Proving continuous disability during an LTD waiting period

When you apply for long-term disability (LTD) benefits, the benefits don’t start immediately. Even assuming you meet all the qualifications for disability under your policy’s rules, you still have to get through the waiting (or “elimination”) period, during which benefits are not paid.

The longer your waiting period, the cheaper your policy is likely to be, largely because the elimination period serves to “weed out” claims for temporary or short-term conditions. Most people keep this in mind when they buy their policies in the first place and plan accordingly. However, they seldom realize that it can be very challenging to prove that a disability was continuous throughout the entire waiting period – and failing to do so can lead to a denied claim.

Work with your doctor to prove your disability is ongoing

The biggest problem that long-term disability applicants face is the lack of adequate medical documentation during the waiting period. If your condition is chronic and incurable, for example, you may see little point in visiting your doctor just to confirm that you still have it – but that’s exactly what you may have to do.

Here are some tips that can help you make it very difficult for the insurance company to say that your condition isn’t continuous:

• Make regular follow-up appointments with your primary care provider and any specialists you see to monitor your condition. Even if you don’t require any changes in treatment, each visit allows your doctors to document the fact that you’re still facing the same challenges.
• Keep a personal diary or journal that documents the daily ups and downs of your condition, including how often you experience flares, what triggers them, what you do to try to alleviate your symptoms and how your condition limits you. This can provide a very clear picture of your ability to function on a regular basis. Take your journal with you to each doctor’s visit and ask that the new pages be added to your medical file.

You may also want to ask your doctors for follow-up blood tests or imaging studies to check the progression of your disease. Again, even if you feel like your condition is stable, these tests can provide objective evidence that supports your LTD claim.

LTD claims are unfairly (and even capriciously) denied all the time – but an appeal can often reverse your fortunes and get your claim approved. If your claim has been denied, consider seeking legal guidance to gain greater insight into your rights and options moving forward.