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Most disability insurance policies require claimants to complete an Activities of Daily Living (ADL) form when applying for long-term disability benefits. ADL forms offer a tangible way to demonstrate the extent of limitations caused by a disability. When completed correctly, they clearly show how a condition impacts a person’s day-to-day life and functionality. By accurately documenting the challenges faced in performing these activities, claimants provide valuable information to support their disability claim. Insurance companies use this information to evaluate the severity of the disability and determine eligibility for long-term disability benefits.
Completing an Activities of Daily Living Form
Begin by carefully reading the instructions provided with the ADL form to understand the requirements and guidelines for completion. Many ADL forms offer instructions for when you need more space, such as using the other side or including a separate sheet to record your answers.
ADL forms are usually broken up into multiple parts. The first few sections will gather general information about you, your education and training, work history, medical treatment, and any other income or benefits you receive.
Ensuring that all sections of the form are accurately filled out is crucial to avoid delays in the review process. However, the most critical section of the form is the one that asks about your daily living activities.
ADLs refer to the routine activities that individuals typically perform on a daily basis without requiring assistance. These activities are essential for maintaining one’s personal well-being and overall independence. ADLs include basic tasks such as:
- Personal Hygiene: Bathing, grooming, brushing teeth, toileting, and dressing oneself.
- Mobility: Walking, transferring from one position to another (such as from bed to chair), and using assistive devices like canes or walkers if necessary.
- Eating: The ability to feed oneself independently, including coordinating utensils and chewing and swallowing food safely.
- Continence: The ability to control bladder and bowel functions.
- Maintaining a Clean and Safe Environment: Performing light household chores and keeping living spaces tidy and hazard-free.
- Other Essential Functions: Financial and medication management, food preparation, and shopping.
Collect relevant details about your daily routines, challenges faced due to your disabilities, and the assistance required for different activities. Evaluating your ability to perform these activities accurately on the ADL form is critical for demonstrating the impact of your disability on daily living.
Tips for Completing Your Activities of Daily Living Form
Activities of daily living forms may seem straightforward, but they hold the power to either support or jeopardize your claim. Addressing the intricate details of an ADL form can be overwhelming, but with the proper guidance, you can navigate this aspect of your claim effectively.
Be Consistent and Establish Credibility
Consistency is vital when filling out an ADL form. Your information should align with your medical records and statements made to healthcare providers. Any discrepancies can raise red flags and undermine the credibility of your claim.
For example, if you cannot work due to limited mobility but claim to spend hours each day caring for your young child, that may raise a red flag. Ensure you provide honest and detailed information about your functional limitations without understating or overstating your abilities.
Provide a Thorough Explanation
When filling out the ADL form, it is essential to provide thorough explanations for each activity. Clearly describe how your disability affects your ability to perform daily tasks such as bathing, dressing, or preparing meals.
When describing your abilities or limitations, offer specific examples or scenarios to illustrate your daily struggles accurately, such as:
- The challenges you face,
- If you need to modify tasks, or if there are tasks you can no longer complete,
- How long it takes you to complete tasks,
- If any assistance is required, and
- If the task exacerbates your condition.
By providing comprehensive information, you can paint a clear picture for the insurance company of the impact of your disability on your daily life. For example, let’s consider how to answer a question about housework. Household cleaning tasks may not directly relate to your occupation, but they still play a crucial role in the overall assessment of your functionality.
Instead of saying, “I have difficulty completing housework, and it makes my condition worse. My spouse completes most cleaning tasks.” say:
“I do not sweep, mop, or vacuum as it aggravates my back and neck pain to bend over, even if only slightly. I can only load the top rack of the dishwasher because the lower rack requires me to bend over. My spouse will wash and dry our clothes, bring me the dry clothes, and then fold them while I sit on the couch. Folding laundry usually takes me 15 to 20 minutes, and then I can carry small amounts of clothes to our dresser and closet. I help with dishes 2-3 times a week and help with laundry once a week.”
Tell Your Story
The activities of daily living form is a snapshot of your daily life and the challenges you face due to your disability. When filling out an ADL form, don’t shy away from detailing the full extent of your disability’s impact on your daily life. Be descriptive and specific in illustrating how your condition hinders your ability to perform essential tasks.
RELATED POST: Why It’s Important To Tell Your Story To The Long-Term Disability Insurance Company
Highlighting the real-life implications of your disability can evoke empathy and understanding from those reviewing your claim, strengthening your case. For example, let’s consider how to answer whether you do your grocery shopping.
You could keep it brief, simply stating that you can only go on short trips and rely on a spouse or delivery service. However, it would be much more beneficial to your claim if you use this as an opportunity to paint a picture for the person reviewing your claim. A better response would be:
“My spouse also takes care of our shopping. I may go along to get out of the house if we only need to pick up a few things, but since I cannot walk for more than 20 minutes before I need to lie down, I can only go on quick trips. After we get home, I must lie down again for at least an hour, sometimes even longer. Even if I were only out for about 15 minutes, I’d be hurting badly the next day. I do most activities in short bursts, and I frequently must stop and rest, usually for an hour at a time.”
This more detailed response highlights the impact of your condition on routine tasks, showcasing the need for assistance or adaptation in performing basic activities. By accurately portraying your daily struggles, you create a compelling narrative that reinforces the validity of your disability claim.
What Happens After I Submit My Completed Activities of Daily Living Form?
After you submit your completed activities of daily living form, the insurance company will review the information provided. They may contact you for additional information to assess your claim thoroughly. Once the review is complete, the insurance company will decide your claim based on the information gathered.
Handling Requests for Additional Information
Insurance companies or claims administrators may request further details or clarification regarding your daily living activities, which can prolong the evaluation process and add to the complexity of your claim. Be prepared to provide any additional documentation or information they may request to support your claim. Communication with the insurance company throughout this process is essential to address any further inquiries promptly. Be proactive in following up on the status of your claim to ensure a timely resolution.
Responding to New Information
In some cases, the insurer may seek input from other experts by requesting a medical file review, a vocational assessment, or an independent medical exam. It’s important to understand that these experts work on behalf of the insurance company, aiming to protect their interests. Claimants should be aware of this dynamic when navigating the claims process and be prepared to advocate for themselves effectively.
In ERISA LTD claims, you have the right to review and respond to new information developed while your claim is being evaluated. It’s crucial to stay informed and actively participate in the process. If you receive updated information related to your claim, make sure to assess it carefully. Being proactive in addressing any new developments can significantly impact the outcome of your claim. Take the opportunity to provide your perspective and relevant insights promptly.
Appealing a Denied Claim
If your long-term disability claim is denied, you have the right to appeal the decision. Understanding the reasons for the denial, gathering additional evidence to support your claim, and effectively communicating your case are crucial steps in appealing a denied claim. This process can be challenging and may require legal assistance to navigate the complex appeals process.
Disability insurance attorney Nick Ortiz is the founder of the Ortiz Law Firm. Since 2005, he has dedicated his practice to helping individuals denied the disability benefits they deserve. He offers a free case review for claimants facing a disability claim denial and a zero fee guarantee to each client. You only pay a fee if there is a recovery, and he represents claimants nationwide.
For a free case review and assistance with your disability claim, you can call us at (888) 321-8131. Professional help is just a call away.