If you’re filing a long-term disability claim when you’ve been injured or sick and can’t work, it helps to know that disability insurance is more complicated than most insurance. There are very strict rules that must be followed.

Be careful with time constraints and deadlines. The policy will say when a claim must be filed. Most policies have a 60-day filing window. Be sure to submit documentation before the deadlines and send all documents and records by certified mail the next day.

Keep your disability claim information private. Do not post details, comments, or complaints on Facebook, LinkedIn, or any disability-related forums, bulletin boards, chat rooms, social networking sites, or other places online. It doesn’t matter if you just filed a claim or if the insurance company has been paying your benefits for ten years: putting this information on the web could cause you to lose benefits.

Insurance companies monitor social media for their claimants very carefully and more than one person has lost their benefits or a judge has made a different decision based on their comments online. If you file a disability claim and post vacation photos that show you hiking in the mountains, insurance companies will consider the photos evidence against your claim.

Once the disability insurance company receives a claim, they will send you the necessary forms to process the claim. These will include a claimant’s statement, treating physician’s statement, and authorization forms that allow access to third-party health, financial, and occupational materials.

Financial records are used to evaluate income, assets, and profit. This feels intrusive and praying, but getting the information right is important. For salaried employees, tax returns and W2 earnings statements will be fairly simple to provide. If you are a business owner or partner in a professional practice or other complex earnings situation, the request for financial records can be overwhelming. It is important to check the specific language of the policy to know what the disability insurance company is entitled to and what is not their concern. The policy is the contract that governs the entire process. If you are asked to provide something that is not included in the policy, contact the insurance company to clarify and explain the request. Carefully document questions to minimize non-compliance issues.

Most disability policies require you to undergo an IME – Independent Medical Examination. Keep in mind that the doctor who performs the exam is paid by the insurance company. Disability insurance company doctors are not independent. Be careful! Disability claimants who think they are talking to a sympathetic doctor are always surprised when the doctor who seemed so friendly reports that they are perfectly fit to go to work. Many recent court decisions, including several in our own practice, have found it abundantly clear that medical exams paid for by insurance companies are not independent. This inherent conflict of interest is something that the courts are carefully watching.

The insurance company may NOT require a disability claimant to undergo an invasive test or require claimants to travel a great distance for an exam. The insurance company is required to schedule an IME at a reasonable distance from your home.

If you are ordered to take a Functional Capacity Assessment (FCE), be careful. Please read your policy carefully to determine whether or not it specifically requires you to take this test. If the FCE is not on the policy, the law does not require you to take it. The FCE is used to test maximal effort. If you opt for an FCE and are asked to do something you know you cannot do without pain or discomfort, say no and do not perform the action. There is controversy surrounding this test and it can be dangerous. Document how you feel after the test and, if you can, see your doctor to make sure you document any injuries you may have suffered from the test.