Maintaining Your Treatment and Disability Record

Sep 30, 2020 - Articles by

Obtaining appropriate medical treatment and care while disabled is not only important for your health and well-being, it is required to secure and maintain your individual disability insurance and/or long-term disability insurance benefits. The appropriate medical care requirement and definition is spelled out in your disability insurance policy. If you have questions or concerns about the appropriate care requirement and/or maintaining your treatment record for your disability, contact a Philadelphia disability insurance lawyer at Seltzer & Associates. Our legal team represents healthcare professionals nationwide.

Your Philadelphia Disability Insurance Lawyer Understands the Importance of Recording Ongoing Treatment

A disability insurance company’s initial acceptance of liability does not guarantee it will continue paying future benefits without proof of ongoing appropriate medical treatment and care. Even after liability is initially accepted, insurance companies continue to evaluate the disability claims that they are paying. Obtaining updated medical treatment records is just one of the methods used by insurance companies to assess whether the disability is ongoing and that it is actually the noted disability that is keeping the insured out of work rather than some other reason.

Obtaining appropriate treatment and having these medical records available demonstrates that the insured is still unable to work due to their disabling condition, thus preserving your disability insurance benefits, or opening the door for your Philadelphia disability insurance lawyer to fight the denial of your disability insurance benefits. Insurance companies can use the lack of ongoing appropriate medical care and/or the lack of medical treatment records as a contractual basis to deny your claim. The argument is simple, if you are not seeking medical treatment, your medical condition is not severe enough to render your disabled from working.

There are also policy definitions for individual disability and long-term disability that change the eligibility for disability insurance benefits. The first definition is “own occupation,” which evaluates whether you can materially perform the duties of your own occupation. Your medical records will demonstrate your limitations in this regard.

Depending on your policy, your “own occupation” coverage might transition into an “any occupation” definition after a contractual time period, or you purchased a policy that only provides “any occupation” coverage. The “any occupation” definition evaluates whether you are able to perform the essential duties of any job in the national economy, based on your education training and experience. While some policies include an income threshold based on your pre-disability earnings, if your policy does not, and you are found able to work in “any occupation” the insurance company can terminate your disability insurance benefits.

This is another reason why it is important to obtain ongoing appropriate medical treatment and care that documents the nature and severity of your disabling medical condition. 

Dealing with Closed Medical Offices

As COVID-19 first emerged and businesses closed, you may have experienced a disruption in your ability to obtain medical treatment for your disability. As social distancing continues, in-person appointments may be more difficult to schedule. An alternative to in-person appointments is virtual or remote appointments. Today’s technology allows healthcare providers and patients to meet via video or phone to conduct healthcare appointments. While this is not a possible treatment for every type or stage of disability, virtual appointments demonstrate an ongoing need for treatment due to your disability, which can be especially helpful for ongoing mental health treatment as cognitive evaluations. 

If you are having difficulty maintaining consistent appointments for your disability treatment during coronavirus, talk to your Philadelphia disability insurance lawyer about how you can maintain a record of your limitations for your disability insurance claim. You may even keep a diary of your symptoms and limitations, which will help you stay organized and provide accurate information to your healthcare provider when your treatments resume. 

Contact a Philadelphia Disability Insurance Lawyer

At Seltzer & Associates, we know the importance of maintaining your treatment and disability records. With years of nationwide experience representing clients in their claim for disability insurance benefits, a Seltzer & Associates Philadelphia disability insurance lawyer is ready to guide you through this process and ensure you stay on track with maintaining your medical records. Contact Seltzer & Associates to discuss your disability insurance benefits claim today.