Posted on Friday, July 1st, 2022 at 6:48 pm
When it’s time to prepare your disability application, you will need to compile documentation that proves both your disability and your eligibility for benefits. There are multiple different types of evidence you should submit, covering both the medical nature of your disability and how it affects your professional life. This post will cover the best ways to document your disabling condition, so you have a better chance of securing the benefits you deserve.
The evidence-gathering process is much easier if you have an experienced legal team on your side. At Capitan Law, our attorneys and staff focus on disability insurance law and support clients across the United States. We can help you understand your rights in the disability system and defend you against unfairly denied claims.
Know What Constitutes a “Disability”
When it’s time to claim the benefits you’ve paid for, look carefully at your insurance policy. You may have an “own occupation” insurance policy or an “any occupation” insurance policy. An “own occupation” policy is meant to compensate you when you cannot perform the functions of your specific job. A concert pianist or a surgeon might purchase an “own occupation” policy. An “any occupation” policy is meant to compensate you when you cannot work in any capacity whatsoever.
Although it can be difficult to prove that you are unable to perform the tasks of any job, it can be even more challenging to prove that you cannot perform the tasks of your particular job. It could be even harder to make sure the insurance company understands that you cannot just perform a similar line of work, such as teaching piano for a concert pianist or practicing general medicine for a surgeon.
Even if you have private long-term disability (LTD) insurance through your employer, you should know what the Social Security Administration (SSA) considers to be a qualifying disability for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits. The success of a private LTD claim and an SSDI or SSI claim are often linked together. Many LTD insurers require that you apply for SSDI while you’re getting LTD benefits.
The simplest way to determine whether you have a “qualifying disability” is to examine the SSA Blue Book Part III, also called the “Listing of Impairments.” This list details each condition that the SSA has determined could make someone unable to work. If your condition is listed in the Blue Book, you may have to meet specific medical criteria to obtain SSDI or SSI benefits.
Any condition that does not appear in the Listing of Impairments will be considered on a case-by-case basis.
What Documentation Should You Use?
Because your LTD carrier might require you to file for SSDI, it is wise to factor in the documentation required by the SSA for disability determinations. You’ll gather as much documentation as possible to show:
- The medical nature of your disability
- How your disability currently prevents you from working
- How your disability affects your ability to work in the future
This proof will commonly take the form of any of the below documents:
- Medical records – Your doctors’ medical records are the best form of medical evidence to prove your disabling condition. These records should detail the specific nature of your condition and include documentation from your doctor about your long-term prognosis. Your medical records should also include documentation from every specialist you have seen because of your condition, any hospitals you’ve attended for testing or care, and any medical providers who provided care during surgery or therapy. Obtain copies of the list of prescriptions you’ve purchased from your pharmacy.
- Consultative examinations – Either your doctor or another physician (depending on the circumstances) could be called upon to perform specific exams and lab tests relating to your condition for purposes of proving the extent of your disabling condition. You will need the doctor’s report and any test results from this examination.
- Job description – Particularly for an “own occupation” policy, you will need thorough documentation of the tasks you perform in your job. The more specific and detailed you can make the job description, the better your chances of getting the insurer to understand whether you can perform your job or not.
Sometimes, the Social Security Administration or your private insurer will ask for additional information to support your claim. You should get your long term disability lawyer to review the request and help you supply the appropriate documentation.
Contact a Long Term Disability Insurance Lawyer Today
If you’re applying for long term disability benefits or need help with an appeal, the long term disability attorneys of Capitan Law are ready to fight for you. No matter where you are in the US, you can seek the answers you need in a free initial consultation with our attorneys. Don’t hesitate to call us today at (267) 419-7888 and put us to work for you.