Being denied long-term disability benefits can be a devastating setback, especially if you’re dealing with a serious health condition or injury. Thankfully, if you’ve been denied, you can challenge the decision. An appeal is your chance to present additional evidence or clarify existing evidence to support your claim. Let’s explore the types of evidence needed to appeal a long-term disability denial.
The most critical component of your appeal will be comprehensive medical evidence that substantiates your disability claim:
- Medical Records: Obtain all records from your doctors, specialists, hospitals, and other healthcare providers. These records should include clinical notes, test results, MRI reports, X-rays, surgical records, and other relevant documentation.
- Doctor’s Statement: Secure detailed statements from your treating physicians that specifically outline the nature of your condition, its impact on your ability to perform work, any work-related restrictions, and your prognosis.
- Functional Capacity Evaluation (FCE): This evaluation is a series of tests conducted by a healthcare professional that assesses your ability to perform work-related tasks. It can be crucial in demonstrating the limitations imposed by your disability.
Personal Statements and Witness Testimonials
Personal accounts can bolster your appeal by offering a more comprehensive picture of your day-to-day struggles:
- Your Statement: Describe in detail how your disability affects your daily life, your ability to perform tasks, and any pain or challenges you experience.
- Witness Testimonials: These can come from family members, friends, coworkers, or anyone who can attest to the challenges your disability presents.
Vocational expert Reports
A vocational expert can evaluate your work history, skills, education, and physical and mental limitations to determine your ability to work. Their report can be vital in demonstrating that your disability prevents you from engaging in gainful employment.
Detailed Job Description
Sometimes, disability denials stem from a misunderstanding or misrepresentation of your job duties:
- Provide a comprehensive job description emphasizing your tasks, physical demands, and other pertinent details:
Evidence of Treatment Compliance
Insurers may argue that you’re not doing enough to improve your condition:
- Show proof of attending regular medical appointments.
- Document any prescribed treatments, therapies, or interventions you’ve undergone.
Video or Photographic Evidence
While not always necessary, visual evidence can sometimes help depict the severity of your condition or the challenges you face in your daily life.
Clarifications on Previous Evidence
Sometimes denials occur due to misunderstandings or overlooked evidence:
- Go through the denial letter point-by-point, addressing each reason given for the denial. Offer clarifications or additional evidence as needed.
Although not a form of evidence, consulting with an attorney who specializes in disability claims can be invaluable. At Bonnici Law Group, we can help you gather evidence, ensure all necessary documentation is included, and navigate the complex appeal process.
Talk with Bonnici Law Group Today
Remember, your appeal aims to present a clear, compelling case that your disability genuinely prevents you from working. By gathering robust evidence and presenting it effectively, you can greatly increase your chances of overturning a denial and securing the benefits you need and deserve. If your first appeal doesn’t succeed, don’t get disheartened. You may have further levels of appeal available, including litigation in federal court. Bonnici Law Group is here to provide guidance specific to your situation. Our priority is getting you the benefits you deserve. Call us at (619) 259-5199, or click here for a free consultation.