SHORT TERM/LONG TERM DISABILITY


Disability claims are made to an insurance company or other entity (not social security claims) when a person is disabled as defined by the insurance policy. The claims process is:

  1. Read the disability policy to determine the definition of disability;
  2. Note whether the person’s medical records meet the definition of disability;
  3. Work with the treating physician to put together an evidence package that proves the person’s disability;
  4. Submit the evidence package to the appropriate person in charge of the claim;
  5. If the claim is denied, determine from the person in charge of the claim the reason(s) for the denial;
  6. If the claim has been wrongfully denied, file suit in a federal district court.

Here is the most important thing to remember:

The trial of a claim takes place on the desk of a claim handler. All evidence proving disability must pass over the top of that desk. Generally, the district court will not admit or consider evidence that has not been submitted to the claim handler. So, the evidence package must be as complete as possible when sent to the claim handler. Only after the best evidence package has been given to the claim handler and the handler has wrongfully denied the claim, do you file suit.

Once again, it’s the evidence that counts!