The specific type of medical evidence that you need to substantiate a long-term disability claim will vary somewhat according to the nature of your disabling condition. However, there are some general guidelines that you can follow in order to ensure that the medical evidence that you provide to your insurance company will be sufficient to support a successful claim for benefits.

First, you will need to show your claims administrator that you have been receiving consistent treatment for your disabling conditions from a doctor or other healthcare provider who is properly qualified to treat your conditions. Evidence of your treatment may include:

·         X-ray, MRI, and CT reports

·         Bloodwork test results

·         Medical records pertaining to each office visit

·         Medication records

·         Statements from your treating medical providers about your diagnosis and prognosis

Insurers often have forms for medical providers to complete and return. However, they may not ask for a great amount of detailed information. You are always free to submit additional information to your insurance company about your condition in the form of medical records or physician statements and new medical information as you undergo testing, therapy, or other forms of treatment.

Next, you also should ensure that your medical records and/or physician statements are clear about the limitations and restrictions that your disabling conditions place on you, as well as the side effects of any treatment that you are undergoing or medications you’re taking. The claims administrator should compare your limitations and side effects of any treatment with your job duties, based on your level of education, training, and experience.

Finally, you should be aware that insurance companies often conduct their own investigation into your claim, which can include scouring your social media accounts, video footage, and other types of surveillance. Any activity that you post or engage in on a regular basis should be consistent with the level of restrictions or limitations that you are claiming. Otherwise, the insurance company may use this information as proof that you are not telling the truth about the extent of your disabling conditions.

ERISA long-term disability claims are complex matters that require intensive knowledge of ERISA law and how those laws affect long-term disability insurance policies. As a result, you will need experienced legal representation and advice to pursue an ERISA-governed disability claim. Bonnici Law Group is a law firm focusing on ERISA long-term disability benefits and bicycle injury cases in San Diego, CA. When you need effective legal representation, contact Bonnici Law Group at 858-261-5454 or email us at help@bonnicilawgroup.com.