How to Get Approved for Disability Benefits

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Despite our impressive wealth of medical capabilities, becoming unable to work due to injury or illness is still common today. When this happens, you may need to rely on disability benefits from your group or private insurance company to fill the financial gap from lost wages.

Getting your disability case approved can be daunting. That’s why we’ve created an easy-to-follow guide that shows you how to get approved for disability benefits. If you need further assistance, our experienced disability lawyers offer a free consultation. Feel free to reach out to us.

Are you wondering how to get approved for disability benefits? Share Lawyers’ experienced team helps you get what you’re owed.

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How to Get Approved for Disability Benefits

If you’ve become sick or injured and are unable to work, you’re probably wondering how to get approved for disability benefits. The following table provides a detailed look at the process.


How to Get Approved for Disability Benefits

Understand Your Policy

Coverage:

Review your insurance policy to ensure that you understand the definitions of disability, the coverage your policy provides, and the conditions under which you can claim benefits.

Eligibility:

Ensure that you meet the criteria specified in your policy, including the type, severity, and any waiting periods.

Gather Documentation

Medical Records:

Collect all relevant medical records, such as your doctor's diagnosis, treatment plans, and notes.

Insurance Policy:

Keep a copy of your insurance policy and a record of any communication with your insurance provider.

Complete the Application

Claim Form:

Complete your insurance claim. This form requires detailed information about your medical condition and how it impacts your ability to work.

Physician’s Statement:

Have your physician complete the medical certification portion of your claim form and ensure they detail your diagnosis, treatment, and prognosis.

Submit the Application

Documentation:

Make sure that all relevant documents are included with your claim form.

Method:

Submit the application according to the instructions provided by your insurance company. This could come via mail, email, or online portal.

Follow Up

Confirmation:

Confirm the receipt of your application with your insurance company.

Additional Information:

Be ready to provide any additional information or clarification requested by the insurance company.

Assessment and Decision

Evaluation:

Your insurance company will review your claim. This could involve interviews, medical evaluations, or consultations with independent medical practitioners.

Decision:

If approved, your benefits will begin as outlined in your policy. If you are denied, you will receive a denial letter outlining why.

Appeal if Denied

Review Denial:

Ensure you understand the reasons for the denial and gather additional information.

Appeal Process:

While you can do this alone, seeking professional legal help is recommended as it increases your odds of success.

Following your insurance company’s appeal process, which may require additional information or escalating the appeal is unlikely to succeed.

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Why Your Claim May Be Denied

Insurance companies regularly exploit the complexities of the disability benefits process to avoid paying their policyholders. Because these corporations often prioritize their bottom line over your health and safety, it’s important to prepare for a denial. To that end, here are some of the reasons a claim can be denied.

  • Insufficient Medical Evidence: Insurance companies may deny your claim if it lacks comprehensive medical documentation. Provide detailed medical records, physician statements, and diagnostic test results to support your condition.
  • Does Not Meet the Definition of Disability: Insurance policies define what constitutes a disability. Your claim may be denied if your condition doesn't align with this definition. Understand your policy's criteria to ensure your condition meets those standards.
  • The Insurance Company Believes You Can Still Work: If the insurance company decides you can still perform your job duties or other types of work, they may deny your claim. This assessment typically involves reviewing your job description and medical reports.
  • The Insurance Company’s Doctors Believe You Can Work: Insurance companies may have their medical professionals review your case. Your claim could be denied if these doctors believe you can work despite your condition. Providing medical solid evidence from your healthcare providers can help counteract this.
  • Pre-existing Medical Condition: If your disability is linked to a pre-existing condition that was not disclosed when you obtained the insurance, your claim might be denied. Review your policy to understand how pre-existing conditions are handled.
  • Surveillance: While it is unfair and a clear violation of your privacy, insurance companies may conduct surveillance to verify the legitimacy of your claim. If their findings contradict your reported limitations, they may deny your benefits. Be consistent and truthful about your capabilities and limitations.
  • Change of Definition: Some policies change the definition of disability after a certain period. For example, the definition might shift from being unable to perform your specific job to being unable to perform any job. Your benefits might be stopped if you don't meet the new definition.

If your disability insurance claim is denied, it’s not the end of the line. While you can file an appeal on your own, it’s highly recommended that you seek guidance from an experienced disability law firm. Team up with Share Lawyers to increase your odds of winning an appeal and securing your benefits.

Share Lawyers Works Hard to Secure Your Disability Benefits

At Share Lawyers, we understand how frustrating it can be to find yourself unable to work because of an illness or disability. If you experience a denial, it can further increase the stress you’re probably already feeling.

That’s why we've worked diligently for over 35 years to fight insurance companies and secure benefits for our clients. We’re one of the first law firms in Canada to focus on disability law, and we’ve fought tooth and nail to help over 8,000 individuals obtain the benefits they deserve.

Our track record speaks for itself. We’re so confident that we can win the cases we take on that our clients owe us nothing until they win. It all starts with a free consultation with one of our disability lawyers.

Need more information on how to get approved for disability benefits? Give us a call, and we’ll explore your options.

Contact Share Lawyers today and let our 35+ years of experience work for you. We can help you win your case againstCanada Life, Desjardins, Manulife, RBC Insurance, Sun Life, and other insurance companies. Our legal team offers a free consultation and works on a contingency basis. There are no fees unless you win your case.

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