Employees in Chicago covered by long-term disability insurance under an employer’s policy often wonder about timing of events in a disability claim. They ask if they claim disability first and seek support from a doctor afterwards, or ask their doctor for support before making the claim. I have seen it both ways, and your particular relationship with your doctor and length of the relationship usually determines how early you have that discussion. But there are a number of good reasons to raise the topic before you make the long-term disability claim.
A good reason to talk to your doctor before claiming disability is to alert the doctor what to expect after you make the claim. The insurer will ask you to send in medical records very quickly and ask for forms completed by at least one of your doctors. If your doctor knows what to expect, you can schedule an appointment near the time you stop working and bring the doctor the necessary forms. Doctors cannot always complete paperwork the day they receive it. The less your doctor feels burdened, the more likely the doctor is to be supportive.
By talking to your doctor before you make a disability claim, you can take the doctor’s temperature on whether the doctor will be supportive or not. Some doctors simply are adverse to doing any more then producing medical records (as they are legally required to do so). Some have this attitude because they simply dislike being involved with your insurer. They went to medical school to treat patients, not advocate for disability. Understandably, some may not be as receptive to you needing forms completed in the future as others.
By talking to your doctors before claiming disability, your doctor’s opinion may be less likely to change based on an insurer’s doctors’ insistence. An insured recently learned how costly a treating doctor’s wavering opinions can be. In Parrish v. Aetna Life Insurance Co., No. 1:17-cv-4837, 2021 WL 1565440 (E.D.N.Y. Apr. 21, 2021), Parrish suffered from severe cervical and lumbar spine degeneration and radiculopathies that could support any person being disabled from even sedentary work. But during the claim review, Aetna’s medical consultants were able to get one of the doctors to change an opinion, which he later changed back after speaking with Plaintiff’s counsel. After Aetna denied the claim and Parrish sued under ERISA § 502(a), the court determined the uncertainty of the opinion, coupled with Aetna’s consultants concluding Plaintiff was not disabled, was sufficient to uphold Aetna’s denial under a deferential standard of review. Here’s a good read on what the standard of review means if your case goes to court.
If you have a denied long-term disability claim, see what an experienced long-term disability lawyer can do to help our claim today.