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Improving Your LTD Application’s Chances for Success
Long-term disability (LTD) benefits can provide crucial financial support to disabled people whose medical conditions prevent them from working. Generally offering between 60-70% of a recipient’s regular wages, LTD benefits are either available through an employer’s group insurance plan or another privately held insurance policy.
In order to receive LTD benefits, claimants are required to go through an application process that often feels complicated and confusing. Insurance companies do not always make it easy for policyholders to recover the benefits to which they should be entitled. And any errors made throughout the claims process can have unintentional impacts on an application’s success.
It is not uncommon for claimants to make mistakes while completing their applications for LTD benefits. Although avoiding these common errors will not necessarily guarantee that a disabled person’s benefits claim will be approved, implementing some best practices when submitting an application could improve the claim’s chances for success.
Our Ontario long-term disability lawyers have helped numerous clients get the coverage they deserve from insurance providers that have unfairly disputed or denied their claims. We have experience with the tactics often used by insurers, and suggestions for best practices that could help reduce your claim’s odds of being denied.
If you have sustained a debilitating injury or developed a chronic physical or mental health condition that makes it impossible for you to continue working and you have access to the appropriate level of insurance coverage, you may be considering submitting an application for LTD benefits. When doing so, it might benefit you to take the following pieces of advice into consideration:
Be Honest
Although it might be tempting to exaggerate the impacts of your medical condition on your ability to work and carry out routine tasks, being dishonest about the reality of your situation on your LTD benefits application can be more harmful than helpful. Being less than truthful on an application can damage your credibility, which can negatively impact your ability to recover the benefits you actually deserve.
Insurers typically investigate the LTD benefits claim submitted to them. Based on their findings, insurance providers may challenge a claimant’s truthfulness. If the insurer can reasonably call an applicant’s credibility into question, they may have reasonable cause to deny their claim altogether. Being caught in a lie can also impact the viability of any claims for additional insurance coverage that may be necessary in the future.
Therefore, it is most advisable to be honest and straightforward about your injuries or illness by neither exaggerating nor downplaying their effects on your life and your ability to continue performing the duties of your job.
Connect the Dots
After being diagnosed with a disabling medical condition or injury, some claimants may think that simply informing their insurance provider of their diagnosis will be enough to secure LTD benefits. However, this information alone is rarely sufficient for an insurer’s approval of a long-term disability claim.
It is important to illustrate to your insurance provider how the symptoms of your disabling medical condition prevent you from carrying out the tasks associated with your job. Claimants who draw clear connections between their diagnoses and the practical, disabling impacts of their medical conditions on their daily lives have better chances of receiving an approval. Providing insurers with statements from employers, coworkers, colleagues, friends, and family members who can vouch for your claim could be beneficial, as could evidence from medical experts proving how your condition would adversely affect your ability to function regularly in the workplace.
Follow Doctors’ Orders
People applying for LTD benefits usually have to prove to their insurance company that, in addition to requiring ongoing medical attention and care, they have been complying with the treatment plan created by their attending physicians. By following doctors’ orders, seeking out recommended treatments and therapies, taking prescribed medications, and complying with all aspects of a recovery plan, claimants can illustrate that they have been proactively seeking resolutions to their medical issues and are not simply looking for a way to get out of work.
Furthermore, showing your insurance provider that your medical condition is persisting even while following doctors’ orders to the letter can help prove the ongoing severity of your injury or illness. Proving this fact can make it more difficult for insurers to justify a denial of your claim.
Understand Your Policy’s Terms
Each insurance policy is unique. Even policies within the same employer’s group plan may have distinctions, variations, and different eligibility criteria for disabled workers seeking LTD benefits. That is why, before beginning your application for LTD benefits, it is important to understand what coverage should be available to you.
In most cases, an insurance plan’s definition of disability changes after two-years of providing LTD benefits to an eligible policyholder. Whereas most plans require an applicant to prove that their disabling condition prevents them from performing their own occupation for the first two years of coverage, after that time has elapsed, the plans typically apply stricter eligibility criteria. After two years, most LTD benefits recipients must be able to prove that their disability prevents them from performing any occupation in order to continue receiving monthly benefits payments.
If you are confused by the terms and conditions of your insurance policy, consider scheduling a free initial consultation with an Ontario long-term disability lawyer who may be able to help explain the coverage to which you should be entitled.
Avoid Social Media Use
It can be tempting to use popular social media platforms like Facebook, Instagram, Twitter, and Tiktok to discuss your medical issues and share personal sentiments about your experience with disability. Sustaining severe injuries or receiving a diagnosis for a disabling medical condition can be an isolating experience, and social media can provide a platform for people to share their stories with a wider audience of friends and members of the general public.
However, anything you post on social media can be taken out of context and used against you by insurance investigators. What might seem like a harmless update about your general mood, your feelings, or your recovery progress could be purposefully misconstrued in order to justify your claim’s denial. You could lose access to crucial, life-saving LTD benefits because of a seemingly innocent photo, video, or status update. No matter how secure you believe your privacy settings to be, by posting about your disability or your benefits claim online, you could derail your chances of receiving the coverage you deserve.
That is why it is always advisable to avoid using social media to discuss your personal matters while applying for or receiving LTD benefits. If the temptation to share information about your medical journey online is too great, consider pausing your use of social media platforms while your application is under review or deactivating your social media accounts altogether.
Contact Preszler Injury Lawyers for Legal Advice
Applying for LTD benefits can be a confusing, overly complicated, bureaucratic process. If you need help completing your claim, consider booking a free initial consultation with our long-term disability lawyers serving Ontario today.
To discuss your situation and receive case-specific feedback about how to improve your LTD application’s chances for success, contact us today and receive your cost-free, no-obligation initial consultation.
