Are you suffering from multiple disabling conditions? You may think that if you are suffering from a set of combined ailments, your long-term disability claim should get approved even faster than if you only suffered from one ailment. But in fact, the opposite is true. When claimants file a long-term disability claim for multiple disabilities, the insurance company will use certain tactics to try to prove that they can still work, but there are ways to combat this problem.
Insurance Company Tricks and Tactics When You Have Multiple Disabilities
When you are suffering from multiple disabling conditions, the insurance company will take your medical file and break it down into pieces before sending it to medical experts for review. This ensures that the medical experts only see a small piece of the puzzle. With only the information provided, the medical expert must determine whether or not a claimant can work based solely on that information. The insurance company hopes a medical expert will determine that you can work because they do not see your overall health picture. They will take these findings from medical “experts” and use them as strong evidence against you.
Here is an example:
Mark was diagnosed with myasthenia gravis, which is a progressive neuromuscular autoimmune disease that causes debilitating muscle weakness. Most people with the disease will need to rest often because too much moving around weakens the muscles and can lead to a dangerous fall. He is currently receiving autoimmune therapy treatments, which weaken his immune system. During his most recent visit, he was also diagnosed with rheumatoid arthritis.
The insurance company ordered independent file reviews to be conducted by two experts, a rheumatologist and a neuromuscular specialist. However, the insurance company only provided each expert with a portion of the claim file. Although his combined symptoms make it impossible for Mark to work, the insurance company hopes that the reviewing physicians will determine that Mark can work based on the limited information available.
Should the medical experts ask for more information on the claimant before deciding? Of course. However, these medical experts are paid by an insurance company interested in seeing your claim denied. It is no surprise that a hired physician would not take this extra step
These practices were supposed to stop with the passing of the new ERISA regulations in 2018; however, some insurance companies continue to use in-house doctors to examine claimants while appealing the new regulations.
Working with a Long-Term Disability Attorney
Claims for multiple disabling conditions may be treated unfairly by the long-term disability insurance company. If the insurance company chooses to ignore your medical experts in favor of their medical experts, they must state that in the denial letter.
An experienced long-term disability attorney knows you are a person, not a medical file that can be split into pieces, and can help you dispute the findings of medical experts hired by the insurance carrier during the appeal process. Furthermore, they can help you stay on top of your deadlines, help you gather your documents, and give you guidance that will help you get your claim approved. The appeal process is critical to the success of your claim, so consider consulting a long-term disability attorney very early on.
Our law experts will focus on your case so you can focus on your illness. At Ortiz Law Firm, we only get paid if you win your case, so you can seek help without worrying about upfront costs or unexpected bills. We offer a free case review with no obligation to use our firm. During the call, you can ask any questions you have regarding your claim, and we will answer them. To see how we can help you win your long-term disability case, call us at (888) 321- 8131.
