Your insurance company should accept the recommendation of your treating physician. However, your choice of doctor can affect the success of your long-term disability benefits application. You should ensure that you are receiving treatment from an appropriate doctor who has the credentials to treat your medical condition. For example, if you have a specific medical condition that could be treated by a specialist, you should get treatment from a specialist rather than a general practitioner or family doctor.
You also should take care not to exaggerate or minimize your medical condition and symptoms. Insurance companies who are considering your application for long-term disability benefits will be skeptical and question your symptoms and their severity. You should be as consistent and credible as possible in describing your symptoms and limitations, as doctors are often not thinking of their medical records being reviewed for disability determination, rather to quickly document the appointment for future reference. You should not exaggerate your symptoms to have a better chance of getting benefits, but you also should not minimize your symptoms. Although you may be uncomfortable, you need to completely, accurately, and extensively explain the nature, duration, and frequency of your symptoms resulting from your illness or injury. Fight the urge to downplay your symptoms.
While the insurance company often is supposed to gather medical records on your behalf, you should not rely on them to do the work for you. Otherwise, the insurance company may end up making a decision on the incomplete records that they have, rather than your full medical records. You should ensure that the insurance company has received the documents that you submit. You can do this by sending the records by fax and getting a fax confirmation or sending them by certified mail and requesting a return receipt.
Bonnici Law Group has handled the claims of countless individuals who have encountered difficulties in procuring long-term disability benefits under their employers’ ERISA-governed insurance policies. We will protect your rights and advocate on your behalf throughout every stage of the claims process. Call our office at 619-259-5199 to set up an appointment to speak with us today.