Why Writing You Own Long-term Disability Appeal is like Goldilocks and the Three Bears

On a message board, we recently came across the following question:

“For Cigna ADL update, is it best to limit my dx and symptoms to the space provided or attach info?  last time, i limited it to the space provided. My friend was to help me write in my words and she typed 1.5 pp single spaced to attach. it is hard for me to correct her errors and i wonder if they want so much to read. will it look like i can work. typing this is hard. i can't see, I'm not coordinated, I'm in pain. i heard don't attach. the examiners don't want to look for info. i also heard tell every detail. I am TOO SICK to do it. i haven't had a shower in over a week trying to do this, cuz i have to cancel my aide and i am not scheduling things with drs. its due thurs.”

What the person is discussing is the fact that on all Activities of Daily Living Questionnaires (ADLs) and on all Attending Physician Statements (APSs), your insurer limits the space provided to answer. Often, instead of allowing you to answer, they provide multiple choice answers. Why do they do this? The long-term disability insurance company limits your answers because they don’t want you to tell them the whole story. They don’t want you to write about ALL your disabilities.They want you to give the shortest answer possible, so they can easily reject you. The person who posted to the message board indicates that “I heard don’t attach.” He or she was probably told by the insurer that they don’t want such detail. The disabled person has been misled and was about to walk right into a trap.

Here is how you avoid falling into this trap. Write EXHAUSTIVE answers. If they give you one line to describe your pain, attach a computer printout. Don’t let them limit your answers.

Here is the catch-22. If you provide too LITTLE information, they will kick you for failure to prove your disability or for lack of severity of that disability. If you provide too MUCH information, they will try to say that you are obviously not disabled if you can write so well or do so much work. There is, of course, a way around this.

Doesn't this sound a lot like the story of Goldilocks and the Three Bears? The insurance company is looking for something that is not too long and not too short - it should be "just right," but you have don't know exactly where that medium ground lies. That's why these long-term disability appeals can be so tricky.

How to protect yourself against this insurance company trick.We've seen the insurance company use great answers written by people trying to appeal their own case to say, “Look, this person can't be disabled if they can write such a thorough answer!” However, there is way that you can help yourself in this situation. Next to your signature line at the bottom, write the following:

Claimant Name: YOUR NAME

Prepared by: __________________

This indicates that you, the claimant, didn’t do all the work. It protects you from the dangers discussed above, and it takes two seconds to include it. In fact, we tell most of our clients to always include that line. Much of the time, our clients aren’t preparing their own documents anyway (that's one of the reasons you may want to consider hiring a long-term disability lawyer like us).

Be smart about your claim. Your insurer wants any reason to kick you, make it hard on them. Always include a “prepared by” line at the bottom. Don’t let the insurance company dictate your answers with childish spacing games.

Ben Glass
Ben Glass is a nationally recognized Virginia injury, medical malpractice, and long-term disability attorney