Do you need to undergo a functional assessment?

On Behalf of | Sep 9, 2022 | ERISA Disability Benefits

If all that it took to get disability benefits was an application, there are undoubtedly people who would abuse the system. Insurance providers are therefore very rigorous in their evaluation of claims, especially when it comes to long-term disability benefits.

The Employee Retirement Income Security Act of 1974 (ERISA) is a law that helps minimize the impact of a possible profit-inspired conflict of interests that could negatively affect claimants. ERISA helps ensure that those who receive certain benefits through employment aren’t left without the support they deserve.

To connect with coverage for an injury, you will typically need to prove that the condition affects your daily life or prevents you from working. A functional assessment is sometimes utilized in a disability claim to help establish the real-world impact of a medical condition. Will you need to undergo a functional assessment to get benefits?

What documentation do you currently have?

The necessity of a functional assessment depends in part on what evidence you already have supporting your claim of a serious disability. If you have extensive hospital records showing a spinal cord injury or similarly debilitating condition, there may be little question about how your medical diagnosis affects your ability to work and live independently.

However, some medical conditions vary drastically from person to person. You could also have a diagnosis but not much more official paperwork. Especially when you do not have extensive diagnostic records and have not received trauma care or surgery, you may require an evaluation as a way to document the condition and how it limits your daily activities.

Making sense of a disability claim can be difficult

When you took a job offer with employer-sponsored disability benefits, you probably assume that you would never need that coverage. Now that you are in the process of adjusting to life with a serious medical condition, it can be quite difficult to try to familiarize yourself with the federal laws regulating such benefits and the terms of your specific policy.

Many people who need to make long-term disability claims benefit from getting legal support. That way, they know what evidence they need and what rights they have while still being able to fully focus on their recovery instead of on frustrating paperwork. Gathering the appropriate documentation will help you more readily connect with ERISA long-term disability benefits.