Applying for long-term disability benefits in California is not an easy process, but if you avoid these mistakes, you will have a better chance of getting approved.
When dealing with a significant injury or sickness, several matters become top priority, including your treatment plan, operations, recuperation, and the well-being of your family.
While it may not be your first priority, filing a long-term disability claim is vital as you begin the long road to recovery. However, when filing claims, making mistakes is common, which often makes the process even more complicated than it already is.
So, how do you avoid such mistakes?
This article lists four mistakes you need to avoid when filing long-term disability (LTD) claims in California and offers solutions to avoid them.
1. Failing to Understand Policy Terms and Conditions
The biggest error that people commit when applying for long-term disability insurance is not reviewing their LTD policy properly.
That said, LTD policies differ from one insurer to another, so the benefits that you stand to gain will depend on the details of your policy. So, neglecting the conditions written in the policy would lead to exclusion from benefits.
Here’s what you should do:
- Review Your Policy Carefully: It is important to carefully review your LTD policy before filing a claim. Some of the important parts that should be paid attention to are the “elimination period,” “total disability,” “partial disability,” and the duration of benefits.
- Contact Your Insurer: If there is anything that you do not understand in the policy, it is advisable that you consult your insurer to elaborate on the provisions for you.
- Hire Disability Lawyer: Even after reading the policy and contacting the insurer, if you are finding it challenging to understand policy terms, you must hire a California long term disability lawyer. Such lawyers help you thoroughly understand your policy terms and claim settlement.
How to Avoid This Mistake:
- Document your condition thoroughly: You should maintain a record of medical appointments, test results, and prescriptions.
- Communicate With Your Healthcare Providers: Ensure they comprehend the requirements for your LTD claim so that they can provide proper documentation of your condition.
2. Not Submitting Enough Medical Evidence
Medical detail is the most crucial component of any chronic disability claim. If the documents are not submitted, the insurance company refutes the disabled individual’s claim, citing a lack of proof that the member is not capable of working.
How to Avoid This Mistake:
- Gather Comprehensive Medical Records: Attach the medical records that reflect the diagnosis’s details, the treatment plan, and how such a condition will affect your capability to work.
- Ask For Specific Documentation: Ask your doctor to write a letter detailing how your disability affects your ability to do work. Ensure the report complies with the specific requirements contained in your LTD policy.
3. Missing Deadlines and Failing to Follow the Claims Process
The timing of filing a long-term disability case is very important. All LTD policies have time limits on when you can file a claim, submit your medical documentation, or appeal a denial.
Failure to meet these deadlines would result in forfeiting the benefits and, subsequently, having no finances to support you.
How to Avoid This Mistake:
- Know the Deadlines: Your policy should contain clear timelines for reporting a claim, providing support, and appealing the decision. Ensure that you are well acquainted with these deadlines and calendar them.
- Submit Your Claim as Early as Possible: If you are certain that you will not be able to work for a long time based on a disability, it is recommended to file the claim early. So, the sooner you take the steps, the earlier you can get the approvals and begin to enjoy the benefits that come with it.
- Follow Up Regularly: Once you have filed a claim, be sure to contact your insurance company frequently and check if they received all the necessary paperwork.
4. Returning to Work Too Soon
People with a disabling condition may feel compelled to return to their jobs as quickly as possible, which may be motivated by financial concerns or a desire to regain normalcy.
However, there are adverse effects on your LTD claim if you go back to work earlier.
Most LTD policies contain a provision where you must be unable to perform the duties of your employment for a certain period to be entitled to benefits.
If you try to go back to work before you are ready and then cannot perform your job, your insurance company could say your disability is not severe, and they may refuse to pay your benefits.
How to Avoid This Mistake:
- Wait Until You’re Ready: Resume work only after your doctor has given you the green light to return and when you are physically and mentally fit to handle the demands of your job.
- Communicate With Your Insurer: When thinking about going back to work, it is crucial to inform your insurer and inquire about how it will affect the benefits. Some policies provide ‘Partial Disability,’ which enables an individual to start working while at the same time receiving LTD benefits.
- Get Medical Clearance: When you are ready to return to work, obtain medical clearance from your healthcare provider and retain a copy of such clearance.
Conclusion
Applying for long-term disability benefits in California is not an easy process, but if you avoid the above mistakes, you will have a better chance of getting approved.
However, if you experience any difficulties while going through the mentioned steps, do not hesitate to consult with an attorney familiar with the peculiarities of the disability claims process.
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