You may have received a letter from MetLife saying your benefits will continue until a certain date, which often says until the age of 65. Do not believe it. The letter fails to put in writing the important clause MetLife is essentially hiding from you: That you will receive benefits only if you continue to meet the provisions of the policy.
Each month, you risk being denied. We want to help you understand how your claim is evaluated and provide you tips on how you can prevent MetLife from denying you your disability benefit once your claim has been approved.
Continuous Medical Treatment with Good Medical Record Keeping Can Prevent a MetLife Denial
It is vitally important that you continue your medical treatment and make sure your doctor is documenting your disabling condition. Doctors are periodically sent forms from MetLife asking them to update your condition. Depending on the nature of your disability, MetLife may ask for an update as often as every month or every two months.
At a minimum, you need to be seeing your doctor at least every 60 to 90 days. MetLife is looking for anything it can use to justify denying your claim.
If you are not receiving regular medical treatment, they may decide that means your medical condition is no longer disabling, and you can return to work. It is important to work with your treating physicians, so they know what is expected of them and if the way they describe your condition in the medical record can make a difference of whether your benefits continue or your claim is denied.
It Can Be Difficult to Get a Doctor to Draft Strong Medical Records and to Provide Supporting Attending Physician Forms
Almost all doctors have a system of checking boxes about your condition and care provided. Some exact portion of a previous medical chart entry will often be copied to the new update. It may not be readily evident that you have new testing results or a change in your medication.
If your record makes mention of “improving,” or “doing fine,” that may be all MetLife needs to say, “Aha. You can go back to work.” The company doesn’t look at how you have improved and what the improvement means. You may still be suffering and unable to work even if you are better compared to how you were on your last doctor visit.
You must have an honest conversation with your doctors to educate them on what you need from them in order to keep your disability benefits. This means your doctor’s notes need to show how your medical condition makes it impossible for you to do your occupational duties, whether they are the duties of your own occupation, or any occupation for which you are trained, educated, or otherwise qualified. The occupational definition depends on the stage you are at in receiving your benefits.
Your Physicians Should Never Rely on the Limited Space MetLife Gives Them in a Disability Claim Form
The claim form given to your physician only has a limited space and does not leave much room for a detailed explanation. We always have the doctor provide an attachment which goes into more detail about why you cannot perform your duties.
There is some wording that needs to be avoided. For example, we caution them to avoid saying you “never” do X, because if the company later puts you under surveillance that shows you are doing X, then they will attack your credibility and your character.
The Monthly Claim Handling Service Offered by our Law Firm is Unique for Many Reasons
At Dell & Schaefer, we offer a unique monthly claim handling service. We charge a flat monthly service fee which is a small percentage of your monthly benefit. When you use our service, we take over every aspect of keeping your claim updated. We monitor closely, and all communication from MetLife comes to us.
We are proactive in making sure you are doing all that you need to do to stay on claim. We work with your doctors to educate them on what documentation we need and the wording of your limitations and restrictions that we have found acceptable to MetLife. We make sure your medical records are strong and support your claim.
We are always available to answer your questions. We protect you at every step of the way. It appears that when MetLife sees a lawyer is involved, they may be more careful at what they require of the claimant.
If you are interested in our services, contact us. We work with clients all over the country and we offer a free and immediate phone consultation to determine how we can help you. Call us at 888-699-9438.