As a last resort, long-term disability (LTD) insurance may assist a person in cases of incapacity to work that is due to severe health risks. It is equally important for the applicants as well as their attorneys to have knowledge of the particular medical conditions that can warrant LTD approval. This detailed article looks into the details of such conditions, the medical records review service, and how the lawyers can assist their clients with such long term disability applications.
Common Medical Conditions That Qualify for Long-Term Disability
Physical Conditions
A person’s physical condition is one of the most frequent claims specialists consider with long term disability applications. A few examples of these more prevalent physical conditions include:
- Musculoskeletal Disorders: Conditions such as arthritis, back pain, and fibromyalgia can prevent a person from moving and even carrying out basic tasks of daily life.
- Cardiovascular Diseases: Heart diseases such as heart attacks as well as congestive heart failure, still make it difficult to complete general working function.
- Neurological Disorders: Other common diseases that can cause this degree of functional impairment include multiple sclerosis (MS), Parkinson’s disease and epilepsy commonly fall under this category.
Mental Health Disorders
Mental health disorders constitute a growing number of diseases that can be approved as conditions for long term disability. Among the most common qualifying conditions are the following:
- Depression: When a person suffers from severe depression, their ability to work may still be degraded because they would be unable to concentrate and relate with people or even keep a regular working hours.
- Anxiety Disorders: Generalized anxiety disorder (GAD) or panic disorders can have interoperable symptoms that adversely affect an individual’s work capabilities.
- Post-Traumatic Stress Disorder (PTSD): PTSD is a disorder that has negative repercussions on the emotional and psychological well being of an individual which leads them to avoid working.
Chronic Illnesses
Chronic diseases usually lead to claims of long-term disabilities as they appear persistent in their condition. These are:
- Diabetes: Diabetes can have some serious complications which can limit working potential, e.g. neuropathy, cardiovascular complications.
- Cancer: Patients under any form of treatment for cancer are likely to be affected by side effects which makes it extremely hard for them to work.
Other Relevant Conditions
Additional conditions that may qualify for long-term disability include:
• Autoimmune Disorders: Lupus and rheumatoid arthritis, for instance, result in chronic pain and fatigue which do not go away easily.
• Vision and Hearing Loss: If one suffers from a hearing impairment or loss of substantial vision, then his or her ability to work may be inhibited and thus qualify for LTD benefits
The Role of Medical Records Review in Long-Term Disability Claims
The review of medical records is an essential step to be taken in the process of undertaking a long term disability case. This service entails the investigation of a claimant’s past medical history, treatment, and other related documents. It makes certain that all appropriate documents are submitted to the relevant insurance firm, substantiating the claim.
Key Benefits of Medical Records Review:
- Accuracy: Confirms that the medical records meet the stated symptoms and claimed limitations.
- Comprehensiveness: Provides a complete picture of the claimant’s medical history, which is crucial for establishing the severity of the condition.
- Legal Support: Assists attorneys in building a strong case by providing detailed medical documentation.
How Attorneys Can Leverage Medical Records Review Services
Attorneys representing clients in long-term disability claims can greatly benefit from utilizing medical records review services. Here’s how:
- Streamlining the Process: Medical records may obviously clarify medical details so the claims process can be accomplished much quicker.
- Enhancing the Credibility: Making use of this best practice will improve the detailed and the overall strength of the claim in the eyes of the insurance adjusters.
- Bridging the Gaps: There are gaps in the medical records that the attorneys are able to help fill up before submission purposes thus boosting the possibility of approval.
Case Studies
Case Study 1: Overcoming Chronic Pain
Overview of the Case: Sarah is a 45 year old Brazilian administrative assistant who developed chronic back pain caused by a herniated disc. After different surgical procedures and physical therapy, she was declared unfit to work.
Challenges: Sarah was declined for insurance cover by the company for the reasons that there was no objective medical proof to show her that she was disabled from work.
Solutions: With attention to the medical history of Sarah, our records review service carefully documented facts, conditions and effects of her medical ways on her activities. On the level of his attorney, we provided a number of materials explaining the details which finally resulted in the grant of her LTD benefits.
Case Study 2: Navigating Mental Health Challenges
Overview of the Case: John is a 35 year old software engineer from Amsterdam who became unable to maintain his job due to acute depression and anxiety disorders.
Challenges: According to the insurance company, evidence of John’s mental health problem is present but did not have visible documentation that was concrete enough to support her claim.
Solutions: Medical records review service such as ours found justification for the severity in John’s symptoms as well as their effect on his activities of daily living. His lawyer was in touch with us in order to make as convincing a case as possible—this is how his LTD payments were authorized in the end.
Conclusion
It is needless to say that long-term disability claims are familiar to individuals that are well trained on the appropriate medical conditions that qualify for such claims. In overcoming this challenge, attorneys are able to enhance their clients’ cases through the use of medical records review service thereby improving the chances of approval. To reiterate, it is critical to understand long term disability law especially its changes and seek counsel in complex such cases.
