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In the matter of insurance claims (and disability claims in particular), it is generally true that "the best defense is a good offense." It will be easier to gain approval of a claim -- whether in the first instance or after a denial -- if you have laid a foundation well in advance of ever filing the claim.
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Don't be stoic. Although it is important to keep an optimistic disposition in the face of chronic illness, bear in mind that claim examiners latch onto patient comments such as "feeling good today" -- frequently recorded by physicians in their medical charts -- as a basis for concluding that a claimant is not debilitated. Do keep a positive outlook, but also make sure you affirmatively report and carefully describe your symptoms. Be specific, concrete, and document any impact on your ability to work or your activities of daily living, such as cleaning, cooking, self-care, grocery shopping, socializing, etc. Instead of saying only that you are "very tired," report that you must take 1-hour naps (at the office), are sleeping 10 instead of your normal 7-8 hours at night, are arriving late to (or leaving early from) work due to exhaustion, have stopped cooking your own meals in favor of ordering in, etc. Such specifics will not only help document an insurance claim, but will do a better job of communicating to your doctor the nature and severity of your symptoms.
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Make sure your doctor takes notes. Many physicians fail to document patient symptoms -- because the symptoms have not worsened or improved, or because the symptoms are unnecessary for diagnostic purposes. Claim examiners, nonetheless, will insist that if a symptom does not appear in a doctor's medical chart, it either did not exist or wasn't very severe. Impress upon your doctor the importance of charting symptoms (with specificity), and that a little investment of time during each office visit may avoid substantial expenditures of time later preparing narrative letters in support of a denied claim.
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Keep copies of all medical records as you go along. Nothing is worse than trying to collect extensive medical records from multiple health care providers in order to meet a tight claim appeal deadline. This process can be even more harrowing when a doctor has, in the meantime, died, moved, or otherwise sold his or her practice. Hospital record departments are notoriously slow in responding to requests. You are entitled to your medical records, upon submitting a signed authorization. Be sure to do so, and to follow up and get those records. It will save you headaches and delays later, and also gives you a means to verify that your treating physicians are fully and accurately recording your medical symptoms and complaints.
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Provide as much detail and documentation as possible when submitting your claim. Don't confine yourself to the little boxes on a claim form. Attach extra sheets to identify all your doctors or to describe your symptoms (and their effect on your functioning) in detail. Get your physician(s) to submit a letter (or letters) in support of your claim. To be effective, such letters should not simply state a medical conclusion, but should instead summarize your diagnoses, medical history (symptoms reported, physical examination findings, laboratory and test results, treatment history, current medications and side effects, complications, referrals to other doctors, etc.), and then the conclusion (for example, that you are disabled or that a proposed treatment is medically necessary). If making a disability claim, you should be sure your doctor knows your occupation, your important job duties, and how your illness or symptoms are interfering with your performance of those duties.
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