All Short Term Disability and Long Term Disability insurance policies have many similar clauses. One of those is the clause of the policy which provides that you must be under the regular care of a physician. This is one of the Long Term Disability requirements which many insurance companies use as a weapon against your coverage.
When you have Long Term Disability coverage, claims representatives jump all over a discovery that a scheduled appointment has been missed, for whatever reason. Of course, courtesy requires that you communicate with the doctor’s office whenever an appointment has to be rescheduled.
Usually, of course, it’s the doctor doing the rescheduling. However, in order to comply with Long Term Disability coverage requirements, you should also keep your Long Term Disability coverage claims representative posted, preferable by some form of written communication so your claims file is well documented. However, rest assured that failure to do so is not a basis for denying benefits even though claims representatives will jump on the slightest pretext to deny benefits.
What Is Considered Regular Medical Treatment For Long Term Disability Coverage Requirements?
Of course, there may be a dispute over exactly what constitutes “regular” care. In the early acute phases of the treatment, the only problem area would be if the doctors have difficulty identifying the precise nature of an underlying debilitating disease. Down the road, as the conditions become chronic, treatment will not be often, maybe just yearly.
There are conditions covered under your Long Term Disability coverage which require no ongoing treatment but it would be a good idea to go to the doctor at least once a year, at a minimum. Otherwise, as we have had to do before, a statement from the doctor may be necessary to show that there is no further treatment to pursue.
At Herbert M. Hill, P.A. we have been on just about any horizon, those points at which it is hard for the claimant to discern what is next. If you have any questions about your Short Term Disability or Long Term Disability coverage claim, please give Herbert M. Hill, P.A. a call and we would be glad to answer any questions you may have. We are available at our office via the phone, or you can fill out our online contact form.
If you would like, after discussing your case, we can set a conference. In most circumstances, that conference would be free of charge but in no circumstance would you be under any obligation to hire me nor would you feel any pressure from me to do so.
About Us
Herbert M. Hill, P.A. is a law firm located in Orlando, Florida with a practice extending throughout the state of Florida. While the vast majority of cases handled are for disability insurance benefits, areas of practice include employee benefit claims of all sorts. The firm handles any claims arising under the Employee Retirement Income Security Act (“ERISA”) for disability benefits, medical benefits, retirement benefits of any sort, including pension, 401k, termination agreements or the like as well as claims arising under private disability policies.
