If you’re planning to apply for disability insurance, here’s something you might not expect: your medical records could cause problems—even if you’re healthy.
We’ve seen a growing trend where doctors, in trying to help patients get coverage from their health insurance, use diagnosis codes that make a condition seem more serious than it actually is. This might help get a procedure approved or a prescription reimbursed, but when it comes to disability insurance, it can backfire badly.
Why Your Medical Records Matter So Much
When you apply for disability insurance, the insurance company wants to know:
“How likely is it that this person will need to file a claim?”
To answer that, they carefully review your:
- Prescription history
- Medical records
- Exam results (if applicable)
If they see something concerning in your records—like a diagnosis of chronic back pain, anxiety disorder, or even a neurological issue—it can lead to:
- Higher premiums
- Exclusions for certain conditions
- Or in some cases, a complete decline
The problem? Sometimes the record isn’t telling the full truth.
Why This Happens
We get it. Health insurance companies have made it harder for patients and providers to get reimbursed. Sometimes, doctors use stronger diagnosis codes or broader terms just to make sure treatment is covered.
For example:
- A patient with a brief tension headache may end up coded with “chronic migraine”
- Mild anxiety during a stressful life event becomes “generalized anxiety disorder”
- Minor back discomfort after a weekend project gets labeled as “degenerative disc disease”
This kind of documentation may be no big deal for your health insurance—but disability insurance companies see red flags.
Real-World Consequences
We’ve helped many physicians and dentists through this process, and we’ve seen good people—healthy people—get hit with:
- Exclusions (meaning the policy won’t cover a specific body part or condition)
- Rate increases
- Declines, even when the actual health issue was minor or temporary
And once it’s in your medical record, it’s hard to explain it away. Disability insurance underwriters don’t assume the diagnosis was exaggerated—they treat it as fact.
What You Can Do About It
If you’re planning to apply for disability insurance, it’s a good idea to review your medical records ahead of time, especially if:
- You’ve been to the doctor recently for pain, stress, or fatigue
- You’ve had procedures approved under your health insurance
- You’ve taken medications that might raise questions (like antidepressants or muscle relaxers)
If you notice anything in your chart that doesn’t accurately reflect your condition, talk to your doctor and ask them to update or clarify it. Many physicians are willing to correct or add notes when asked.
It’s much better to handle this before applying than to try to explain it away after the insurance company flags it.
Our Advice at DoctorDisability
We’re here to help you get the strongest policy possible—and that means helping you avoid surprises during underwriting.
If you’re not sure what’s in your medical records, or you’re worried about how something might be interpreted, talk to us before you apply. We can help you take the right steps, time things correctly, and work with your doctor if needed.
Final Thought
Your medical records are meant to help you—but sometimes they can get in the way, especially when applying for disability insurance. A small coding change or outdated note can have big consequences.
Reach out to us at before you apply, and let’s make sure everything is in order.
Getting coverage should give you peace of mind—not surprise headaches. Let’s get it right, together.
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