What Role Does Your Doctor Play in a Long-Term Disability Claim?

If you’re filing for long-term disability (LTD) benefits, your doctor’s role makes a big difference in your claim outcome. Insurance companies don’t just take your word for it—they rely heavily on medical documentation and your physician’s opinion.

Without strong doctor support for LTD claim efforts, your application could be delayed or denied. Here’s what you need to know about your doctor’s role in an LTD claim and how to get them involved.

Why Doctor Support Is Essential for Long-Term Disability Claims

LTD insurance providers require objective proof of your condition. While your personal statement is important, it’s not enough. Insurance companies place a lot of weight on forms and letters submitted by your doctor.

Strong treating physician support gives your claim credibility and structure. It helps insurers understand how your medical condition affects your ability to work.

Your long-term disability medical records should include notes from appointments, test results, and a clear diagnosis. That isn’t all the insurance company wants to see, however. They also want a direct opinion from your healthcare provider stating that your condition is disabling, how your condition limits daily activities, and whether you can still work in any capacity. If your doctor only sends chart notes and lab results, your application might appear incomplete.

What Your Doctor Should Provide for a Strong LTD Claim

So, what should your doctor provide for a strong LTD claim? First, you’ll need a detailed Attending Physician Statement (APS). The APS is a common form that insurers send to your doctor. It includes questions about your diagnosis, treatment, and how your condition impacts your function. A vague or incomplete attending physician statement for LTD can hurt your case.

Make sure your doctor describes all of your symptoms clearly and states any specific work-related restrictions. They should also note whether your condition is expected to improve.

You’ll also need a Residual Functional Capacity (RFC) assessment. An RFC form for long-term disability measures your physical and mental ability to work. It asks your doctor to evaluate your ability to sit, stand, walk, lift or carry weight, and your ability to concentrate, remember things, and manage stress.

Insurers use this to compare your capacity with your job duties. A supportive RFC form can make or break your claim.

Finally, your doctor should write a statement for your disability claim. This letter should explain your condition, your prognosis, and why you’re unable to work. Note that the language your doctor uses matters. A simple, strong sentence like “In my medical opinion, the patient is unable to maintain full-time employment” is very persuasive.

How to Talk to Your Doctor About Supporting Your Disability Claim

Talking to your doctor about your disability claim is often new territory for most people. Here’s how to handle it:

Be Honest About Your Limitations

Many people try to appear stronger than they feel in front of doctors. This can backfire when applying for disability benefits. Your doctor needs an accurate picture of your symptoms. Be open about:

• How your condition impacts your daily routine
• Side effects from medication
• Pain levels or cognitive issues

Doctors can’t support your claim if they don’t fully understand your struggles.

Schedule a Focused Appointment

Don’t bring up your LTD claim at the end of a regular visit. Instead, schedule a separate appointment specifically to talk about your disability certification by a physician. Bring copies of any forms your insurer provided. Ask your doctor to go through them with you and clarify anything that seems confusing. This gives your doctor time to offer thoughtful, detailed answers.

Know What to Say—and What to Avoid

Finally, you might feel uncomfortable when asking your doctor for support. That’s normal. However, your physician’s role is to treat and advocate for your health. Try saying:

• “I’m applying for disability benefits because I can’t work full-time.”
• “The insurance company needs your input on my limitations.”
• “Can we go over this insurance disability form together so I don’t miss anything important?”

Avoid pressuring your doctor or asking them to “just sign it.” Most doctors want to help—but only if they believe your condition truly limits your ability to work.

Professional Support for Your LTD Claim

The doctor-patient relationship is central to any long-term disability claim, but getting the right documentation can be tough when you’re not sure what you need. Unfortunately, without clear, consistent medical evidence for LTD approval, insurers often deny legitimate claims.

Contact Capitan Law by calling (267) 419-7888, and let us help you navigate the disability claim process.