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What Proof Do You Need for a Disability Insurance Claim?

By Jenny Tsay, Esq. on April 17, 2014 | Last updated on March 21, 2019

When filing a disability insurance claim, claimants will need to provide proof of their medical conditions.

Depending on your disability insurance policy, the required proof can include things like a doctor's letter and records from the agency that provides the disability benefits.

So here's a rundown of the claim filing process and how to provide proof of disability:

Filing a Claim

The first step towards receiving disability benefits is to file a claim with the insurer. In general, filing a claim typically requires the policy holder to fill out forms describing her injuries and job duties. Most disability insurers will require the policy holder's physician to submit a report detailing the injury, treatment plan, and confirm that the worker isn't able to return to work with the current injury. After that, the insurer may approve or deny the claim.


One thing to look out for in your disability insurance plan is a discretionary clause. Discretionary clauses gives insurers the ability to overrule doctors' opinions and rule that the injured person isn't entitled to benefits. However, some states like California have barred discretionary clauses in disability insurance policies.

Providing Proof

Your disability insurance plan will tell you exactly what you need to prove in order to claim a disability and receive benefits. The bottom line is that it's up to the insurance agency to determine what documentation is acceptable.

For example, the Office of Personnel Management for the federal government accepts statements or letters on a medical professional's letterhead stationary or statements or records from a federal government agency that issues or provides disability benefits.

On the other hand, Oregon's disability insurance for its public employees won't cover disabilities if there's proof that the injury is caused by drug use, a pre-existing condition, mental disorder, or being under the influence of intoxicating liquor.

It's important that you know what's needed to prove your disability insurance claim, because failure to abide by the claims procedure could result in a denied claim.

If you're unsure what type of proof you need to provide for your disability claim, contact an experienced disability attorney in your area to help guide you through the process.

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