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12 Secrets to Winning a Disability Claim

There are a number of steps to winning a disability claim, and not all of them are obvious. Attorney Jeffrey Hensley shares his secrets

PALM HARBOR, Fla. (May 29, 2007) – If a person is disabled because of an illness or injury, the process of collecting a claim from the insurance company may not be as straightforward and simple as one might think, according to Atttorney Jeffrey Hensley.

Disability insurance companies indicate they will stand by their customers in difficult times, but the truth can be very different, Hensley said.

“Unfortunately, that is seldom the case,” Hensley said. “Insurance companies simply hate to settle claims, and many will reject claims as an automatic first step, hoping the insured party will simply give up and go away.”

To have a successful outcome, Hensley said, claims should be pursued with determination, and with the right kind of representation.

Hensley said he has 12 “secrets” that he considers to be important in the successful pursuit of a disability claim. Follow these steps, he says, and the chances of success increase enormously:

Secret #1: Recognize the problem (disability) when it arises. People don’t have to be catastrophically injured or terminally ill to collect. Many policies provide money for partial disability. People should look for such things as loss of productivity, loss of income or the inability to perform the material and substantial duties of one’s occupation.

Secret #2: Give the insurance company notice of claim as early as possible. Late notice could result in a substantial loss of monthly benefits.

Secret #3: Use multiple witnesses to identify the material and substantial occupational duties — someone such as a colleague or a vocational evaluation expert. The insurance company or jury must clearly understand the important occupational duties. Make sure witnesses identify and verify the duties of one’s position.

Secret #4: Identify and focus on the material and substantial duties that can’t be performed due to physical or mental limitations. Once the insurance company or jury understands the occupation’s requirements, it must understand what duties cannot be performed due to the disability.

Secret #5: Document the loss of productivity with business records or even appointment calendars. The court looks for proof of the disability. Since memories often fade, it is important to present a case based on something other than one’s memory. Written records, such as an appointment calendar — and even a daily journal — greatly increase credibility and give the jury the support it needs.

Secret #6: Use business records and income tax returns to document loss of earnings based on loss of production. The bigger the loss, the more likely the jury will recognize the disability.

Secret #7: Use past medical records to demonstrate the disability’s onset and progression. Medical records provide accurate snapshots of symptoms and conditions. The better the doctor’s documentation, the better the chances for a favorable jury decision.

Secret #8: Maintain a regular schedule of medical treatment. Avoid lapses in treatment to occur. When insurance companies see lapses, they are likely to suggest that no real disability exists. Insurance carriers may suspend benefits in the absence of ongoing medical treatment.

Secret #9: Identify and focus upon the physical limitations giving rise to the disability. The treating physician should understand and support the claim, since juries rely heavily on the doctor’s evaluation and assessment. If the doctor does not support the claim, it may be time for a different doctor.

Secret #10: If the jury rules against the disability, there may be grounds for appeal. Simply getting a bad result at trial is not grounds for an appeal, but there may be a chance of reversible error — an error so significant that the judgment must be reversed by the appellate court. That amounts to grounds for an appeal.

Secret #11: A loss in court does not prevent the filing of a new claim. Disability is a month by month contractual benefit. As medical conditions change, a new claim may be appropriate.

Secret #12: If an insurance company has acted in bad faith, that may open the door to additional money damages.

Jeffrey Hensley is one of the most established and respected attorneys in the Tampa Bay area. He strives to be a leader in the fields of law in which he practices. His support staff is among the most professional of any law firm in Florida. To learn more about Jeffrey Hensley and his law practice, visit www.hensleylaw.com.