Applying for disability benefits can be stressful. You’re
sick and unable to work. You’re not sure about your financial future. You have
forms to fill out, doctors to see, and decisions to be made. But being careful
and thorough when filling out your application for disability benefits can
prevent further hassle down the road because it improves your chances of being
approved right away, and avoiding a lengthy and time-consuming appeal.
Here
are some helpful hints for filling out an application for short or long-term
disability benefits. If you are still denied disability benefits after your
application, we recommend speaking to an attorney experienced with appealing
disability denials before appealing the decision to insure you know all your
rights regarding administrative appeals.
#1. List all your health conditions
Many
people list only the one condition they feel disables them, forgetting the four
or five other health issues they have that all interact to create the full
picture of their health and abilities. It is important to list all your
conditions so the insurance company will have all the information necessary to
make its decision.
If
your disability is primarily physical, do not forget to list any psychological
issues you have such as depression or anxiety in your application as well. The
same goes for if your condition is primarily mental; do not forget to list your
physical issues as well.
Do
not forget conditions such as: chronic pain, cognitive issues (problems with memory,
not thinking clearly, or thought processing), physical or mental fatigue,
migraines or chronic headaches, and other issues you may consider peripheral to
your main health concern. The co-morbid effects of how these conditions
interact and affect each other must be considered by the insurer.
#2. Provide All Relevant Medical
Records
Remember you
are ultimately responsible to prove that you meet the definition of disabled in
the policy and are therefore eligible for benefits, so you must make sure the
insurer gets all the relevant medical records. When we as attorneys help
claimants apply for benefits, we generally attach all relevant medical records
to the application – we do not wait to see what the insurer will ask the
claimant to provide. Insurers tend to request far fewer records than we provide.
The insurer will request them from fewer doctors and for a shorter span of
time. But it is not the insurer’s responsibility to get this information. So be
proactive and make sure all medical records relevant to your health conditions
are in the insurer’s hands when it reviews your claim.
#3. You Can Add Supplemental Pages
A
disability application is usually only one or two pages long – not nearly
enough space to adequately explain a disabled worker’s numerous conditions,
symptoms, and why he or she cannot work. Do not feel constrained by this lack
of space. Simply write “See supplemental pages” in the form, and attach a
type-written page fully and thoroughly answering the question asked.
#4. Explain Your Symptoms,
Restrictions, and Limitations
While
it is important to list your diagnosed conditions, generally the insurer is
most interested in what symptoms you actually experience, and how they prevent
you from working. List all your symptoms, how severe they are, and how
frequently you experience them. Then explain what specific functions you cannot
perform at work because of these symptoms. Compare these two examples:
1. I
have severe migraines and my doctor says I cannot work.
2. I
have continuous migraines that have not stopped for three months. The pain
fluctuates – 4 days a week the pain is a 6 on a scale of 10, and 3 days a week
the pain is an 8 or 9 on a scale of 10. When the pain is above a 7, I am unable
to leave my room. I turn all the lights off, pull the shades, and lay in the
dark unable to sleep because of the pain. I am unable to leave my room, much
less go to work and perform my duties. Also, see my neurologist’s statement
supporting this application.
The second explanation
explains how bad the pain is, how frequently it occurs, and why it keeps the
claimant from working.
#5 What Your Doctor Needs to Say
What
your doctor says is key to whether you will receive benefits. It is important
for your doctor to describe the frequency and severity of your symptoms, any
measurement she or he has done of your symptoms and limitations, and list
specifically what you cannot do and why. Compare the following:
1. Betty
can no longer work due to her chronic pain.
2. I
have been treating Betty for 10 years, and her chronic hip and back pain has
gotten progressively worse. We have treated her with X, Y, and Z treatments
which have not helped. According to the testing we have done in my office,
Betty is unable to sit for more than 1 hour without being in extreme pain. She
may then shift from sitting to standing, which helps for a short time. In a 12
hour period, she cannot sit for longer than 3 hours maximum.
This second example
gives more detailed descriptions of what activity Betty has difficulty doing
(sitting) and what her restrictions/limitations are for that activity (1 hour
at a time, 3 hours maximum in one day.)
If you have questions about how to gather
necessary information, how to answer specific questions, or need help filling
out the application, we have experience with the long and short-term disability
application process and would be happy to speak to you. Contact the Law Office of Katherine L. MacKinnon to find out if we can help.
