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Is It Hard To Get Approved For Long Term Disability Insurance? - YouTube
Channel: Dell Disability Law
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hi i'm greg dell with attorneys down
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shaffer and i'm here with attorney cesar
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gavidia and today's
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disability question is is it hard to get
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approved for
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long-term disability insurance
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and caesar this is a question that you
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know we get a lot not just from people
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that call us but from people that we
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see on the you know people we come into
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contact all the time when they say hey
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what do you do and you say i'm a
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disability insurance attorney and they
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go oh i have that
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is it hard to get approved and what's
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your
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what i mean so many things must be going
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through your mind when you hear that
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yeah i mean it's it's a general question
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it's
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it's relative right so if you're someone
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with
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you know stage four cancer god forbid
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then and and you follow disability claim
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because you're
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terminally ill and you can't function
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and you can't go to you can't go to your
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doctor's appointments you have to get
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transported there or something then
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clearly it's not going to be difficult
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for that person to be approved but for
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the average person
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for
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someone who's going to be potentially
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you know having the nuances of their
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occupational duties
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and the details of their specific
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limitations and they have doctors that
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maybe they're not sure is going are
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going to support their disability claim
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or not sure what they should say
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for them to you know
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be approved for their disability claim
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that person may encounter some
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challenges sure
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and um
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in in terms of when we say get approved
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what are other factors in terms of the
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type of policy that a person has that
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could make it more or less difficult to
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get approved
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well i i just think
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when you're you're thinking in different
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types of
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policies one of the things that
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is is really critical is the definition
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of disability right what if if you have
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a disability policy that ensures you for
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disability in your own occupation
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versus a disability standard of being
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able to work in any game full occupation
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then
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just by the definition of disability
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you're going to have a much harder time
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getting approved from disability from
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any gainful occupation than you would
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from disability in your own occupation
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right possibly and i also think one of
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the big things in terms of the type of
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policy you have is whether you have a
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policy that's governed by erisa which is
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usually an employer-provided policy or
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if you're the type of individual that
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bought a policy on your own
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from a disability
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insurance company through the use of an
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agent and you know that's a complete
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situation where you get what you pay for
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because the disability private policies
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usually 10 times the cost per dollar for
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every dollar coverage versus the
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employer provided one
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because the policy definitions are and
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the language is so different and
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one's governed by erisa the employer
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provided one and the other one isn't
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which gives you rights to jury trials
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right innately just by being having
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being an employee benefit policy one
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governed by erisa
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there's going to be huge advantages to
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the insurance company so just by their
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very nature they're going to be much
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it's going to be much more challenging
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to be approved on an employee benefit
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erisa disability claim than it would be
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on an individual disability policy and
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you know and then the other thing about
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is it hard to get disability benefits
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approved is well
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have you seen a doctor
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what's the status of your medical
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treatment touch just briefly why is
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medical treatment so important in a
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disability claim well just from the very
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onset they're disability insurance
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companies and it's because it's a legal
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standard in many places that if a doctor
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does not if you have not seen a doctor
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in and around the time that you stop
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working and what i mean by in and around
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the time within
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a week or two of stopping work and that
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doctor is not saying you need to stop
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working you can no longer continue to
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function uh you know in your occupation
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then
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you're like you know that the insurance
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company could very well challenge your
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claim and say you're not entitled to
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benefits so just from from the very
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onset without that support there without
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having
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seen that doctor within that time frame
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you may not get approved just for that
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reason and then
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you know going forward it's not just
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about establishing that moment that you
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stop working it's about establishing
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every month thereafter because every
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month you have a duty to continue
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proving your disability and to ensure
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that your doctors continue supporting it
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because at any point that that fails to
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happen the insurance company is going to
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deny your claim but does the claimant
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have to keep going to the doctor
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continuously absolutely there's
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appropriate care provisions in these
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disability policies
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now
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sometimes you'll see language that says
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if we deem or if we find and we is the
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insurance company that uh ongoing
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treatment is no longer of a benefit to
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you or you no longer need to continue
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seeing your doctor then we won't require
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it but i often explain to clients and
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into people that it's a trap okay
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because what's happening even though
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perhaps it's being established you don't
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have to you know how long have to see
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your doctor we're not going to require
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as many frequent visits to your doctor
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what you're doing is actually you're
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working against your own claim you're
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working against yourself because the
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documentation is not going to be there
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the recorded history of your complaints
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of your symptoms of your ongoing
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problems of your ongoing limitations is
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not going to be there and you're just
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setting yourself up to be denied so i
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always counsel people continue seeing
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your doctor even if you don't have if
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the insurance company is only asking for
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an update every six months every you
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know every year continue seeing them by
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month every two months or every three
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months at don't let more time than that
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pass by so cesar i think the simple
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answer to can is it difficult to get
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disability benefits paid is to you got
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to be prepared
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and you got to make sure that you have
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appropriate doctor support that you have
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the backing of employers or co-workers
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to have a difficulty i mean you got to
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have a real issue that prevents you from
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being able to either do the duties of
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your occupation if that's what the
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definition of disability is which is
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usually what it is the first two years
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of any policy
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and then possibly unable to do the
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duties of any gainful occupation but it
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is not going to be like the process when
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you bought your policy and you just went
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ahead and applied for coverage and they
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go okay send us your tax returns you're
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approved it's a whole other animal
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caesar we've done tons of videos in
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terms of how to apply
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what to do if you've been denied
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tips for applying for benefits how to
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get supportive doc i mean so many videos
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which
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you know leads me to suggest to people
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watching this video that we encourage
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you to subscribe to our youtube channel
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where you can watch all these other
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videos and and more more important than
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that is that call us call cesar myself
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any of our lawyers for a free initial
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consultation let us review your
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disability policy let we want to let you
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know
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what's at stake in your claim and how we
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can help you no matter what stage you're
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at our offices
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are we're available to represent you
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anywhere in the country
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and we welcome the opportunity to speak
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with you to discuss your claim
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you
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