The first thing to remember is that the rules that apply to you (for ex- ample which deadlines apply to you, the benefits you may be entitled to, how to apply for benefits) are all found in your specific insurance policy. There are very few general rules that apply to all long-term disability claims – the specifics vary from policy to policy, so you need to check your own policy to determine which rules apply to your claim.
Each long term disability insurance company has its own application package that you need to fill out and return to them. They generally all include three basic forms:
- Claimant Statement Form (you fill this one out yourself)
- Employers’ Form (your employer fills this one out)*
- Doctor’s Medical Report Form (your doctor must fill this one out)
*If you are a self-employed professional or business person, you will have to fill out application forms for the self-employed. These will be supplied by your insurance company.
A delay in the insurance company receiving any of these forms will hold up your entire application. It’s extremely important to have these forms filled out properly by yourself, your employer and your doctor.
My doctor supports my LTD claim but the insurance company wants me to see a doctor they have chosen. Can they do this?
Many LTD policies allow the insurance company to have you assessed by the doctor of their choice to decide whether you are entitled to benefits. If that happens, the doctor chosen by the insurance company must be reasonably qualified to do the assessment, and the exam itself must be reasonable.
If you refuse (without good reason) to see the insurance company’s doctor, you will be in breach of the insurance policy, which may be grounds for the insurance company to deny your claim.
This is often an area of great concern; if you have any doubts or questions, it may be in your best interest to seek the advice of a qualified lawyer.