You’ve just been approved for long-term disability. Or maybe you’ve been receiving benefits for a while now and you wonder how often you need to see your doctor to keep your claim active. There’s definitely a correlation between keeping your long-term disability claim active and the number of your doctor visits.
Failure to keep regular doctor appointments and treatments can raise huge red flags with your insurance company. But how often is “regular”, and what do you do if your doctor doesn’t think you need to be seen as often as an insurance company requires?
How Insurance Companies Think
Every month, a claims adjuster from your insurance company reviews your file and submits a report to determine whether or not you get paid. These claim adjusters are always looking for reasons to deny or cut off your claim (that’s how the insurance company makes money), and it’s why you can never let your guard down.
For most clients, it’s important they see their doctor every 3 months to ensure their records are kept up to date.
Failure to keep regular doctor appointments and treatments can lead the insurance company to think the following things:
- You don’t see the doctor as often because you no longer need treatment.
- Your condition isn’t severe enough to see a doctor regularly, which means you can go back to work.
- You’re not keeping your appointments because you’re not interested in getting better and you just prefer to sit at home and collect payments.
- You’re “doctor-shopping”. Sometimes there are gaps in treatment because you’ve switched doctors. Many insurance companies will think this is because your original doctor no longer supports your disability status and you’re looking for a new doctor who will.
So what do you do if your doctor says he/she doesn’t need to see you as often as every 3 months? Or if you legitimately need to switch doctors because you’re dissatisfied with them or there’s a change in your insurance?
Tips to Keep Your Long-Term Disability Benefits
Being proactive is the best way to ensure your medical records are up to date. The following tips can help.
- If for whatever reason you’ve had to change providers, make sure the insurance company is aware. Explain to them why there may be a gap in treatment and that you’re doing everything you can to get back on a regular schedule.
- If your doctor tells you that treatment won’t help your condition and he/she decreases your treatment schedule–get a letter from your doctor explaining why frequent treatment is neither helpful or necessary in your case.
- Make sure you keep all your treatment appointments–even if they are not helping. Sometimes treatment can be painful, time-consuming, and expensive. It’s frustrating to not get the results you hope for, and it’s easy to think “what’s the point?” Unfortunately, if you give up on treatment, your insurance company may think that you aren’t going to treatment because you don’t need it anymore or because you don’t want to get better.
- Make sure your doctor is properly listing down ALL your complaints. Keeping a journal documenting your symptoms and how they keep you from working and doing everyday activities is critical to keeping your medical records up to date.
What Do I do if my Insurance Company wants an updated Evaluation?
Since insurance companies are constantly monitoring your medical records, it’s not unusual for them to request an update or even want an independent medical evaluation. This independent evaluation is usually done by a doctor paid for by the insurance company, and they may very well refuse to fill out your disability form. If this happens to you, what do you do?
Tucker Disability Law has put together a FREE guide you can download now HOW TO GET YOUR DOCTOR TO SIGN YOUR DISABILITY FORM full of up-to-date information, a Q&A section, and exclusive tips to get your doctor to sign your forms. Also included in our guide is a Capability Journal that will help you keep track of your systems, making it easier to communicate with your doctor.
We also offer a case supervision program to keep track of your disability claim so you don’t have to. For a modest monthly fee, we can take the burden of dealing with insurance company paperwork off your plate. To find out more about this, or any of our other services, fill out the contact information in the blue box to set up a call or an online chat.
Fighting the big insurance companies is what we do every day, and unlike some of those other firms, we don’t settle for pennies on the dollar.
At Tucker Disability Law, we don’t settle for less. Neither should you.
