How Can I Get My Doctor's Help With My Group (ERISA) Long Term Disability Case

 

In every long term disability claim you will have to submit both medical records and an "attending physician statement" from one or more of your health care providers.

You might not even know that this is going on because most often the disability insurance company is sending the forms directly to the doctor.

Doctors, trained in medicine but not disability claims, often carelessly fill out the forms or write "support" letters that are of no help at all.

Here's a model for a doctor's narrative. A narrative letter (which may cost you some money) is generally better than the form the insurance company send them.

A narrative should include the following:

  1. Diagnosis
  2. Scientific back up for the accuracy of the diagnosis
  3. Number of years that doctor has know you
  4. The definition of disability in your policy (each poilicy is different and, depending on how long you have been disabled, the definition can change within the policy)
  5. A listing of your occupational duties (if you are still in the "own occupation" period in your claim
  6. A listing of your "restrictions" and "limitations" (explaining what you can and can't do)
  7. A rationale for listing these specific "restrictions" and "limitations" in your case (and it usually has to be more than you self-reporting that you can't do things

Yes, this is a lot more work for the doctor but it is far better than having him fill out one of those silly forms that says how much you can lift!

One last thing. Get your doctor a copy of my book, Robbery Without a Gun, Why Your Employer's Long-Term Disability Policy May be a Sham.

 

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