Many years ago when I was still giving expert testimony in disability cases and depositions, the attorney would tell me in no uncertain terms: TO SHUT UP! “Yes” and “No” are still very good answers they would tell me. “If you continue to speak, you’ll just be giving the opposition more ammunition to come back at you with.” These were hard lessons to learn, but they remain true today especially when it comes to disability claims,
Disability insureds and claimants come with all sorts of different personalities including those who think that the more they OVERSPEAK their claims, the more payable they are. Actually, it’s quite the opposite. Writing ten pages about your disability over and over again has a surprising effect most claimants wouldn’t even consider. That is, excessive writing and written subjective description gives claimants and insureds WORK CAPACITY.
Let’s take for example a female claimant who was an Executive Secretary. She is now claiming disability on the basis that she cannot sit for long periods, and can no longer do repetitive keyboarding. Yet, her insurance company continues to receive long reports from her expounding on her disability and how it affects her. Other claimants often call the insurance company and carry on long conversations about themselves and their disability.
I think it is important for all insureds to remember that, “insurance companies cannot hold against you what you do not say.” In fact, this is one of the major recommendations I make to my clients. Another is, “answer the insured’s questions, then STOP.” It is important for all claimants and insureds to remember:
- Insurance companies consider claimants and insureds to be the least credible. What you say doesn’t matter.
- Insurance companies do not care about how you “feel”, or how your disability is affecting you. Leave out all of your subjective comments about your health and disability.
- Do not send any insurance company letters with more than two paragraphs. There may be exceptions to this, but only under the guidance of an expert or attorney.
- Answer only the questions you’ve been asked, then STOP.
Never communicate specific functional capacity since your activities will be used as a basis for surveillance. Remember, less is more. Responses should be the truth, but generic in nature. For example, all insurance companies have a version of the question: “Describe a typical day for you.” Most insureds will give the obvious response and begin with “I have my orange juice in the morning,” and after two pages of described daily activity, “I go to bed after the news.” Wrong, wrong, wrong. The best response is: “My daily activities continually change in accordance with varying levels of pain (or, whatever applies to you) and confusion.” While this is a truthful answer, it does not give specific detail about activity.(See my previous posts on how insurance companies determine work capacity by using METS.)
My message here is that as a claimant who is continually being investigated in order to receive benefits, know what to say, how to say it, and know when to STOP talking. I’ve labeled this tendency as OVERSPEAKING your claim. OVERSPEAKING a claim may indicate to the insurance company that you have work capacity. If you send long letters often, eventually they wind up in the trash as no one is willing to keep reading them. Answer only the questions asked and then, as my attorneys always said, “just SHUT-UP!”
