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Disability Income Insurance: While On Disability

What To Do If You Are Contacted To Prove That You Are Still "Disabled" For Purposes Of Disability Income.

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If you should be contacted by an investigator for Social Security or an insurance carrier or even a former employer, keep in mind that:

  • Just like when you first applied for a disability income, it is up to you to prove that your disability continues.
  • The general rule is: "Cooperate - within reason." It is an easy tactic (particularly for an insurance company) to stop payment of your checks if it feels there is a lack of cooperation. You would then have to prove that you are due the money. While you do have to cooperate, you don't have to "roll over."
  • Your answers to an ongoing investigation should be consistent with the answers that prompted the income award in the first place. Pull out the forms and other documents you submitted when you first applied for disability income. That information becomes the starting point for any information to be supplied in a review.
  • If anyone calls you:
    • You can say that you would be happy to respond to any questions, but that you will have to call back to verify that the caller is indeed from the insurer. As you are likely aware, do not give any personal information to strangers who call. (To learn more, see Identity Theft.)
    • Once you have established that the call is legitimate, decide whether you want to talk on the phone or in person. It is recommended that you request an in person interview.
    • Either way, decide what is the best situation for you. For example, you may want to schedule a follow-up call or a person-to-person meeting for a time when a family member, friend or someone else can be there or listen on an extension or on a speaker.
    • If you aren't feeling well, postpone the interview until you are feeling better.
  • If someone shows up at your doorstep without an appointment:
    • First verify who the person is and his or her relationship to Social Security or a private payor.
    • Then explain that you would be happy to meet but that now is not a good time. For example, you can say that you're not feeling up to it or you have a doctor's appointment. It is not advisable to say that you have a tennis date or some other physically active event.
    • Set-up an appointment for when it is convenient to you and whomever else you wish to be present. If you would feel more comfortable meeting in another location (such at your social worker's office) set the meeting for there.
  • When you do speak with the investigator:
    • Get the investigator's name and telephone number.
    • Make note of the time, date and place of the interview.
    • Answer questions like you've seen witnesses do on T.V.: Stick to the answers to the question. Don't volunteer any information except when needed to clarify an answer.
  • The investigator will likely ask questions about your activities to find out whether you are in fact disabled.
    • Answer truthfully. Feel free to qualify answers about the activities you can do by saying something like: "When I feel up to it, I .…"
    • Keep in mind that your answers should indicate how your disability continues to interfere with your ability to work.
    • If you are receiving income from Social Security, Form SSA-454-BK is the form the representative will complete at the interview. It is strongly recommended that you complete the form prior to the interview to help you pull all your information together, make sure you don't leave anything out, and to make your answers consistent with each other. The form and advice for completing it can be found on our site at: SSA-454-BK.
  • If any questions make you feel uncomfortable, ask how the question is relevant to your claim. If you continue to feel uncomfortable in spite of the answer, ask that the question be put in writing, along with a written explanation for the reason that the question is being asked. Tell the investigator that you will respond in writing.
  • If the interview is in person, do not go overboard and try to look "disabled." At the same time, there is no need to try and "look your best" for any meeting either. Look how you always do.
  • If it makes you too uncomfortable to see someone in person, say that you will answer questions over the telephone or provide written responses.
  • If you are doing volunteer work, and that comes up in a review, communicate that you set the hours and the pace of the work. Distinguish your volunteer experience from work for wages. If applicable, explain how your bad days, or the side effects of your medications, or treatment schedules, etc. (which are unpredictable) interfere with a regular schedule. From the insurer's perspective, if you can show up on schedule and do regular tasks, you can do work for wages.
  • It is advisable to record the conversation or make notes of the questions you are asked and of your responses. Keep this record with your copy of your disability policy or other relevant file.

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