What is the number one thing the long-term disability insurance company doesn’t want you to know about your claim?
You’re not going to believe it — The one thing the insurance company doesn’t want you to know about your long-term disability claim is that your medical records are not enough to prove your disability. Let me say that again. Simply presenting your medical records is not enough to prove your long-term disability.
In almost all of the cases that I see. I see people who do exactly what the insurance companies say. They say, “Get me your medical records. Give me a list of your health care providers. And we’ll get all the medical records.” And they get all the medical records, and they review all the medical records.
What Happens Next
Guess what happens next? It’s not enough. What the insurance company says is, “There is not enough to substantiate your disability in this case.” So what do they do? They deny your disability claim, but what else are you supposed to do? You did everything that they told you to do. You gave them all your health care providers, you provided all your medical records. What else are you supposed to do?
In my experience, what I tell people to do is to make sure that your doctor understands what you’re doing or why he or she needs to document certain things. You see, doctors are not creating medical records for the purpose of proving your long-term disability claim. They’re not creating the medical record for the purpose of proving your social security disability claim. They’re creating medical records for the purpose of reminding themselves later on down the road, why they did a certain thing. So they highlight certain things that justify medical decisions that they make, but they don’t do other things. They may not document some other things, even though that might be important to your long-term disability claim.
What Can You Do Now?
So what do you do now? You know that simply submitting your medical records to the insurance company is not going to be enough to win your long-term disability claim. What do you do? Let me tell you. You go to your doctor and you ask for a narrative report. Now, you may have to pay extra for this. This is not just getting your medical records and turning them over to the insurance company.
That does not require any of your doctor’s time, but what does require your doctor’s time is for him or her to sit down, review all of your medical records and write an opinion saying, “This is the reason why she cannot work in her own occupation anymore. This is the reason why she cannot work in any occupation anymore. These are all of the symptoms that I observed. There is no objective testing for this particular condition, or there is objective testing for this condition. This is the result of the objective testing, proving that my patient has X, Y, and Z.” And that is what wins the day on a long-term disability appeal.
Now that is not necessarily always going to win the appeal, but your chances of succeeding. You’re at the claim process when you’re initially claiming long-term disability, your chances of succeeding go up dramatically. At that point, once you’ve sat down with your doctor, you’ve got a medical narrative detailing why you can’t do your job anymore, and then you’ll be in a much better position to win your long-term disability claim and an appeal if you get to that point than if you just submit the medical record.
So let me be clear about this. I think the insurance companies do you a disservice because I think they lie to you. I think what they do is they say, “Oh, well, we just need these medical records in order to approve your claim.” It sounds innocuous enough, right? It sounds fair that they need medical records to approve the claim. Sure, that’s a true statement, but it’s an incomplete statement. It’s a lie of omission. They are omitting the fact that the medical records almost invariably are not enough to award your long-term disability claim.
So make sure that you follow my advice. Go to your doctor, talk about what the standard is, talk about why you need him or her to do this narrative report. Get the narrative report done, and then present that to the insurance company, in addition to your medical records. That is what is going to give you the best chance of succeeding long-term.
Hope this video has been helpful. If you have any questions about getting a medical narrative, what the medical narrative should say, or what doctor should give you the medical narrative, give me a call or send me an email. Happy to help.