Dealing With a Long Term Disability Claims Adjuster
If you cannot work because of a serious injury or illness, the insurance company will assign an adjuster to review your long term disability claim.
The adjuster may ask for medical records, information about your job, incident reports, details about your injury or illness, and other documents they can use to evaluate your claim.
The adjuster works for the insurance company, not for you.
Their job is to review the claim and determine what the insurance company has to pay. That means they may also be looking for information they can use to limit or deny benefits.
Know What Your Long Term Disability Policy Requires
Start by reading your disability policy. It explains what conditions are covered, how long benefits may last, and what you have to prove to qualify.
For example, some policies look at whether you can still do your regular job. Others may eventually look at whether you can perform another type of work. How your policy defines disability can make a big difference in your claim.
If you are not sure what your policy requires, a long term disability lawyer can review it with you.
Keep Up With Your Medical Treatment
Your medical records are one of the biggest parts of your long term disability claim.
Continue getting the treatment you need and make sure your doctors understand how your condition affects your ability to work. Your records need to show more than a diagnosis. They also need to explain your symptoms, restrictions, and limitations.
Be Careful What You Say and Post
You do not need to panic every time the insurance adjuster contacts you, but you do want to be careful and consistent.
What you tell the adjuster should match what is documented in your medical records and claim paperwork.
The same goes for social media. Insurance companies may look at public posts, photos, and other activity when reviewing a disability claim. A post may not tell the full story about your condition, but the insurance company may still use it to question what you reported.
If Your Long Term Disability Claim Is Denied
If the insurance company denies your claim, read the denial letter carefully. It should explain why the claim was denied and what you need to do to appeal.
If your long term disability benefits are through your employer and your claim falls under ERISA, you may have only 180 days to appeal.
An appeal is also more involved than simply filling out another form. This may be your opportunity to submit additional medical records, information from your doctors, job information, and other evidence supporting your claim.
If you have questions about your long term disability claim or have received a denial letter, contact our team at Donahoe Kearney.
Contact Donahoe Kearney About Your LTD Claim
Related Resources
Do You Need a Lawyer for Long Term Disability?
What Should I Do If My Long Term Disability Claim Was Denied?