A long-term disability claim can be denied for many reasons, both big and small. One missed deadline or mistake on your claim form can have a major impact on your life. Unfortunately, denied disability claims are all too common.

There are some things you can do to improve your chances of getting your disability claim approved. One is to avoid making common mistakes when filing your claim. Another is to get the help of an experienced disability lawyer. Your insurance company has an army of lawyers and endless resources; you should not go through the process alone.

We’ve outlined five common reasons long-term disability claims are denied here. Every insurance policy is different, and additional reasons could apply to your situation.

Why would long-term disability be denied?

Insufficient medical evidence

To apply for long-term disability benefits, you must show that your medical condition or injury has prevented you from working. You must have the support of one or more treating physicians, or you will not be able to prove your claim.

Insurance companies often send out attending physician’s statement forms to your treating physicians. Do not rely on the forms from your insurance company. They ask questions designed to only satisfy the minimum level of information necessary to fulfill the law and their judgment.

Reach out to your doctor and other medical professionals directly, and ask if they will write a statement on your behalf.

Failure to meet the definition of disability under the plan

Your insurance policy will have a specific definition of disability that you will have to meet.

Under most policies, disability is based on a person’s ability to perform duties under their regular job, or “own occupation.” Some policies define disability more broadly so that it applies to “any occupation” that you can do for a specific income. The definition of disability in your plan may change after a certain length of time, usually 24 months.

It’s important that you know how disability is defined in your insurance policy. Request a copy of your policy as soon as possible to understand all of the terms and limitations of the plan.

Inconsistent evidence to support disability

Your insurance company can deny your disability claim or terminate your previously awarded benefits if evidence contradicts your claim. Your daily activities and social media posts should match up with your medical records and statements about your physical condition.

Your insurance company may go to great lengths to deny your claim, even if it’s a valid one. That includes having a private investigator follow you to record your daily activities to determine if your claim is legitimate.

Follow your doctor’s instructions, and do not exaggerate your limitations to your insurer.

Your insurance company can deny your disability claim or terminate your previously awarded benefits if evidence contradicts your claim.

Missed deadlines or errors in your claim

It’s important to file your disability claim right after you’re diagnosed and to include as much accurate information as you can. Most policies require notification within 60 days. If you miss this deadline, the insurance company can deny your claim for lack of timely notice.

You should do your best to gather all medical records and any other supporting documentation before filing your claim. If you don’t have all of your records yet, file your claim early, and then keep your insurer updated as you gather more information.

Conflicting medical assessments

Insurance companies may hire medical experts to determine whether you are eligible for long-term disability benefits.

They may even require you to have one or both of these tests to evaluate the impact of your disability:

These tests can be inaccurate or biased in favor of the insurance company, which may conflict with your doctor’s assessment. In many cases, they use the results to prove that you do not qualify as disabled. If your insurance company has set you up for either of these examinations, you must talk to an attorney today.

Wrongfully denied disability? Here’s what to do next

If your insurance company has wrongfully denied your long-term disability claim, you have the right to file an appeal. Unfortunately, the appeals process is complex with strict deadlines, especially if you have an ERISA plan. A simple oversight could kill any chance of receiving the benefits you deserve.

We have been battling long-term disability insurance cases and nothing else at Roy Law Group since 2009. This area of the law is incredibly complicated. Let our team of experts handle everything for you. If we take on your case, you are in a winning battle.

Contact us for a free consultation today.