Preparing for Your Long-Term Disability Interview: Questions to Anticipate, Mistakes to Avoid, and Tips to Remember!

 

It’s not unusual for your long-term disability (LTD) insurance carrier to request an interview with you to learn more about your claim. These interviews can be conducted over the phone or in person, and are sometimes called a field interview.

It is important to cooperate with these interviews while also staying on guard. This is because most insurers use these interviews to gather evidence to deny your LTD insurance claim. Thus, if your insurer requests an interview with you, it could be a sign your benefits are in jeopardy.

This article reviews:

• typical questions you should prepare to answer during your field interview
• common mistakes LTD claimants make during these interviews that can devastate their LTD claim
• interviewing tips and tricks to help strengthen your claim and make it more difficult for your insurer to deny LTD benefits

Classic LTD Field Interview Topics

There are a variety of topics the LTD insurance representative will want to discuss during your interview, some of which may feel redundant. After all, by this time, it’s likely you have already completed countless forms for your insurer and provided them with extensive medical records. Shouldn’t they already be familiar with your case?

The answer is yes; however, the insurer has an ulterior motive for these interviews. They may be trying to catch you making inconsistent statements so they can cast doubt on the reliability of your claim. For that reason, it is important to be aware of the common questions so you can provide the best possible answer to protect your credibility and your LTD benefits.

Treatment and medications

The insurance representative will likely ask you to provide:

• the names of your current treating physicians
• how often you treat with them
• the date of your last appointment, and
• the date of your next appointment

They will also want to know what medications you are taking and in what dosage, and whether these medications cause any side effects.

Given your insurer likely already has your medical records, as well as the information you provided in your insurance paperwork, they probably know the answers to most of these questions already. However, they will be checking to make sure your answers are consistent with that which was previously reported in your medical records and claim forms.

Daily activities

It’s common for the LTD insurance representative to ask you to describe your typical daily routine. They will also likely want to know whether you are able to perform household chores—such as doing laundry, vacuuming, grocery shopping, cooking, doing dishes, mowing the lawn, shoveling snow, etc.—and whether you require assistance with any of these tasks. They may also ask about your ability to drive, including how far you can drive at one time.

Remember, the insurance representative will compare your answers to what has already been reported in your Activities of Daily Living form and medical records. For that reason, it is important to be consistent in your reporting of your activities and to make sure your doctor is aware of your activities and supports them as within your range of restrictions.

Use of assistive devices

The LTD insurance representative may ask whether you use any assistive devices, such as a cane, or walker. Give honest answers, keeping in mind the insurance company may have already conducted surveillance on you. Thus, if you report you “always” need a cane, but the insurance company has footage of you walking to the mailbox without your cane, they may use that evidence to portray you as a fraud. (See here for more information about managing surveillance related to your LTD claim.)

Sleep patterns

The insurance representative will likely ask about your sleep patterns, including

• how much you sleep at one time
• how much you sleep total during the night, and
• whether you take naps during the day

These questions are important to assess your potential daytime fatigue levels, including the ways in which your fatigue levels could impact your ability to work.

Memory and concentration 

The insurance representative may want to know whether your medical conditions impact your memory or ability to concentrate. This is especially relevant for claimants suffering from the distraction of chronic pain, and your answer can help assess your ability to perform the cognitive duties of any occupation.

Physical restrictions and limitations

The insurance representative will want you to discuss:

• how long you can sit and stand at one time
• how long you can cumulatively sit and stand during the day
• how far you can walk
• how much weight you can lift, and
• if you have any difficulty with the use of your hands

In answering this question, explain how your abilities may differ from day to day. It can also be helpful to give examples (i.e., you may only be able to sit at a desk for 20 minutes at a time, but can sit longer in a recliner since you are able to lean back). You should also discuss the symptoms you experience when you exceed your limits, and how you may “pay for it” the next day.

In answering questions about your restrictions and limitations, keep in mind the insurer will compare your responses to what has been documented in your medical records, claim forms, and any surveillance footage.

Avoiding Common Mistakes

As noted above, it’s a red flag if your insurer requests an interview with you; they are likely looking for a way to deny your claim. However, you can decrease the likelihood that the interview will lead to a claims denial if you avoid making the following mistakes:

Don’t exaggerate

It is important to provide truthful answers, especially considering the LTD insurer may have already obtained surveillance footage of you. If you are untruthful in your responses, they will be able to cast doubt on your doctors’ reliance on your reported symptoms to assess your functionality.

Never say never (and never say always)

Avoid answering questions in absolutes. This is because the insurance company is likely going to be able to find at least one instance in which any absolute statement did not ring true. For example, you may say you always use your cane, but the insurer has footage of you walking from your car to the doctor’s office unassisted.

Don’t do the LTD field interview at your home

If the insurer requests to conduct the interview in person, it is a good idea to select a neutral location for the interview, such as an attorney’s office. This is because the insurance representative can also rely on their observations of your home environment to deny your claim. For example, if your home was recently cleaned and the yard recently mowed, they may assert you have greater physical capabilities than you’ve reported.

Don’t answer questions with broad generalizations 

During the interview, avoid answering open ended questions with broad or sweeping generalizations. For example, if the insurance representative asks how long you can sit, be sure to take your time providing an accurate and complete response describing how the answer differs based on the type of chair in which you’re sitting, your pain levels, how recently you took your pain medication, and whether you are having a good or bad day.

Tips for a successful LTD interview 

1. Be polite and respectful, but don’t think of the interview as a courtesy visit. Remember that the insurer is looking for a way to deny your LTD insurance claim; they are not stopping in out of the goodness of their heart to check on you and see how you are healing. At the same time, being rude or evasive does your claim no good.

2. Have a list of your medications and corresponding dosages, doctors’ names and contact information, and upcoming appointment dates at the ready.

3. Prepare for the interview by reviewing your medical records and claim forms. It is important that your interview answers are consistent with information reported in those documents.

4. Be mindful of your conduct during the interview and don’t be afraid to ask for breaks. For example, if your medical condition limits your ability to sit for prolonged periods of time, adhere to your restrictions and ask for breaks during the interview to stretch or alternate positions. Likewise, if your medical conditions interfere with your ability to concentrate, you should let the insurance representative know if you are struggling to pay attention to their questions.

5. Be honest. If you don’t know the answer to a question or can’t remember the information, let the insurance representative know you will need to research the information up and get back to them later. This allows you to avoid guessing at information and inadvertently making an inconsistent statement.

6. Obtain legal representation. An attorney will review your LTD policy, claim forms, and medical records to help you prepare for and practice answering interview questions. Additionally, a long term disability attorney can be present during the interview to help manage your answers and ensure your rights are respected.

Contact an experienced LTD attorney

An experienced disability attorney will help you prepare for LTD field interview questions, avoid common mistakes that can jeopardize your claim, and even be present during interview to make sure all goes smoothly. If your LTD insurer asks to conduct an interview with you, contact our office right away. Our attorneys are experienced in navigating long term disability interviews and would be happy to meet with you to discuss your case.

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Jessa Victor