How crucial is medical evidence in a long-term disability claim?

On Behalf of | Jan 17, 2025 | Long-Term Disability (LTD)

If you are pursuing a long-term disability insurance claim in Pennsylvania, the importance of medical evidence cannot be overemphasized.

The success of your claim can hinge on the quality and comprehensiveness of the medical documentation you provide. Without strong evidence, your claim may face delays or even denial.

The role of medical evidence

Thorough documentation is the backbone of a successful disability claim. It should include documentation from health care providers that details your condition, its severity and how it impacts your ability to work. This evidence helps you demonstrate that you meet the medical criteria for a successful claim as outlined by your insurance policy.

Types of medical evidence

The more relevant the documentation you submit is, the stronger your odds of a successful claim are. Medical evidence that can help to support your claim includes:

  • Official records: These include clinical notes, hospital records, lab test results and imaging studies (X-rays, etc.). They should detail your diagnosis, treatment and prognosis.
  • Individual reports: Detailed reports from your treating physicians are particularly influential. They should describe your symptoms, treatments received, response and prognosis.
  • Specialist assessments: Reports from specialists can carry substantial weight. For instance, if you have a cardiac condition, a cardiologist’s report will be more pertinent than a general practitioner’s.
  • Functional capacity evaluations (FCE): An FCE assesses physical abilities and can demonstrate practical limitations caused by disability, such as difficulties in lifting, walking or sitting for extended periods.

If your condition includes a mental health component, records from your treatment providers are also essential. They should document how your mental health condition impairs your daily functioning and work ability.

Incomplete or poorly documented medical records can lead to delays or denials. Sound legal guidance can help to prevent this from impacting your claim.