Long Term Disability Law Blog
People often think that filing for their MetLife disability insurance benefit is as simple as filling out the claim form the company sends you. That is exactly what they want you to think. But if you want your claim to be approved the first time you submit it, you need to provide a lot more information than what is asked for on the form.
Our years of experience representing MetLife disability insurance claimants has taught us what needs to be submitted to avoid a disability insurance claim denial. The process is the same whether you are applying for short term disability (STD) benefits or long-term disability (LTD) benefits.
The above video gives you an overview of how our attorneys at Dell & Schaefer approach the application process in a way that gives you the best shot at getting approved for your MetLife disability insurance benefits.
Analysis of the Policy
MetLife’s disability policies are all different. The first thing a disability insurance attorney at our firm will ask is for is a copy of your policy. The policy is the roadmap we use for everything we do in applying for your disability benefits.
The definition of disability may vary from one policy to the next. The elimination period is different. It can range from between seven days in a STD policy to up to a year for an LTD policy.
In your application, you must provide information that meets all the criteria that your policy requires. Otherwise, you will likely be the recipient of a denied disability claim.
Determine the Elimination Period
The elimination period is the time between your first day off work and the date upon which you can begin collecting disability insurance benefits. In a STD policy, it is generally between 7 and 30 days.
In a long term disability insurance policy, the elimination period may be 90 days, 180 days, or even up to a year.
Provide Detailed Medical Evidence to Support Your Claim
We must anticipate everything that MetLife is going to look for when they evaluate your claim. The most important thing MetLife needs is medical evidence to support your claim of inability to perform your job. Some people tell us “My back’s been killing me for six months” but they have not seen a doctor. Without strong medical evidence that you actually have a back problem, and that problem interferes with your ability to perform your job duties, your claim will be denied.
On the other hand, you may have been receiving treatment for a medical condition for years. MetLife will ask, “What has changed for you? Why are you now seeking disability?” These are questions that must be answered by medical professionals and included in your medical records.
When we represent claimants, whether they have filed their claim or not, our disability lawyers work diligently to be sure to get the appropriate medical evidence to support the claim. Not all doctors know what the insurance company is looking for. Just because you have been treating with you primary care doctor for years, you may also need the opinion of an orthopedist, neurologist, or other specialist.
This may take several months to gather all the documentation. This may be frustrating, but this is the make or break part of whether your claim will be approved or denied. We know that MetLife will have their own medical specialists who will review your medical records and give an opinion as to whether they agree with them.
If your doctors are not on board with what is going on, your claim is dead in the water. It will not be approved.
Definition of Disability
We look carefully at the definition of disability as it is presented in your policy. Often, the definition for disability for at least the first 12 months is “the inability to perform the duties of your own occupation.” Your disability attorney will need to determine if that means the inability to perform your occupation according to how it is expected to be performed in the national economy versus how you performed for your own employer.
MetLife will work to deny your claim. For example, if your job is as an executive, MetLife will say your occupation is a sedentary one. This means you can do your job if you can sit for six hours a day with a break as needed every two hours. If you can do this, then MetLife will say you can do your job. If that is all your job entailed, then there would be hundreds of thousands of people applying for disability insurance benefits!
But that is not how it works. When your Dell & Schaefer disability insurance attorney submits an application on your behalf, we do not just rely on your employer’s statement of what your occupation is. We get a specific definition from you of the requirements of your job. We will give examples showing exactly what job duties were required and the specific tasks you were expected to perform.
Connect the Dots: How Your Medical Condition Makes It Impossible for You to Perform Your Job
The number one reason MetLife uses to justify its disability insurance claim denial is that your complaints and your medical records do not match up. Our disability insurance attorneys will work with you to get the medical records necessary to make the connection.
It is not enough to just say “Here are my medical records and my job description.” We must show how your particular medical condition makes it impossible for you to perform your job duties. We make sure your doctors are on board with the process and educate them as to the need to make the connection to how your medical condition interferes with your ability to do your job.
How We Work at Dell & Schaefer
The key to presenting a successful claim is to build tremendous medical support. We have to present details about what your occupation requires of you. We have to make sure you and your doctors understand the definition of disability.
Contact us at Dell & Schaefer either online or by calling us at 888-699-9438. We will ask you to send a copy of your policy for review by a disability insurance lawyer. We will then set up a free initial phone consultation. We will let you know if we think we can help you and explain our fees to you.
We generally do not charge fees or costs unless we make a recovery for you. We do not ask for any money to review your policy, so there is no risk to you of reaching out to us and asking for help. If you have already filed your claim, we will review it and possibly obtain the necessary medical support and file an addendum.
We represent disability insurance claimants nationwide, so do not hesitate to call us no matter where you live. We look forward to speaking with you about your disability claim.