Do you have any disability insurance claim filing tips if I want to go it alone?

Obtaining long term disability benefits is not a simple task.  Estimates indicate that approximately 70% of disability claims are denied.  In addition, those that are approved stand a good chance of being denied down the road.  

For those individuals who would like to apply for long term disability benefits without legal representation, below are some tips to follow:

  • 1. Read your entire disability insurance policy, from cover to cover. Understand all clauses, restrictions, limitations, terms and conditions.
  • 2. Know if your disability policy is an individual policy or employer group plan (ERISA).
  • 3. Organize and gather all medical records, including lab tests, physician reports and opinions supporting your disability claims.
  • 4. Know and understand why your disability prevents you from doing your job or any other job.
  • 5. Promptly file your disability claim. Fill out the disability application completely and truthfully. Add additional sheets if necessary. Follow all insurance company requests.
  • 6. Be prepared to file all supporting evidence initially, not later as an amendment.
  • 7. Know that you may be placed under secret video surveillance.
  • 8. Follow up after applying. Follow up your telephone communications with a written letter. Keep detailed communication records, including person spoken to, date, time, matter discussed, and conclusion of conversation.
  • 9. If your claim is denied, know and understand your appeal rights, including important timeframes and deadlines.
  • 10. Know your insurance company's or employer group plan administrator's deadlines.

The Law Firm of J.P. Gonzalez-Sirgo, P.A. represents individuals that have had their valid long term disability benefits denied, delayed or terminated irrespective of whether the policy was purchased individually or issued through an employer group policy.  The firm is available to assist individuals with the initial application process, during the administrative appeals process, handling denials of claims or termination of benefits, litigation in state or federal court, and negotiating a one-time lump sum settlement or buy-out.  Please contact our office to discuss your case in more detail.