Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Aug 13, 2020

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Determining your eligibility for disability benefits is a process that involves you, your physician, and the disability insurance company. Once your eligibility for disability benefits is approved, you will start receiving your monthly benefit payments. Periodically, you will need to demonstrate you are still eligible for disability benefits in order to keep receiving them by submitting medical information and complying with any other request from your insurance company.

TIP: Sometimes, insurance companies can be over zealous and terminate your disability benefits eligibility before you are able to work.

Losing Eligibility for Disability Benefits

As long as you receive payments, you will need to prove you are eligible for disability benefits. The insurance company will send forms to your medical physician requesting updates on your disability. If there are no objective findings of medical evidence to support the disability or if there are conflicting medical diagnoses (one doctor says one thing, insurance doctor says another), then you will no longer be eligible for disability benefits. The insurance company can stop benefit payments with any indication that you are physically able to work.

What to Do When You Lose Your Disability Benefits Eligibility

Before your disability benefits eligibility is even reviewed, be sure that you keep an open communication with your physician. This will allow you to avoid any surprises. If the company states they are terminating your eligibility for disability benefits, your first step is to get the reason in writing! Depending on the reason you need to do the following:

  1. If you are being denied disability benefits eligibility due to a lack of medical records, find out which record the disability insurance company needs and get it to them. If your doctor needs to fill out a form, try hand delivering the form if possible and ask when you can pick it up to expedite the process.
  2. If your benefits are cut off because the disability insurance company claims that you can return to work at some job, even if not in the same capacity as you used to, review your policy to see what level of work you must be capable of before you lose your disability benefits eligibility. You can get assistance from your physician if you disagree with the company’s assessment of your capabilities.

  3. If your disability benefits eligibility is cut off due to lack of medical objective findings, get your physician involved. He or she may be able to talk with the disability insurance company and deliver the necessary medical documents to prove your disability.
  4. If your disability benefits eligibility is denied because you are able to return to work on a partial basis, review your policy for such benefits as a residual benefit rider or partial disability income rider to see if you can get some insurance money to assist your transition back to full time work. In this case, the disability insurance company or your employer may also want their doctor to be involved in any medical review decision.

Your disability insurance contract will fully explain when you are eligible to receive benefits. Know your policy, and be prepared to demonstrate what is necessary in order to get the benefits you need when you are injured and unable to work.

Working with a Disability Insurance Lawyer

If you feel your condition is still serious enough to prevent you from working, but the disability insurance company is forcing you back to work, it may be time to review your claim with a disability insurance lawyer. A disability insurance lawyer can help you if your disability benefits are cut off prematurely by collecting medical documentation, requesting independent medical exams and referencing applicable state law with regards to your denial in order to help you restore your eligibility for disability benefits. Consultations are usually free, so reach out to a local disability insurance attorney. Click here to use the Free Advice attorney finder, and have one review your case today!