No matter how specifically the insurance policy defines what it takes to be considered disabled, insurance companies can always create enough wiggle room from their definition to determine that a claimant does not meet the policy definition. Indeed, the #1 reason why disability claims are denied is that the insurance company contends that the claimant has provided insufficient documentation or evidence to meet the policy definition of disability. The difficulty usually stems from the fact that the physician who is treating you is likely a very busy individual whose goal is to provide proper medical care for his patient, not document his patient's file for the purpose of proving a disability claim. Because it is the physician's chart notes which the insurance company reviews to determine whether disability has been proven or not, the disability claim will often be denied simply because the doctor's office notes don't specifically state why the patient can't perform his or her job.
For example, the doctor's notes may simply state that the patient should be off worker that the patient is disabled from working or other similar types of conclusory statements. While those statements are more than adequate to document the patient's chart from the physician's perspective, these types of conclusory statements are rarely sufficient from the insurance company's perspective.
As a result, it is extremely important that you request your physician to specifically document, either in your chart or in a supplemental report, the specific types of work activities that you are unable to perform due to your physical limitations. For example, if your job entails the regular lifting of heavy boxes over your head, the doctor's notes need to specifically reference those limitations as opposed to simply stating "patient is unable to work." As another example, if your job requires typing all day long and you have broken one or more of your fingers, the doctor needs to note that your "regular typing duties can't be performed because of your condition, not that you are simply unable to work".
As can be seen, the goal is to connect specific physical limitations to your specific job duties and requirements rather than simply relying upon conclusory opinions from your physician which, even though honest and well intended, will cause the insurance company to claim that you have provided insufficient proof as to why you are disabled and unable to work.
