If you sustained an injury or developed a severe medical condition that makes it impossible for you to work, long-term disability insurance can offer the necessary financial assistance. But there’s no guarantee that companies that offer disability insurance will approve your claim. Long-term disability insurance can be bought individually from a provider or given by employers in group plans. Typically, insurance companies delay benefits to try to hold on to premium payments. As insurance companies can deny disability claims for various reasons, you must understand these reasons. These include the following:
Disability Definition
Your injury or medical condition should meet the disability requirements of your policy. A skilled disability attorney can walk you through these definitions and determine if your condition meets the requirements. If so, they will help you fight for the benefits you deserve.
Insufficient Medical Documentation or Evidence
Disability claims need to be supported by proof of the disability in writing. In some instances, insurance companies do not get all your medical records. Ensure the insurer requested all documentation that supports your disability claim and that such records were received. Documentation includes chart notes, medical records, test results, and prescription records. You must also demonstrate that you are getting regular medical care from a physician or therapist. If you are suffering from a mental health problem, you should have proof of visits to a psychiatrist or psychologist. If you cannot present this supporting evidence, the insurer may deny your disability claim.
Missed Deadlines
If you are seeking disability benefits, you need to file a claim and submit the requested documents on time. If your claim is denied, make note of the filing deadline and the deadline to file an appeal. Missing the deadline can mean losing your chance to file a lawsuit against an insurance company in federal court. You must submit all medical documentation and records as soon as possible.
The Policy Does Not Cover Your Condition
Some medical conditions are not covered by ERISA or private long-term disability insurance. Also, this insurance denies coverage for conditions such as alcohol or drug abuse, a crime-related injury, or a self-inflicted injury. Often, pre-existing conditions are not covered. Also, insurance companies may limit or even deny coverage for conditions based on subjective complaints like chronic fatigue syndrome, depression, or fibromyalgia.
Disability benefits can be a lifeline for people who cannot work due to a disability or serious illness. If you cannot work because of an illness or an accident-related injury, you may be entitled to long-term disability benefits. To reduce your risk of being denied benefits, hire a disability attorney to help you.
