Anyone who applies for long-term disability insurance is required to prove that they are unable to work due to their conditions. Sometimes, when submitting a claim, the medical records and statements provided may not be sufficient. If your long-term disability benefits claim was denied, you have the right to appeal. However, it is a good idea to create an ironclad claim before submission to avoid the need to appeal completely. Here are our top tips for winning an LTD claim or appeal. 

Hire A Lawyer

Disability insurance is a complex field that can be difficult for even the most educated person to navigate. Working with an attorney who has experience with disability insurance policies and laws is the best way to effect a positive outcome. A lawyer will be able to help with your own occupation disability insurance and all occupation claims or appeals with equal finesse.

Make Sure You Have Objective Evidence

LTD claims that are submitted with strong objective medical evidence are more likely to be approved. An insurance provider will have a hard time denying objective advice from a reputable medical professional, even if they have their own doctor perform an evaluation. Gather clinical statements, lab tests, and the results of your functional capacity evaluations prior to submitting a claim or an appeal.

Get A Copy of Your Claim

If your claim has been denied and you plan to appeal, make sure you have a copy of your original claim. The claim file will have all communications between you and the insurance provider, copies of submitted forms and reports, and, the guidelines used to deny the claim. Knowing why your claim was denied will help you cure those problems upon appeal.

Prepare a Vocational Assessment

This assessment will provide thorough detail as to why your conditions prevent you from remaining gainfully employed. This assessment may include a list of duties and how your conditions prevent you from completing those duties. Depending on the policy type, the assessment will also determine if you are qualified to work in a different occupation while suffering from a disability.

Hire Your Own Experts

When filing a claim or an appeal for long-term disability benefits, assessments play a critical role. The insurance company will always have its own evaluators, but you have the right to hire your own. Have a reputable medical professional perform a functional capacity evaluation for consideration. Mental health is another important aspect to be assessed. You can also have a trained medical provider perform a neuropsychological evaluation for both cognitive and mental health changes.

Respond to the Denial

It is important to review the reasons your claim was denied and remedy those issues. The most common issues are a lack of medical evidence, poor or no treatment for the condition, and no evidence that there are severe symptoms. Being able to work with certain accommodations and actually having your condition improve are other common reasons for the denial. Respond to each denial reason provided to avoid facing an appeal denial.

Get The Benefits You Deserve

With the right planning and a savvy attorney, getting approval for LTD benefits will be a breeze. For those who are facing an appeal, working with a lawyer and following the suggestions above will put you on the path to success.

Author Bio: Heather Blacksmith has a Bachelor’s Degree in Finance and works at a finance firm based in Seattle, Washington. She specializes in small business finance, credit, law, and insurance. When she is not working, she spends her time in her favorite coffee shop writing on various finance-related topics. Other than that, she enjoys adult coloring books, recycling, and running.