Your long-term disability claim has significant hurdles to go through before being approved. Unfortunately, insurance companies have monetary reasons to look for every mistake that may exist in your long-term disability claim. Especially when you are filing by yourself.
Many long-term disability claims are denied for trivial reasons that exist in the fine print. Do not go at this process alone. Insurance companies have an army of lawyers, and you do not have to be an army of one. Roy Law Group’s team of attorneys are here to help you.
Why long-term disability claims are denied:
1. Insufficient Medical Evidence
Proving that your injury or illness significantly impacts your day-to-day activities and ability to work is critical when filing for long-term disability. Insurance companies will deny your claim if you do not have sufficient medical evidence. You must have the support of one or more treating physicians, or you will not be able to prove your claim.
You generally must be seeking appropriate medical care. Many policies require the support of a treating physician who also must provide you with appropriate medical care, as defined by your policy.
For example, if you have a neurological condition and your policy contains an appropriate medical care clause, at least one of your treating physicians would need to be a neurologist because that is the specialty most suited to treat your condition. Appropriate medical care also requires regular and routine office visits with your physicians.
Regular medical appointments do not necessarily justify your disability according to your policy. You need detailed statements from medical professionals and doctors, detailing exactly how your conditions affect your work and daily activities, and your treating physician must be willing to detail specific work restrictions and limitations while providing their opinion on your ability to work.
Do not rely on the forms from your insurance company. Insurance companies often send out attending physicians statement forms to your treating physicians. They ask questions designed to only satisfy the minimum level of information necessary to fulfill the law and their judgment. Your physician can and should submit as much information as possible to support your claim.
To counter this insurance company approach, reach out to your doctor and other medical professionals and see if they will write a statement on your behalf. In some cases, medical professionals will charge an hourly rate to draft a medical statement separate from the forms they are asked to fill.
2. Inconsistent Video Surveillance
Follow your doctor’s instructions to the letter. Do not make statements to your insurer that you are more limited than you really are. Insurance companies may have a private investigator follow you to video your daily activities to determine if your claim is legitimate.
A five-minute recording can paint a different picture of your life than reality. Your benefits can be denied, or your previously awarded benefits can be terminated if you are videoed doing activities that are seemingly inconsistent with your medical records or statements made about your physical condition.
You should not live your life in fear of being surveilled; however, you need to be aware of the reality that insurance companies will go to great lengths to deny your claim. That includes an invasion of privacy that may include video.
3. Long-Term Disability Insurance Doctors That Do Not Agree with Your Doctors
Insurance companies will hire their own medical experts to look over your medical records and determine whether you are eligible for long-term disability benefits – they may even send you to be examined by them. Many times, insurance companies’ doctors will not agree that you are disabled. This is normal. It is what the insurance companies’ doctors are paid to do.
When two medical professionals disagree, disability claims get denied. You need to persuasively distinguish why your treating physicians’ opinions are more reliable than the insurance companies’ doctors. There are many ways to do this and experienced long-term disability attorneys can help you determine the most persuasive way to present your case.
Have you been denied on your long-term disability claim?
At Roy Law Group, we have been battling disability cases and nothing else, since 2009. This area of law is incredibly complicated. Let our team of experts help you. If we take on your case, you are in a winning battle.
Contact us to learn how we can help you, today.