Your long-term disability benefits are essential to your financial stability and peace of mind, but insurance companies often look for reasons to deny or terminate claims. Understanding these common traps—and how to avoid them—can help you protect your benefits and secure your future.
Trap # 1 Misleading Return-to-Work Dates
When your doctor provides an estimated return-to-work date, your long-term disability carrier may treat it as a definitive timeline, even if your condition hasn’t improved by that date. For instance, if your doctor writes that you “might” return to work in six weeks, insurers may take that as proof you’ll be fully recovered, even if it’s only a best-case scenario.
How to avoid this:
- Discuss your condition thoroughly with your doctor before they provide an estimate to the insurance company.
- Ask your doctor to clarify that the return-to-work date depends on significant medical improvement or successful treatment.
- If your condition hasn’t improved by the estimated date, ensure your doctor submits updated records to explain why a return to work isn’t possible yet.
Trap # 2 Evidence of Medical Improvement
Insurance companies scrutinize medical records for any signs of improvement, even minor ones, to argue that you can return to work. For example, a note in your medical records stating that a new medication helped reduce fatigue might be used to claim you no longer qualify for long-term disability benefits—ignoring the ongoing severity of your other symptoms.
How to avoid this:
- Ensure your doctor includes detailed notes about your overall condition, not just improvements.
- If one symptom improves, make sure the records also highlight any ongoing or worsening symptoms that still impact your ability to work.
- Document the full picture of your disability, including how your symptoms affect your daily activities.
Trap # 3 Non-Compliance with Treatment
Failing to follow your doctor’s treatment plan is a red flag for insurance companies. They might argue that you’re not doing everything possible to recover and use it as an excuse to deny your claim. For example, skipping physical therapy sessions—even for legitimate reasons—can work against you if it’s not properly documented.
How to avoid this:
- Follow your doctor’s recommendations as closely as possible.
- If you can’t comply with a treatment plan, have your doctor document the reason. This could include financial constraints, side effects, or a lack of improvement with the recommended therapy.
- Keep detailed records of all your treatments, appointments, and progress to demonstrate your commitment to recovery.
Trap # 4 Activities That Appear Inconsistent with Your Disability
Insurance companies often hire private investigators or monitor social media for evidence of activities that contradict your disability claim. For instance, attending a wedding or posting photos of a vacation—even if you were sitting or resting the entire time—can be misinterpreted as proof that you’re not truly disabled. You can read more about this in our article on protecting yourself against insurance surveillance.
How to avoid this:
- Be cautious about what you share on social media. Even innocent activities can be misrepresented by insurance companies.
- If you engage in an activity that appears strenuous, such as walking short distances or attending an event, make sure your medical records explain any limitations or aftereffects, like increased pain or fatigue.
- Assume your activities may be observed and ensure they align with the restrictions outlined by your doctor.
Trap # 5 Omitted Diagnoses or Symptoms
Missing key diagnoses or symptoms from your medical records can create an incomplete picture of your disability. For example, if your doctor forgets to include your chronic fatigue on a form, the insurance company may assume you no longer suffer from it and reduce or terminate your benefits.
How to avoid this:
- Review all medical forms and records submitted to the insurance company for accuracy and completeness.
- Ask your doctor to include all diagnoses, symptoms, and limitations—even those that seem minor—to provide a comprehensive view of your condition.
- If an omission has already occurred, ask your doctor to correct the records as soon as possible and submit updated forms to the insurance company.
How Tucker Disability Law Can Help
Understanding these common traps and taking proactive steps can help you avoid losing your long-term disability benefits. But even with the best preparation, insurance companies may still try to deny your claim.
If you’re facing challenges with your benefits, Tucker Disability Law can help. Our expert team specializes in protecting clients like you and ensuring you get the support you deserve.
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At Tucker Disability Law we don’t settle for less. Neither should you.
