Insufficient Medical Evidence Leads to Long-Term Disability Denial

Making a claim for long-term disability benefits can be a stressful and tedious process. Assembling the documentation, going to the medical examinations, and continuously following up with your provider are just a few of the steps that come when making a claim. But what happens when your claim is denied? What happens when the basis of that denial is insufficient medical evidence?

Medical evidence is essential in establishing disability. Treatment providers and medical experts are often called upon to address this issue. Insurance companies are looking for “objective” evidence of a disabling condition such as test results, x-rays, MRI’s, CT-scans. Often these test results don’t provide definitive evidence, however, the more information regarding the medical reason for your disability, the higher your chance of being approved for disability benefits.

Insufficient Medical Evidence

Insufficient medical evidence is often the reason given by insurers in situations where the medical documentation only lists the medical conditionbut does not specify how it interferes with your ability to do your job. Medical evidence can also be found insufficient if it has inconsistencies, contradictions, falsehoods, or omissions (such as previous medical conditions).

To enhance the chances of your claim being approved, medical documentation should:

• describe the nature, severity, and duration of the employee’s impairment, the activity or activities that the impairment limits, and the extent to which the impairment limits your ability to perform the activity or activities; and
• substantiate why the condition is a disability
• provide a treatment plan and goals that will be worked towards with the help of a health practitioner

Overall, your documentation must support the claim you are making, with appropriate medical history, supporting medical documents from your healthcare practitioner, and extensive information about the symptoms you are having and how they affect your work and life.

If the insurance company denied you because of a lack of "objective medical evidence", this does not mean you are ineligible for benefits. Having your doctor(s) support your claim for disability is also very important, and having them prepare the Attending Physician Statement, and adding additional information beyond the forms questions, may enhance your chances of being approved.

If your claim has been rejected by the insurance company, retaining a lawyer who understands the nature of your medical condition and has experience litigating these insurance claims is the next step. Contact Share Lawyers today or Ask A Lawyer your question to get started.

Denied your long term disability claim?

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A note from our long term disability lawyers

Taking a medical leave from work is not an easy decision to make. Concerns about providing for yourself and your family and keeping your job may cause you to want to push through your pain, but this won’t make your problems go away. Stopping work is often the smartest decision for your long term health and well-being, and your disability benefits are there to provide you with financial support until you can return to work.

If you have made the tough decision to stop working and apply for your short term disability or long term disability benefits, you may feel overwhelmed by the process and have questions that your employer and your insurance company are not able or willing to answer. Share is There to see you through and answer your questions.

Our Disability law firm knows what you have been going through

We understand that things have not been easy for you over the last little while. Your health has been suffering, you are unable to work, and now your insurance company, who was supposed to be there in your time of need, has decided they will not pay your disability benefits or respect your disability claim. These benefits exist to provide you with the financial support you need so that you can focus on your health and rebuilding your life. It is unfortunate that your insurance company has not lived up to its promise. If your disability claim has been denied, we will fight to get you the benefits you are entitled to. Our disability lawyers have helped thousands of Canadians get their long term disability benefits over the past 35 years, and we can help you too.

Our experienced disability lawyers can fight back on your behalf

Share Lawyers believes that every client who is dealing with a disability claim deserves superior personal service. To achieve that goal, we have developed our team of experienced, compassionate, and caring long term disability lawyers, law clerks, and administrative staff to meet all of your needs. Our team of experienced long term disability, life insurance, employment, and critical illness insurance lawyers have made successful claims against many insurance companies, third-party administrators and employers.

If you are unable to work, your disability benefits should be there to provide you with the financial support you need. While your insurance company may be focused on finding ways to avoid paying your claim, our focus is on what is in your best interest. When Share Lawyers gets involved, you have an entire team of lawyers that are there to support you and to fight for what is yours.

Our disability claim lawyers fight for your disability insurance claim by relying on our many years of experience to apply the best strategic planning and approach in each case, using the latest technology available. Experience matters, and with Share Lawyers, you are in the best hands with 35 years of success on your side.

In this video, we explain the role of a long term disability lawyer and how we can support you when you have been denied your long term disability benefits.