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Steps that you should take before applying for employer provided disability benefits

Steps that you should take before applying for employer provided disability benefits

Before applying for disability benefits, you should consult several different materials that can be obtained from your employer. First, you should consult your employee handbook. Your employee handbook will usually contain a brief description of the disability benefits (if any) provided by your employer and how to apply for them. It is through this handbook that you can usually determine whether your employer provides long term disability benefits. (Please note that there is no law requiring your employer to provide long term disability benefits).

Second, you should obtain copies of both the disability plan document (which is often an insurance policy) and the summary plan description (“SPD”) of the plan. The plan document is the legal document that states all of your rights and obligations for benefits. The SPD summarizes your rights and also specifies information concerning the administration of the plan. Specifically, the SPD will describe the amount and duration of benefits, waiting periods, application deadlines, limitations on coverage, the type of proof required, and the definition of disability for purposes of eligibility. Upon written request to the administrator of the plan, these documents must be furnished to you. If they are not furnished within 30 days, the plan administrator can be personally liable for statutory penalties of up to $110 per day for each day the documents are not furnished to you.

Third, you should obtain a copy of all relevant application forms. You should review these carefully. They should be completed fully and carefully. An incomplete or misleading response on the form could cause a denial or delay in obtaining benefits. A NY state disability lawyer will be able to ensure that your filling out of these forms are not done in error. When completing the forms, do not be afraid to add riders and attachments. Most forms only give you a small amount of space for your answer. By adding a rider or attachment, you could give a complete response, which will benefit you. Responses that do not give complete information, such as not listing all of your symptoms, benefit the insurance company. Again, a NY state disability lawyer will be able to provide invaluable insight into these details which a layperson such as yourself might miss.

In addition to gathering the above documents, you should very early on consult with your doctors. If you are going to apply for disability benefits, you are going to have to establish that you are disabled. All disability plans have forms for your doctors to complete. They all ask their opinion as to whether you are disabled. If your doctor will not say you are disabled, then you have very little chance of obtaining benefits. You therefore must have a sense that your doctor will support you during the application process.

The next thing a NY state disability lawyer will examine are your medical records. You should also gather all of your medical records, including physician treatment notes, hospital records, and test (blood tests, xrays, MRI’s, etc.) results. You cannot rely on the insurance company to gather all of your medical records for you. The insurance company may request the records of your main doctor, but if you are treated by multiple doctors the insurer will often not obtain all of your records. In that case, you may be missing documents that could have provided strong support for your claim.

Certainly, if and when you consult a NY state disability attorney, having your medical records will save the cost of having the attorney gather them for you.

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