If My Doctor Says I Can’t Work, Shouldn’t that Be Enough to Qualify for Benefits?

If My Doctor Says I Can't Work, Shouldn't that Be Enough to Qualify for Benefits?

Generally it is NOT simply enough for your doctor to say you can't work in order to be approved for insurance benefits. Nor is a doctor's note that says you are fully disabled and can never return to work. Insurance companies want the specifics. They want objective, comprehensive medical EVIDENCE that there are specific functional restrictions that prevent you from returning to work.If My Doctor Says I Can't Work, Shouldn't that Be Enough to Qualify for Benefits?

An insurance company or Social Security is looking for the following:

-how long you can stand, walk, or sit

-how much weight you can lift, push, or pull

-whether you can reach overhead, bend, or stoop

-whether you can handle small object with your fingers or type

-how frequently you need to take breaks, and

-how much time you need to take off work for sick days or hospitalizations.

If your doctor provides the above information and it definitively shows your functional limitations are severe enough to keep you from working, you will probably be approved for long term disability from your insurance as well as Social Security Disability (should you apply for that as well).

DO NOT rely on the insurance company to send the proper forms to your doctor to fill out. They do not usually help that willingly or easily. It will be up to you to obtain a functional capacity form and make sure your doctor fills it out completely, AND that it gets returned to the insurance company or Social Security.

The functional capacity form is great because it also asks for clinical finding and test results to back up what your doctor's opinion on your restrictions is. This information is KEY to getting approval.

Make sure you explain to your doctor that the form should be filled out WITH details and then ask them to send you a copy so that you have it for your own evidence. If you're delivering it back to the insurance company yourself, make sure you remember to make yourself a copy.

In the event that you're ALREADY BEEN OFFICIALLY DENIED, you will need to talk to a disability lawyer about filing an appeal.

See Also:

Social Security, Disability and Brain Injuries

Five Things Social Security Won't Tell You

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