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Understanding the Start of the Disability Claims Process

Tucker Disability Law | September 22, 2023

Filing for disability can be exhausting, especially when you’re already dealing with the challenges of a medical condition. It’s what the insurance companies want. They hope you’ll give up. We’ve put together information about how the disability claims process begins and what you can expect along the way.

1. Work Status and Filing for Disability: Should I Quit My Job Before Filing?

If you have disability coverage through your employer’s policy (an ERISA plan), quitting your job is generally not advisable before filing for disability. Quitting your job can lead to losing your coverage.

However, there’s a difference between not working due to a medical condition (e.g., on sick leave) and quitting your job. In the latter case, it’s crucial to understand the implications for your coverage.

If you have an individual disability insurance policy, the decision to quit working may not impact your application. However, it’s essential to consider your specific circumstances.

If you need help deciding when to leave your job or stay. Book a Free call with us. We’ll help you make the right decision for your situation.

2. Preparing to File a Claim: When Should I Consider Filing for Disability?

Who Should You Contact:
When you believe that filing for disability is your best mental and physical option, the typical path involves contacting your employer’s HR department.

Each HR department may handle filing for benefits differently. They may provide a phone number to call. Or give you a website for you to complete an online form. Or a brochure provided by the insurance company.

However, some individuals may bypass HR and contact the insurance company directly, especially if they are already aware of the process.

You will contact the insurance company directly if you have your own policy. Your policy should have instructions.

Book a Free call with us if you need help reviewing the how-to file process. We’ll help you make the right decision for your situation.

3. Submitting a Disability Claim: What Happens When You Submit a Claim?

Once you submit a disability claim, it typically goes through a claims department at the insurance company. Initially, you may receive a phone call from a representative who gathers essential information about your case before a Disability Analyst or adjuster is assigned.

Who Manages the Claim?
The Disability Analyst assigned reviews your claim request/reviews your medical records and other data provided in your claim application.

Claim Approval or Denial:
If your claim meets the Disability Analyst criteria, they’ll move your claim to the next phase. If not, they’ll reject the claim. In most cases, you’ll get notified by mail of their opinion.

Proving What You Say is True
Provide to the Disability Analyst that you physically or mentally can no longer work. One of the best ways is our Capabilities Journal. Use it to journal every day what you are unable to do and how you feel. Are you in pain? Click here to get our Capability Journal now.

4. Claimant Resources and Deadlines:

Instructions and Documentation:

Once you submit a claim, the insurance company usually sends you an application package with detailed instructions on what to do next.

Acknowledgment of Application:
You can expect the insurance company to usually acknowledge the receipt of your claim application within 1 to 10 days.

Examination Requirements:
On the other hand, most claim denials don’t really involve tests by insurance company doctors. It’s really important for you to be getting regular medical treatment to establish your disability, but you generally won’t need any special examinations.

Claim Deadlines:
When it comes to disability insurance, there are two important deadlines you should know about:

  1. Notice of Claim: This is the timeframe when you need to apply for disability benefits, usually within 30 days from the day you’re unable to work anymore (when your disability starts).
  2. Proof of Loss: You typically have 60 to 90 days to provide supporting evidence of your disability to strengthen your claim.

Navigating the process of filing for disability can get complex, but understanding the key steps and deadlines can really help you out. Make sure to check your specific disability policy and reach out to your employer’s HR department or the insurance company for guidance. With the right information and support, you can increase your chances of having a successful disability claim.

Book a Free call with us if you need help reviewing the how-to file process. We’ll help you make the right decision for your situation.

At Tucker Disability Law we don’t settle for less. Neither should you.

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