What not to say when filing a long-term disability claim

On Behalf of | Feb 20, 2024 | Long-Term Disability Insurance

No one ever expects to become disabled. But it can happen without any notice, and if you’re not prepared, you can face significant financial struggles. That’s why many New Jersey residents turn to private long-term disability and ERISA plans for coverage. These policies can pay out disability benefits that provide you with an income replacement option when you’re no longer able to financially care for yourself.

But recovering the benefits you deserve isn’t as easy as it may seem. Even if your disability is obvious and you think it’s clear that you should be paid the benefits you seek, your claim could end up being reduced or denied. That’s why as you proceed with your claim, you need to be careful with what you say to insurance representatives.

What you shouldn’t say

There are certain this you shouldn’t say to an insurance representative when seeking long-term disability benefits. Your own words may work against you. They might give an indication that you’re not really disabled, which will drive the insurance company to deny your claim. That’s why you should avoid discussing the following with insurance representatives:

  • Your job dissatisfaction: As they assess your claim, an insurance adjuster is going to ask you questions about your job and the duties you perform there. These questions are aimed at gauging your ability to work. If you start talking about how much you hate your job or your co-workers, then you’re going to open the door for the insurance company to argue that you’re only saying you’re disabled so that you don’t have to return to a job that you don’t like.
  • Your travel plans: Unable to work, you’re going to find yourself with a lot of extra time. You might plan to take a vacation or travel to visit family and friends, but you’re better off keeping that information from your insurance company. After all, if you’re able to travel in a cramped airplane or survive a multi-hour drive in a car, then the insurance company might wonder whether your injuries are less severe than you claim them to be.
  • Your sick relatives: If you have a parent, spouse, or child who is dealing with a serious medical condition, you might feel compelled to discuss it with those around you, including your insurance adjuster. But doing so might make the insurance company think that you’re only seeking disability benefits so that you can take time off to care for your loved one. This will drive them to find evidence to support their opinion, thereby putting your claim at risk of being denied.
  • How long you’ve been dealing with pain and discomfort: A lot of workers push through a certain amount of pain and discomfort so that they can avoid taking time off work and can continue to earn a wage. But if you talk about how long you’ve been dealing with pain and discomfort, then you raise the possibility that the insurance company will argue that your disability is a pre-existing condition and therefore not covered by your policy.
  • What you do on a daily basis: The insurance company might try to gauge the severity of your condition by assessing the daily activities you conduct. Even though there are things that you can do when you’re disabled, the insurance company might view them as evidence that you’re capable of working. That’s why it’s best to forego discussions about what you do on a daily basis.

Advocate for the disability benefits you need

There’s a lot that can go wrong when seeking benefits from your private long-term disability or ERISA policy. That’s why it’s a good idea to educate yourself on the process and what you can do to position yourself for success. We hope you’ll find our blog and our website a good resource in that regard.


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