Workers who have disability benefits provided by employers often take for granted that they have protection. If they get diagnosed with cancer or incur a major injury in a car crash, they assume that their long-term disability or short-term disability insurance provided by their employer can help them.
After all, those benefits specifically exist for the protection of those who cannot work due to medical challenges. Contrary to what people often expect, the claims process for private disability insurance is often very complex and lengthy. Insurance providers often look for any excuse to deny a claim.
Even when someone has a policy provided by their employer, they may struggle to get the benefits they need to support themselves and their family. While the Employee Retirement Income Security Act of 1974 (ERISA) protects workers who require disability benefits, actually proving the need for benefits can be more difficult than people expect. Thorough testing can make all the difference during ERISA-governed claims and appeals.
Test results can affirm the need for benefits
Even when someone has clear records of an injurious incident or a major diagnosis, insurance professionals may try to claim that the situation does not meet the necessary standard for full benefits. A professional might insist that the worker is still capable of performing their job and simply chooses not to do so.
Particularly when someone has an unusually severe presentation of a medical issue or unusual physical responses to an injury, they may need help convincing the insurance company of their situation. Thankfully, there are tests that can help those adjusting to life with a disabling medical condition. Functional capacity evaluation involves multiple hours of extensive communication and physical work with one trained medical professional.
That professional might be a physician or a physical therapist. Their job is to perform a series of standardized tests to document how someone’s health challenges affect them. They can help prove that someone needs assistance simply fulfilling the obligations of daily life and could not safely complete job responsibilities because of their limitations.
The in-depth testing produces thorough medical records that can bolster someone’s claim that they cannot work. For some people, undergoing testing before applying for benefits could potentially increase their chances of a prompt approval. For those navigating a complicated ERISA appeal, the evidence secured through functional capacity testing could show that the previous professional made the wrong choice. Even if they don’t succeed during the appeal itself, the medical records the testing generates could help them prevail if they have to take legal action against the insurance company.
Pursuing ERISA disability benefits after an injury or during an illness can be a difficult endeavor. Those who have the right support and who gather the right documentation may improve their chances of getting the benefits they require for their financial stability and comfort.