March 4, 2024

When filing a long-term disability claim, one of the most crucial steps in the process is the evaluation conducted by the insurance company. During this evaluation, the insurance company will assess the validity of your claim and determine whether you meet the policy’s requirements for long-term disability benefits. 

The evaluation process can be complex and confusing, leaving many claimants needing clarification on what to expect. It will be helpful for you to know what to expect during a long-term disability claim evaluation, including the information the insurance company will review, the medical evidence required to support your claim, and how to prepare best for the assessment to increase your chances of a successful outcome. You can also hire a nationwide long term disability claims lawyer if you need legal help for the evaluation. 

Understanding a long-term disability claim evaluation:

  • Review of your medical records

During a long-term disability claim evaluation, the insurance company will thoroughly review your medical records. This review will help them assess the validity of your disability claim by examining the severity of your medical conditions, the extent of your limitations, and how they impact your ability to work. 

Ensuring that your medical records accurately reflect your conditions and symptoms is crucial to support your claim’s validity. Any discrepancies or inconsistencies in your medical records may raise questions about the validity of your claim and could lead to a denial of benefits.

  • Assessment of your work history

The insurance company will examine your work history to determine if your disability prevents you from performing your duties or any other job you are qualified for. They may consider your education, training, and experience to determine if you have transferable skills that could allow you to work in another field. 

It is essential to provide a detailed work history to support your claim and demonstrate the severity of your disability.

  • Independent medical examination (IME)

During a long-term disability claim evaluation, the insurance company may require you to undergo an independent medical examination (IME). A doctor of their choosing performs this examination to evaluate your medical conditions and limitations. The results of the IME will be used to determine if your disability claim is valid and if you meet the policy’s requirements for long-term disability benefits. 

  • Functional capacity evaluation (FCE)

Another assessment that may be required during a long-term disability claim evaluation is a functional capacity evaluation (FCE). This evaluation is a series of tests to determine your physical and cognitive abilities and limitations. 

The FCE will help the insurance company assess your ability to perform your duties or any other job you are qualified for. It is essential to prepare for the FCE by providing accurate and detailed information about your medical conditions and limitations to ensure that the evaluation accurately reflects your abilities.