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Question: I am a licensed psychiatrist with long-term disability insurance. Why is the insurance company making it so difficult to get my claim approved?
As a licensed psychiatrist, you are a specialist in both psychology and medicine. Your expertise will also earn you a higher salary. In 2019, the average salary for a psychiatrist was over $200,000, according to Zip Recruiter. A higher salary means a higher monthly benefit that the insurance company will have to pay if your claim is approved. In this article, we will discuss the following:
- Why it is so difficult to get a long-term disability claim approved as a psychiatrist;
- What information you will need to get your claim approved;
- Suggested ways to stay organized; and
- How to get a professional evaluation of your disability insurance claim.
Why Is It So Difficult to Get an LTD Claim Approved as a Psychiatrist?
One simple reason – money. Because the insurance company is looking at your case from a financial standpoint, they are looking at how much money it will cost them to provide you with benefits throughout your illness or disability. The longer it could potentially take you to get back to work, the less likely they are to approve your claim.
In addition to your regular salary, you may have a residual rider that helps you recover what you have lost during your disability period. If you own your psychiatric practice, you can expect that your current patients will need to seek care from another provider while you recover. When you return to work, you’ll need to work to replace the clients you’ve lost. This rider will help you offset the loss of these clients and help pay your bills while you rebuild your practice.
What Information Do I Need to Get My Claim Approved?
To get your claim approved, you will need evidence. Two types of evidence are critical: medical and financial. As a psychiatrist, you may or may not be familiar with completing long-term disability paperwork for your clients. In addition to medical evidence, you will need to provide your financial information. This is probably the most tedious process of filing an LTD claim: gathering all the documents that will support your claim will take time.
Gather Your Medical Evidence
You will need to provide evidence that you are under the care of a doctor for your condition. All medical documents from your physician regarding your condition, including but are not limited to your official medical file, lab reports, x-ray and MRI reports, physician notes, list of surgeries including surgical reports. Make sure your doctors note your pain and any mental conditions you are experiencing, such as depression. Sometimes doctors do not take notes when the patient expresses concerns about pain.
Gather Your Financial Information
As a psychiatrist, unless you work for a hospital, you probably have your own practice. You will need to provide financial information about your practice, especially any losses that may be incurred due to your absence.
Suggested Ways to Stay Organized
There is a lot of paperwork to keep track of when applying for long-term disability. Staying organized and saving all correspondence will help you if your claim is denied and you have to go to court. Create a folder or filing system for the following documents:
- A copy of your LTD policy;
- Copies of all letters from your insurance company and from you to the insurance company;
- Why you cannot perform your job duties (this will require medical documentation);
- A list of all medical providers that you have seen for this condition and a letter from each provider stating that your condition prevents you from working;
- Letters summarizing all conversations (by phone or in person) between you and the insurance company representatives, nurses, doctors, and your employer. Send copies to everyone involved in the communication by certified mail as proof of receipt; and
- Keep everything in chronological order so that if your claim is denied, you will have a complete record of how your claim was handled.
Representation by an Experienced Long-Term Disability Attorney
Psychiatrists will find it difficult to get a long-term disability claim approved. The insurance company will look for virtually any reason to deny the claim. By providing strong medical evidence, keeping a low profile, and not rushing back to work too soon, a psychiatrist can create a solid case for disability.
Using an experienced disability attorney will help you protect yourself from insurance investigators. The Ortiz Law Firm is based in Florida but represents claimants across the country. Get a free, no obligation case evaluation by calling (888) 321-8131 with no obligation. We can help you evaluate your claim to determine how to move forward with the process.
Request a Free Policy Evaluation
If you are considering purchasing a disability insurance policy or have recently purchased a policy, we can help you understand what you are entitled to and whether there are deficiencies in your coverage that could lead to a denied claim. It is easy for individual policyholders who are not trained to read insurance policies to misread or misunderstand the disability policy. As part of our evaluation, we will explain what everything means to you in your situation.
Some of the aspects of your policy that we will review include:
- Total versus residual disability;
- Own occupation versus any gainful occupation;
- Mental and nervous disability benefit limitations; and
- Self-reported conditions benefit limitations.