own activities of daily living forms and your physicians records to argue that you are subjectively disabled. It’s crucial that your physician understand the definition of disability in your policy and what should be in your medical records to document the objective basis of the diagnosis and your disability.
6. If your Long Term Disability claim is denied, simply writing an appeal letter won’t get your benefits instituted. We obtain a copy of your Long Term Disability file and thoroughly review it to determine the basis of the denial.
We then develop with you and your treating physician a strategy for addressing each basis of the Long Term Disability claims denial. That includes developing any medical and vocational evidence to support your Long Term Disability claim.
7. Many times there are vocational issues in the denial of your Long Term Disability claim. Many times the Long Term Disability carrier may say that you are still capable of performing the material and substantial duties of your occupation or one or more of the essential functions of your job. It’s important that an accurate job description be prepared and that it be analyzed in the context of the Dictionary of Occupational Titles definition. Many times we use vocational rehabilitation counselors in the context of medical professional claims to establish why, from a vocational standpoint, that you can’t perform the essential and material duties of your job from a vocational standpoint. This is particularly important in dual occupation claims.
Hiring a disability attorney cannot only be affordable, but can make the difference between financial disaster or the receipt of your disability benefits.