You have a medical condition that is legitimately disabling and you're preparing a disability claim to submit to your insurance company.

A lot is riding on this: your health, your finances, your future as you know it. You've heard insurance companies have high denial rates for long term disability claims (hovering around 60%) and worry they will deny your LTD claim like they have so many others.

Why are long term disability claims denied?

There are several common reasons why disability claims are denied by the disability insurance company. Some of the most common reasons are:

• Filing a claim or appeal late: Policies from disability insurance providers often stipulate a timeline under which to submit a long term disability claim, beginning from the point you first became disabled, but this timeline isn’t always clear.
  
  

• You are not “totally disabled”: Insurance companies use the term “totally disabled” because they want you to believe that you need to be paralyzed or in a coma to qualify for long-term disability. “Totally disabled” means that a doctor has confirmed that you’re unable to perform the essential aspects of your own job.
  
  

• Insufficient medical evidence: The disability insurance company may not accept your doctor’s assessment of your disability, especially in cases where your condition cannot be verified through medical evidence such as diagnostic imaging or a blood test. This is often the case with mental health claims and chronic pain disability claims, that cannot be proven through testing.
  
  

• Your medical condition is contested by the insurer: An internal medical consultant may review your long term disability claim application and report that your condition is not severe enough to meet the disability insurance benefits criteria.
  
  

• Pre-existing condition: One of the most common reasons for rejecting a disability claim is the pre-existing condition exclusion clause. If the insurance company determines that you sought treatment before your disability insurance policy took effect, your long term disability claim may be denied.

Why exaggerating your symptoms can cause a denial of long term disability benefits

Applying for disability benefits can be intimidating, especially knowing how often insurance companies unfairly deny legitimate disability claims. Because of this, it might feel tempting to do everything in your power to submit the best claim possible - one that they could never turn down. We’ve heard it from many clients over the past 35 years of working in long term disability law: some people feel like they could exaggerate their symptoms, thinking that it might give them an extra chance of receiving their long term disability benefits. However, it's important to remember that if the insurance company finds out that any information in your application is untrue, your claim will be immediately dismissed with little chance of appeal or working with our long term disability lawyers to fight back and get what is owed to you.

Your insurance company’s claims adjuster has years of experience handling disability claims. They are eager to weed out what they consider to be "invalid" claims. Don't attempt to outsmart the powerful insurance company - it’s a losing game. Instead, arm yourself with legitimate proof to support your claim. Don't allow feelings of fear and intimidation to get the best of you. Stand behind everything you claim in your disability benefits application.

In addition to this, if you have applied for long term disability benefits, your insurance company may be watching you.

As we’ve discussed many times, surveillance is standard practice for insurance companies, as their ultimate goal is to deny your claim or terminate your existing benefits. To build a case against you, the insurance company will often check in on you to ensure that you’re not lying or exaggerating your insurance claim.

Follow the rules to avoid a denied disability claim from the insurance company

Though it may seem tempting to exaggerate your symptoms, it’s not worth the risk. You have a valid claim if:

• You have strong support from your medical doctors validating that your disability prevents you from working

• You have followed the claims submission process as outlined in your insurance policy

What is in your power is to present the facts and hope that your insurer lives up to their end of the bargain.

If you do receive a denial, that's when you need to hire a lawyer experienced in the area of disability law to fight for your benefits on your behalf. Be proud of yourself for being honest and following the rules. Remember, that with our help, you will get what is rightfully yours. Contact us today for a free consultation.

If your disability claim has been denied but you’re not ready to talk to anyone, you can read more on our Denied Disability Benefits page.

Denied your long term disability claim?

Contact the disability law firm Share Lawyers today and put our experience to work for you. Our 35+ years of experience can help you win your case against Canada Life, Desjardins, Manulife, RBC Insurance, Sun Life, and other insurance companies. Our disability law firm offers a free consultation and there are no fees unless you win your case. Join us on Facebook and become a Top Fan for a chance to win each month.