Shocked at Receiving Your Long Term Disability Denial?

But the Insurance Claims Representative Seemed Like She Was my Best Friend Forever…

What is the foremost rule in pursuing a long-term disability claim through either the government (social security-SSA) or a private carrier (Aetna, the Hartford, Unum, etc.)?  Right behind “always be truthful” is this gem: the claim representative is not your best friend forever. Not now. Not while you are tearfully explaining why you are disabled. Not when you are joking about your common interests.  Not when you are discussing your pets. Not when you are talking about your friends and family.  Never.

Am I overstating my case?  How many friends do you have who would record every interaction listed above in hopes of using the information to deny your claim, adversely impacting your right to much needed financial and medical benefits?

This is not to say claims representatives are nefarious just because they represent the government or a big insurance company.  Quite the contrary, the representative, an agent of the company, may be acting in a very professional manner.  It is his or her job to gather information and process your claim.  But it’s his or her job.

Remember the old adage that “an open enemy is better than a false friend?” When you are lulled into thinking the claims representative is on your side, you weaken your case. The little notice you’re provided at the beginning of any telephone conversation:  “this call is being recorded for quality assurance purposes…” is telling.  The representative wants to assure the quality of the service he is providing to the company.  Again, that’s his job. Assuming the information will be collected in a responsible and objective manner, the representative is doing what he or she is being paid to do. If there is any error, it is on your part as the claimant.  Your expectations are out of whack.

While you have a duty to provide relevant information to assist the government or insurance company in processing the claim, pleading your case to a claims representative will do little good.   The disability calculation—whether you are proving that you are disabled from your own occupation or any occupation—is based upon an assessment of the medical evidence your physician’s opinions and your limitations, not your winning personality.

A good approach is to  remember that the claim representatives are not your friends. Keep your conversations short, simple but polite.

A better approach is to provide the information requested on the forms, and request that all communications, to the extent possible, be in writing to help eliminate any misunderstanding.

The best approach is to relieve yourself of this stress, and hire our office on a contingency fee basis to deal with the government or insurance company on your behalf.

Invictus Legal Center, PLLC

George Andre Fields Attorney at Law, gafieldsdisabilitylaw@gmail.com 800-567-1556

Disclaimer: The above article is designed  for informational purposes only and not for the purpose of providing legal advice. Use of and access to this Web site or any of the e-mail links contained within the site do not create an attorney-client relationship. An attorney-client relationship can only be created by a signed agreement with our firm. There will be no action taken to protect or preserve your rights absent such a written agreement.   No privileges are waived by the transmission of this communication. Unsolicited information sent to our office by persons who are not clients of the firm is not subject to any duty of confidentiality. Prior results-- which were probably wonderful--do not guarantee a similar outcome.  Attorney advertisement.

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