When you have suffered an injury that prevents you from working, time is literally money. You need the disability insurance benefits you have applied for to come through soon. Unfortunately, the insurance company takes time to review each claim, and you could be waiting several months before you discover if your claim was approved or not. Why does it take this long?

The Insurance Company Will Do a Thorough Review

Calendar and ClockThe disability insurance carrier has medical, vocational, and financial teams that need to review all parts of your application. Their job is to determine if there is enough evidence to prove you have been injured, that the injury prevents you from performing your job duties, and how much money you should receive. Your specific policy likely has language regarding the time the carrier has to review your claim. In general, they will:

  • Request medical records. Your application will list the medical providers you have seen since your injury. The insurance company will contact each to get copies of your medical records. Their own medical staff will review the records and decide if the diagnosis and physical limitations placed on you are justified according to their standards.
  • Review your finances. To determine the value of your claim, the financial team will review your monthly income and decide how much your disability will affect your income.
  • Confirm your limitations. Vocational experts will review your training, education, job duties, and physical limitations to decide whether they agree that you are disabled.
  • Request more information. If you did not submit a complete application and the carrier wants more information from doctors or your employer, they will contact you. Anytime this happens, it delays the decision by several weeks at least.
  • Conduct interviews or investigations. You might be asked to submit to an interview to address concerns the adjuster has about your claim. The company might also send an investigator out to talk to coworkers and see if you are engaged in activities you have claimed you cannot do.
  • Approve or deny your claim. Once the information is gathered and reviewed by their experts, a claims committee will make a determination and inform you of the outcome.

Working with a long-term disability insurance attorney from the beginning of your claim will ensure that process goes as quickly as possible. Your attorney will make sure that your initial application is complete so the carrier need not request additional information. He will also field questions from the company to protect you from being trapped into saying something you shouldn’t. Finally, your attorney will advise you on the best ways to handle the possibility of a private investigator poking into your life.

Insurance Company Delay Tactics

Some insurance companies will do things to drag the process out if possible. Instead of requesting all the information they need at once, they might ask for documents one at a time. They might make it difficult for you to schedule an interview or fail to respond to your questions or emails promptly. They might also require you to have an independent medical exam or a functional capacity evaluation to gather their own information about your condition. If your initial claim is denied and you have to file an appeal, the process could take many more months.

Monast Law Office Will Light a Fire Under Your Claim

When you need to file a claim for employer-sponsored group LTD benefits, request a copy of my free book, How Insurance Companies Sabotage Disability Claims, and call my office in Upper Arlington to learn more about my expertise in handling these claims. With my help, the process will move along as quickly as possible. As a workers’ compensation attorney with over 35 years of experience, I know what it takes to build a strong disability claim, and I understand how the ERISA process works. Time isn't on your side with a denied LTD claim. Contact Monast Law Office to get off to the right start with your appeal.

 

James Monast
Connect with me
Fighting for Ohio’s Injured Workers and their Families