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Five Things to Consider If You Might File a Disability Claim in 2023

Marcellino & Tyson
Marcellino & Tyson August 1st, 2022

employee signing disability claim charlotte nc

With the new year here, people often reassess their many things in their lives, including their employment situation. For individuals suffering from a medical illness or injury, that may include considering filing a claim for short or long-term disability in 2023. If you are in that position, here are five things you might want to consider in your decision-making process:

  • Timing—don’t try to work too long: One common issue is that individuals will work right up until the day before they file for disability, rather than making use of company leave programs (such as FMLA or sick leave). Deciding when to stop working and claim disability is a decision that should be made based on many factors, including talking with health care professionals about what is best for the individual’s medical needs. From a disability claim perspective, however, working right up to the point of filing can have negative repercussions. First, if you’re having trouble performing your job (as almost anyone with a disability would be) and you are terminated before you file your disability claim, you might lose your disability insurance. Second, many businesses are concerned about a recession in 2023 and have already begun laying off workers. Being laid off prior to filing a disability claim may result in loss of the disability insurance. Third, insurance companies will often try to use an individual’s attempts to continue working as evidence that the individual is not disabled. We understand that disabled individuals will often try to continue to work well past their ability to do so because of financial implications. However, waiting too long to stop work and file for disability can oftentimes be as harmful as quitting work too early.
  • Start talking to your doctor and look at your medical records: Probably the most important factor for your claim are your doctors’ statements about your ability at work, as well as the medical records he or she has compiled over the last year or so. Have you talked with your doctor about how he or she would fill out a form discussing your ability to work? Does your doctor know the type of work you perform and its physical, mental, and other requirements? Has your doctor made any statements in your medical records regarding your potential ability to work? Before filing a disability claim, it is prudent to consider these factors.
  • Get your plan documents: Second in importance to medical records in determining whether you are “disabled” under the terms of your short-term or long-term disability policy is what “disability” means under the policy. Many long-term disability insurance carriers (such as Hartford, Reliance Standard, and CIGNA/Life Insurance Company of North America (LINA)) will have relatively similar definitions of disability. However, it is always important to review the exact terms of your policy. This can be especially true if it is not a group policy through your employer, but an individual disability policy that may have more specialized terms. Knowing what you have to prove to the insurance company to collect disability benefits can tell you what medical and other information you might need to support your claim.
  • Understand the process for claiming disability benefits: Most long-term disability insurance provided by an employer is subject to a law called the Employee Retirement Income Security Act, often abbreviated as “ERISA.” This law establishes an administrative procedure that participants must usually follow to claim their disability benefits. ERISA also sets forth specific standards for filing a lawsuit if the insurance company denies your claim for disability benefits. The process is different than what most people think of as normal court procedure. Making sure you understand the process and applicable timelines is critical to claiming disability benefits.
  • Consider whether your supervisors and coworkers can help you: It is important to keep in mind that the definition of “disability” in most plans does not center around your medical condition, but rather how that medical condition affects your ability to perform the essential functions of your job. In order to show that you can’t perform your job functions, it may be helpful to consider whether coworkers or supervisors at your job can provide information to the insurance company telling it that you cannot perform those job functions. This can be especially helpful because those individuals may have observed you on a day-to-day basis and may be able to speak to your inability to perform the job on account of your medical condition.

If you’re considering filing a disability claim in 2023, the above five points may be things to consider as you contemplate claiming your disability benefits. While these are not the only considerations for anyone considering filing a disability claim in 2023, they may be important factors to consider as you work through that process.