“Self-Reported” Symptoms: How to Fight Back With Medical Evidence
If you’re living with a disabling condition, you probably have a long list of symptoms that don’t show up on an x-ray or MRI. These might include fatigue, nausea, chronic pain, depression, and anxiety. While these conditions are very real, disability insurance companies are often skeptical of subjective or self-reported symptoms.
In this blog, Bryant Legal Group explores these hard-to-understand symptoms and how insurers try to use them to deny or reduce the value of long-term disability (LTD) claims.
What Are Self-Reported Conditions?
Self-reported conditions involve symptoms that cannot be objectively confirmed by a diagnostic test — such as a CT scan, blood test, or nerve conduction study. These conditions don’t just include nebulous conditions like fibromyalgia and chronic fatigue syndrome; more mainstream diagnoses like lupus, migraines, inflammatory bowel disease, and many auto-immune disorders also involve subjective symptoms.
Common self-reported symptoms include:
- Fatigue and decreased stamina
- Chronic pain and discomfort
- Nausea and stomach pain
- Depression and anxiety
- Visual disturbances
- Ringing in the ears (tinnitus)
- Poor concentration and memory loss
There are often valid (and sometimes even life-threatening) conditions behind these symptoms. However, because of their subjective nature, these underlying conditions sometimes remain unknown — and proving their existence becomes complicated.
Why Do Disability Insurance Companies Focus on Subjective Symptoms?
Insurance adjusters have one job: to determine whether or not you meet the requirements of your disability insurance plan. Because subjective symptoms are typically unquantifiable, insurance companies tend to assign them less weight than objective symptoms when making this determination.
Insurance companies focus on self-reported conditions for a variety of reasons. First, their employees are trained to be skeptical and on the lookout for fraudulent claims. While fake disability insurance claims are very rare, they do occur.
Second, insurance companies also want to avoid having to pay LTD claims and will search for excuses to reject your claim or reduce its value. Most long-term disability plans include a limitation for “self-reported” conditions. If your claim falls under this clause, you might only be eligible for two years of benefits — dramatically reducing the value of your claim.
Medical Evidence Can Strengthen Your Disability Insurance Claim
If your disability largely involves subjective or self-diagnosed symptoms, obtaining medical records and other evidence will be crucial to proving your disability claim. However, proving the validity of your claim isn’t as simple as handing the insurance agency your medical history.
Consistently Seek Medical Treatment
When you’re not working, it can be tempting to reduce your out-of-pocket medical bills by self-treating, especially if you know how to manage symptom flares. However, your physician can document both your self-reported and objective symptoms. These notes will serve as critical evidence in an LTD claim since they identify the frequency and severity of your symptoms.
For example, suppose you have COPD or chronic asthma and experience a symptomatic flare. You can document self-reported problems like fatigue and shortness of breath in a disability journal, and your doctor’s office can substantiate them with your oxygen saturation levels, pulmonary function tests, and chest x-rays. Just as importantly, your doctor might also be able to help you improve your symptoms with a comprehensive treatment plan.
Provide Detailed Medical Records and Notes With Your LTD Application
Some medical reports are merely a record of past injuries, illnesses, and treatment plans and do not include the type of information insurers need to assess your disability. You’ll want to ensure that your medical records focus on how your symptoms impact your daily life and abilities.
- Let your doctor know that you are filing (or are considering filing) for disability benefits.
- Ask your doctor to record any impairments and objective findings they notice during your appointments and examinations.
- Inform your doctor of any episodes or difficulties that occurred between visits and ask them to include a note in your record.
Submit a Doctor’s Letter Explaining Your Disabilities
Many disability insurance companies do not lend much credence to a doctor’s letter, especially if it is short or written after you applied for benefits. However, a thorough letter could be beneficial to your claim. Ask your doctor to write a letter that includes:
- A summary of your treatment history
- Your current physical or psychological conditions
- Objective findings that support your diagnoses, highlighting test results and clinical evidence
- A discussion of how your condition limits your ability to work
- A projected recovery timeline or prognosis
Bryant Legal Group: Discover Our Approach to Disability Insurance
Bryant Legal Group’s respected disability insurance lawyers are known for their sophisticated legal strategies and client-focused results. If the insurance company denied your claim or limited your benefits due to “self-reported conditions,” please contact our office for a free consultation. We can help you understand your legal options.
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.