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Avoiding the "self-reporting" nightmare of a disability claim

1,200,100 Social Security benefit claims were filed in 1999 (48 percent or 579,000 were rejected). In 2009, ten years later, 2816,200 requests for social security disabilities were filed (65 percent or 1830,530 applications were rejected). The number of requests for disabilities has more than doubled, while the number of rejections has more than tripled. In one year, she lost more than $ 23 trillion in annual benefits.

In 2011, trillions of dollars in worth of claims from insurance, social security and veterans affairs will continue to be unnecessarily dismissed.

Disabled Americans who have been diagnosed with serious medical and psychological illnesses have begun to tackle the gravity of the physical, emotional and financial challenges they will face. This is the worst time imaginable to file a disability claim.

Insufficient preparation and submission of an insufficient claim for long-term disability (LTD) greatly increases the likelihood that your request will be rejected, especially when it is a claim of chronic fatigue or another “self-reported” disability (fibromyalgia, carbel tunnel).

Review your LTD policy. Do they provide aggregate benefit benefits only, or do they provide partial or residual benefits (long-term partial disability) so that you do not have to completely disrupt the collection of benefits? Hope it will be the last. What is the policy definition of partial disability? Are you indicating your inability to perform one or more daily physical duties from your profession and / or is there a reference to performing your profession duties in a reduced capacity?

For "self-reported" persons with disabilities, we would like to share some "advice" to improve your chances of collecting disability benefits.

Tip # 1: Our experience, over three decades of work and specialist in disability insurance business, has been that an incorrectly completed LTD claim form increases the chances of claim being rejected, even when full information is submitted to the insurance company after the initial claim has been submitted. Remember that you are applying for benefits to replace your lost salary. You will need to prepare your application for benefits with the same (or better) attention to detail as it does when applying for your job.

Tip # 2: You will need to have a focused conversation with your doctor about the specific ways in which you will need to collaborate while on the go with the limited claim process. You also notice: You must get fully positive cooperation from your doctor, as well as your agreement with you regarding your disability. Full documentation of your “self-reported” disability, supported by irrefutable evidence from the attending physician (treating physicians) (who are recognized experts and authorities in the treatment of your specific condition, is absolutely essential in the initial submission of your claim).

Tip # 3: Is your doctor treating a specialist (expert) in treating your specific condition? Very few are. If it is not him or her, be careful. Due to the specialized nature of the diagnosis, your insurance company expects your doctor to have experience treating your specific condition. The disability insurance company is looking for expertise in treating any disease, especially "self-reporting" cases. This, however, does not mean that you have to change doctors. Your primary care physician (PCP) may have already referred you to a specialist for diagnosis and primary treatment. In such a case, the PCP will likely follow your treatment path, with an accidental update with your specialist.

Tip # 4: What is your doctor's experience helping other patients with "self-reported" disabilities get disability benefits? Was it a big hit or a big difficulty? Your doctor must be your ally in the claims process, especially in order to start receiving benefits.

Tip # 5: What kind of test was used to confirm the diagnosis? When "self-reported" disabilities first began to be recognized as unique and difficult to diagnose diseases, much controversy surrounded various diagnostic methods. Senior researchers and physicians, the Centers for Disease Control and Prevention and the National Center for Infectious Diseases have developed various guidelines to assess your condition. (For more, we encourage you to do a web search and read "SSR 99-2P: Your guide to successful CFS claims.")

Summary

When reviewing many long-term disability claims that insurance companies have rejected, there is one overriding topic: the personal physician and / or other subsequent medical documents that have not supported or confirmed the extent of the disability. Prosecutors were expecting a specific result (to pay their claim) while the medical information accompanying their claim form did not establish the extent of the deficiency. In essence, the demands and the doctor only did not communicate properly. Bottom line … do it right the first time.

Copyright 2016

Alan Chikway, RHU

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