The Importance of Your Treating Physician’s Notes

Physicians filing a disability insurance claim often underestimate the complexity of the process. Unlike health insurance, which pays one-time reimbursements for services provided, disability insurance claims are ongoing and expensive. The disability insurer heavily scrutinizes each claim for disability benefits it receives, including looking at the records of treating physicians.

Insurers carefully examine every claim form and your treating physician’s notes for any information that can be used to deny the disability claim. It is important that these records are complete and descriptive in the insured’s diagnosis, symptoms, and functional limitations. Unfortunately the pressures of a modern medical practice mean that physicians spend less time treating patients and more time filling out paperwork. What should be detailed evaluations of a patient’s history and limitations often become abbreviated notes cobbled together from several doctors. As an article in the New York Times noted, “A doctor’s note turns into a cut-and-paste collage instead of an accurate and personalized narrative of illness; and documentation becomes an electronic and potentially dangerous version of the game ‘Telephone.’”

Insureds thus cannot rely upon merely being treated by their physician; they must take an active role in ensuring that their physician adequately documents their disability, its nature, and most importantly, the resulting functional limitations. Treating physicians’ notes often lack sufficient description of what the insured can and cannot do—and the insurer will be happy to fill in the missing information in its favor. Treating physicians need to use language such as “incapable of performing his occupation” as part of detailed narrative statements describing the insured’s condition. Insureds must work with their disability insurance attorney and treating physician to properly present their claim, and the foundation begins with a detailed treatment narrative.