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Denial of Disability Benefits: Insufficient Medical Evidence

Disability Law

In many cases, disability insurance companies will deny applications for disability benefits on the basis that the medical information submitted is insufficient to prevent you from working. In order to understand why your claim has been denied, it is important to understand the disability insurance process.

Your Application Form

Firstly, when applying for disability benefits, you are required to complete an application form yourself which asks you for a number of things, including your limitations and restrictions. It is important that you provide in detail your functional restrictions and limitations that affect you on a daily basis and that you specifically explain how these functional limitations impact your ability to perform the daily duties of your occupation.

Your Physician’s Form

Secondly, your physician is also required to complete a form which is often called the ‘Initial Attending Physician’s Statement’. This form outlines your medical diagnosis, restrictions and limitations, and your prognosis for recovery. This form is often only a page or two in length and allows limited space for your doctor to provide their answers and opinions.

It is often the case that when your application is being reviewed by the insurance company’s medical consultant, the only objective medical information that the medical consultant has in front of them is what is contained in the ‘Initial Attending Physician’s Statement’. It is therefore important that you have your physician provide as much detail as he or she can. Specifically, your functional restrictions and limitations are a very important consideration for the insurance company. Therefore, you will want to ensure that your physician links your functional restrictions and limitations to your inability to do the specific job demands of your occupation.

Lastly, you should ensure that your physician provide any relevant clinical records and notes along with the ‘Initial Attending Physician’s Statement’. The more relevant medical evidence the insurance company has at the time your application is reviewed, the better.

If you require assistance with your initial application for disability benefits or you have been denied benefits, Zacharias is here to help. Contact one of our disability lawyers today.

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