How Do I Prove I Have a Disability?

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It’s not as easy as it sounds. There are countless stories about those denied disability benefits, so we’re not lacking in the experience. However, what many claimants don’t know is that there is a way to really prove that you deserve those benefits.

There Are Multiple “Legal Definitions” of Disability

And the tricky thing is that every insurance company, the SSA, and the VA differ. Your first step is to look at your policy. What does it say? How does it define disability for you? It’s your first step in determining whether or not you may actually qualify; and it’s important to get that situated in your mind even before it becomes an issue in the event that you may have to pursue a disability claim.

Most policies mention something such as “due to sickness or injury” as the employee is “unable to perform the material and substantial duties of his or her own occupation.” Remember that it’s the insurance company that will define disability for you, so pay close attention to the words.

Keep in mind that there’s a financial conflict of interest here. The insurance company obviously doesn’t want to pay, so based on your situation, if it doesn’t perfectly match their definition of disability, you could be denied even if your doctor says you shouldn’t be. It’s technically not a medical issue—but a practical and financial one. If legally you don’t satisfy the definition of the policy, you don’t receive any benefits, plain and simple.

But What If Social Security Even Says You’re Disabled?

You’d think that would be enough. However, as we mentioned: there are several definitions of disability; and Social Security only has one variation. Traditionally any person under the age of 50 would still have a tough time getting approval based on the SSA definition. Why? To receive those benefits, you would have to prove that you can’t maintain at any occupation at all in the national economy, not just the one you were working in.

That presents an issue where the SSA and the insurance company may differ, and yet there’s nothing one can do. Again, the insurance company has the final say even if the SSA agrees with you. Even worse, logically the insurance company wouldn’t even want to help a claimant receive Social Security benefits as it helps the insurer financially. However, whatever you’re approved for by the SSA will offset the actual amount demanded by the insurance company after payments have been sent out.

Oftentimes the SSA will perform a vocational review requested to ensure the claimant either is completely disabled or may have options depending on the severity or level of disability. The work done by a vocational analyst may determine that there are, in fact, some jobs that could fit the profile, albeit perhaps somewhat flawed and unreasonable. Again, the concern is the bottom line: realistically an insurance company doesn’t want to have to make disability payments.

Your Burden of Proof Belongs to the Insurance Company

Your best opportunity is to consult a qualified attorney that can successfully argue your case. If the insurance company denies your claim, you can always appeal the denial with the help of a disability lawyer.

Written by AskTheLawyers.com™ on behalf of Marc Whitehead

Author: Marc Whitehead

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