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The Do's & Don'ts of Filing for Disability Claim

09/30/2016

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Getting What You Deserve

What happens when you are stuck with a debilitating illness or a life altering injury that leaves you unable to work? Of course, you want to focus on your health and getting better, but making ends meet when you are unable to work can be quite the challenge. Filing a disability claim is the natural decision for such an unfortunate turn of events, but even that can be overwhelmingly frustrating — especially when the system is so complex. What follows below are some “do’s” and “don’ts” of filing for disability. With these tips in mind, you’ll have a better chance of qualifying for disability, and the process won’t be so confusing.

DO’S:

  1. Obtain All Medical Records: The necessity of accurate medical records is crucial and can make or break your case. Give your insurance provider the names of all your medical providers, treatment dates, and medical history. Completely and accurately fill out all necessary forms, which includes information about your employment and medical history. Adding copies of your records with your disability application is always a good idea.
  2. Get a Detailed Medical Source Statement: Ensure that the statement your treating physician supplies provides a detailed description of your current condition and how your restrictions and limitations both physically and mentally prevent you from working. If you haven’t been with your current doctor for very long, it’s a good idea to get additional statements from previous physicians that you have worked with longer. These statements will help your insurance provider confirm the reasons why you can no longer work, and prove that, while you are currently getting treatment, your recovery process won’t have a quick turn-around. 
  3. Follow Your Prescribed Treatment: Be sure that you are receiving treatment for all conditions and following all directions. Your insurance provider will see your combined medical conditions when making their decisions, so if you can’t work because of several conditions, then you need to seek treatment for all of them (not just a major one). If the insurance company sees that you aren’t following your treatment, they could deny disability claim on the grounds that you would be able to work if you followed treatment as you should. 
  4. Know the Difference Between “Own Occupation” and “Any Occupation” on Your Policy: When filing for disability, be sure to look over your policy and see whether you qualify for “any occupation” or “own occupation.” “Any occupation” requires that you are unable to work in any occupation for which you are suited based on age, education, status in life, income, and experience. “Own occupation” only covers you if you are no longer able to perform the “substantial and material” duties of your chosen occupation — meaning you may still be able to collect disability even if you are able to work in another occupation.
  5. Consult an Experienced Disability Expert: This is always a good idea. Applying for disability is tricky, and there is a good chance your carrier will look for any opportunity to deny your claim. Disability experts can educate you on common reasons people are denied disability and how to avoid them. Be sure to consult with one early to confirm you are applying correctly and have everything necessary. If your claim is denied, the expert is already familiar with your case and can be ready to challenge the denial of your disability claim. Please contact your LBMC EP Representative as we have a disability expert. 

DON’TS:

  1. Do Not Miss Site Visits, Doctor’s Appointments, or Filing Deadlines: One of the important aspects of filing for disability is meeting your deadlines. Failing to turn in your application or other requested documents could result in your claim being withdrawn or denied. Likewise, missing interviews with your insurance carrier could result in the same. Again, your carrier will look for opportunities to deny your claim, so meeting deadlines and showing up for interviews is essential to your disability claim being approved. 
  2. Do Not Lie: This should go without saying. Insurance providers are experts on uncovering the truth. If you did lie about anything on your application, expect your claim to be denied. Your insurance company will investigate everything. They will send their own doctors to evaluate you, they will inspect your house, and they will speak to all your physicians. You should also be sure to not over-exaggerate anything, as this can also be considered a lie with enough proof. 
  3. Do Not Use Words like “Never” or “Always:” You should refrain from using words such as “never” and “always.” The reason being that if any evidence is found that you actually can perform a certain activity or you didn’t take your medication that you “always” take, your claim can be denied.
  4. Do Not Post Anything on Social Media: When filing for disability, avoid posting anything about it on social media. Even the most innocent posts and pictures can be taken the wrong way. If you say that you can only get out of bed for a few hours a day, but the insurance company sees a recent picture of you out with your friends, they could deny your claim — even if it was only one day out of the week, and you spent the rest of the week in bed. Just to be safe, if you are unsure about anything, don’t post it. 
  5. If Your Claim is Denied, Do Not Give Up: If you haven’t hired a disability attorney yet, now would be the time to do it. There’s a chance your claim was wrongfully denied, and if so, your attorney will know the right actions to take.

Knowing your disability rights and knowing who to call to get disability, whether it be through the state or a private insurer are also important things to consider for your disability claim. Knowing these key things will also help ensure that you get the disability that you deserve. Here are some good websites where you can learn all you need to know about your rights and qualifications for disability: 

Applying for disability can be complex and confusing. However, if you follow these do’s and don’ts outlined in this blog, the process should be less stressful. The experts at LBMC EP are well-versed in disability claims and are eager to make sure you get what you deserve. If you are unsure about anything or need help filing a disability claim, please don’t hesitate to contact us. We also work with FEDlogic, a value add to LBMC Employment Partners' PEO, for disability claim support. Contact FEDlogic's Frank Cardenas at 615-830-4630.

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