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Disability Insurance: Appeals

Step 4. Obtain New Information

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The insurance company is not likely to change a decision using the same information that was used to deny the claim. You're going to have to either provide some brand new information or show a brand new way to look at what the insurance company already has.

Consider:

Medical records

Look for additional material from a doctor whose records the insurance company didn't have. Keep in mind the records we're talking about relate to the date you claimed you became disabled, not from the time of your appeal.

Subjective symptoms

If part of your disability claim is based on pain or fatigue, provide more proof about your symptoms and the effect they have had on your work and on your daily life.

  • If you've kept a Symptoms Diary, make sure everything was listed - particularly how each symptom affected your work and/or daily life. If you haven't been keeping a diary, this is a good time to start keeping one. At the least, it will be helpful for future doctor appointments. To learn more, see: Symptoms Diary.
  • Obtain written statements from family and/or friends.
  • If there were performance problems at work, there may be memos in your personnel file. Your supervisor can provide excellent support if your performance was suffering and he or she can document that fact either through past performance reviews, warnings or a letter. If there is no existing documentation, see if your supervisor would be willing to write an affidavit now describing your symptoms and the effect they had on your work. See: Statements from Supervisor and Co-Workers, below.
  • If it hasn't been done before, now is the time for your doctor to take the time to write a multi-page letter. See "Letter from your physician", below.

More accurate job description

  • Consider obtaining an affidavit or at least a letter from your supervisor or the HR department that explains all the "material" duties of your job.
  • It would be particularly helpful if the affidavit or letter and clarifies the tasks that your symptoms prevent you from doing.

Letter from your doctor

  • If it wasn't done before, now is the time for the doctor to take the time to draft a very complete (usually multi-page) letter that explains, from a medical point of view, why you are unable to perform your job. Keep in mind that the insurance company needs to see more than a statement that says: "I'm a doctor. I say she's disabled. Therefore she's disabled."
  • The letter should be written as if it is directed to another medically trained person.
  • The letter should include details geared to change the opinion of the insurance company such as an analysis of lab results showing a different conclusion than the insurance company reached, or an elaboration on progress notes expanding on the symptoms you've encountered.
  • If the insurance company points to a particular capability that you deny, it would be helpful for the doctor to address that subject directly.

Statements from co-workers and supervisor

  • If you were having trouble doing your job, your co-workers and supervisor were in the best position to see it. An affidavit or at least a letter giving anecdotes of how they saw your performance slipping will help immensely. For example: "I have been Mary's supervisor for two years and she was always a good employee, but three months ago she started missing work and her performance when she did work deteriorated to the point I had to give her a written warning."
  • The affidavit or statement should also state how each of your symptoms affected your ability to do specific, material, parts of your job.
  • To learn more, see: Affidavits from Co-Workers.

Statements from family and friends

  • If your family observed the problems you were having and continue to have, a written statement giving anecdotes about the problems they witnessed will bolster your position. The anecdotes should be as specific as possible.
  • For example, instead of a friend writing, "John has problems with pain," it is better is they describe what the friend saw and how it affected your activities: "There were times when John's pain was so severe, he had to cancel plans to go shopping with us."
  • To learn more, see: Affidavits From Friends And Family.

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