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Your Doctors And Disability Insurance Claim

When you’re suffering from a medical condition that requires you file a disability insurance claim, especially a condition that leaves you totally disabled, your doctor is one of the most important people you have on your side. Your doctor runs tests, prescribes medication, and generally does everything he can to make sure you are comfortable.

But when it comes to a disability claim, your doctor plays a bigger role than you may think. A recent long term disability case in Florida — Sobh v. Hartford Life and Accident Insurance Company — highlights just how important it is to have your doctor’s cooperation. In that case, the claimant lost his long-term disability benefits because his doctor did not timely respond to requests from The Hartford and failed to provide the necessary proof for his disability claim.

The claimant’s treating physician was very active in providing documentation to The Hartford, proving the claimant was unable to perform the duties of his own occupation and Hartford approved the disability benefits. However, after the 24 months own occupation period, The Hartford required updated documentation to establish that he was unable to carry out the duties of any occupation. The Hartford requested updated medical evidence from the treating physician as well as a questionnaire to be completed by the physician.

The physician completed the questionnaire, which stated the the claimant was still “unable to work at any job” and was “permanently disabled.” Unfortunately, the physician did not provide any updated medical records or treatment records. After making several unsuccessful attempts to obtain the necessary information from the doctor, The Hartford terminated his disability benefits were terminated. The Court noted that the doctor’s failure to provide the updated medical information played a large role in the reason for the termination of benefits.

The disability policy specifically stated that The Hartford “could terminate benefits if requested proof of disability was not provided.” Therefore, the doctor’s failure to provide the requested documentation, on its own, would have been enough to support the termination of benefits.

It is so important that your doctor plays an active role in your disability claim. They are the ones who control your medical records and who provide the professional opinions of your medical conditions. Without their support, your claim does not stand a chance.