5 Reasons Why Your LTD Claim May Have Been Denied & What to Do Next
Living with a disability is one of the most exhausting challenges a person can face, especially when you have no source of income because your disability insurance claim is denied. On top of your health difficulties, medical treatments, and being unable to work, the insurance company that was supposed to be there for you has decided they will not pay your disability claim. The insurance companies' decisions can often be frustrating, not to mention the reasons are often poorly explained. If your long term disability benefits have been denied, Share Lawyers, a law firm that specializes in disability law, will fight to get you the disability benefits you are entitled to. We offer a free consultation and there are no fees unless you win your case.
Here are the 5 most common reasons a disability lawyer sees for denied long term disability claims.
Insufficient Medical Evidence
If your disability insurer says there is not enough medical information to approve your long term disability benefits, it means they don't believe you should get benefits because they don't think your medical situation is bad enough. A disability lawyer will understand that your doctors know best and if they say you should go off work and get your disability benefits, then you should.
Insufficient medical information is a common obstacle met by many long term disability leave claimants. Unfortunately, this often means that insurers are requesting more detailed proof of diagnosis than what an individual may have at their disposal. Navigating the disability claim process can be tricky, as it's important for those with severe medical issues to get professional advice from a doctor (and disability lawyer) who understands their cases best – not an insurance industry representative making decisions on disability claims without all the full facts and context in hand.
Does Not Meet the Definition of Disability
Another reason an insurance company might not approve a disability claim is if they don't think the person is disabled enough. The insurance company might think the person can still do their job, even though their doctor says they can't. This isn't right. If the doctor says someone is too disabled to work then the insurance company should agree. If the insurance company does not agree, you should consider moving forward with legal services.
If you have been denied disability benefits, it can be very upsetting. Denial of disability claims can feel like a devastating evaluation specifically for those with invisible medical conditions, such as chronic pain and mental illness. However, it is important to know that the insurance company's decision is not necessarily final; many times insurers make decisions that may override your doctor’s expert opinion. If you believe you are entitled to receive disability support but have been denied coverage by an insurer - don't give up hope! You should consider challenging their verdict with the help of an experienced disability lawyer.
The Insurance Company Believes You Can Work
Despite the medical evidence included in your application, the insurance company thinks you can work. They might have you talk to one of their doctors or have their doctor review your medical claim. But the opinions of your doctors are important too. Your doctors know you better than a doctor who has spent a very limited amount of time assessing your disability.
The insurance company's review of your disability claim may come to a conclusion that differs from what you and your doctor believe. Your insurer might have you speak to one of their doctors or have their doctor review your medical claim. While the insurance company may base their decision on the opinions of their doctors, the opinions of your doctors and other health care providers are important as they have your best interests in mind and know you better than a doctor who may have only reviewed a paper file or spent a very limited amount of time assessing your disability. If their doctor’s review has resulted in a denial of disability benefits, then you need to contact us immediately.
You Have a Pre-existing Medical Condition
If your insurance company denies your disability claim because they say your medical condition is pre-existing, they might not be saying that the medical issue causing you to stop working existed before your disability insurance coverage started.
A pre-existing exclusion under your policy only applies if you have been covered under the policy for a short time (usually in the first year you have benefits). This kind of denial needs a proper review of your medical records to see if the insurance company was right to deny you. It's best to talk to one of our long term disability lawyers to see if it is possible to fight their decision.
If you are having difficulty obtaining disability benefits due to a pre-existing medical condition, know that it is not an uncommon situation. A pre-existing policy exclusion typically only applies in the first year of coverage, so getting legal advice on your specific case can be essential for determining whether or not these restrictions will apply. With experienced and compassionate guidance from a long term disability lawyer familiar with this complex process, you could find yourself one step closer to securing much-needed support during difficult times.
Insurance Company Surveillance
Insurance companies can use social media and private investigators to look into people's activities. If your insurance company is using information from surveillance to deny your claim, it does not mean you are lying. Sometimes insurance companies make decisions without checking if the information is true. Even if they find information that proves you can do your job, they might be wrong. Talk to our team of disability lawyers to see how you can fight their decision to deny your disability claim.
Insurance companies can be ruthless when it comes to disability benefits, oftentimes resorting to surveillance tactics like monitoring social media posts or hiring private investigators. Though their goal is likely intended for the greater good of protecting themselves from fraudulent claims, too often this kind of investigation results in innocent people's disability claims being denied without taking all necessary context into account.
Being denied LTD benefits can be a confusing and frustrating experience. You may be wondering why your claim was denied and what you can do next. While there are many reasons why claims are denied, it's important to keep in mind the five most common reasons. Hopefully, this information will help you understand the denial letter you received and give you a better idea of how to proceed.
It's understandable to be overwhelmed and feel lost if you have been wrongly denied your disability benefits. It can be hard to figure out your next steps in getting a fair settlement and securing the disability payments you are entitled to. Don't lose hope. You are not alone.
If after reading this post you still have questions or need assistance, please reach out to our disability lawyers for a free consultation. Our disability lawyers will explain in detail how best to pursue your disability benefits and what type of compensation you may qualify for. It's always free to talk to us and there are no fees unless you win your case.
In this video, our disability law firm explains why you shouldn't give up on your disability claim if you've been denied.
Not ready to speak to someone? This page has all kinds of helpful information about disability benefits for Canadian residents that can help you start understanding your options.
Denied your long term disability claim?
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