Law

COMMON REASONS LONG-TERM DISABILITY CLAIMS ARE DENIED

Long-term disability claims can be complicated, and failure to meet the requirements of your policy can lead to the denial of your claim. The application of the claim itself is lengthy, complex, and tedious. Also, some disabilities can make the process of filing the claim and collecting the evidence an arduous task.  It sometimes takes only a slight mistake to get a rejection later from the insurance company.

However, having a long-term disability lawyer by your side can help you avoid unnecessary mistakes when filing a long-term disability claim. A long-term disability lawyer is also aware of the common reasons claims are denied and helps you avoid them. Go here to gain some insights into long-term disability claims and look at some of the mistakes that could cause the denial of your claim.

Late filing of the claim

A long-term disability claim features notice clauses that stipulate the timeline for submitting your long disability claim to the insurance company. The time frame starts running from the date of the disability. So filing your claim late or past the deadline can lead to the denial of your claim. It is wise to inform the insurance company of the disability as early as possible. Many insurance companies claim that late filing interferes with their ability to manage the claim correctly.

Not communicating with the insurer.

Many people believe that they are not obligated to communicate with the insurer after filing their claim. Even if your benefits have already been approved, the insurer is obligated to adjudicate the claim on an ongoing basis. They will continue to communicate with you to obtain medical records and ascertain whether you meet the tests for disability as your policy specifies. The company can terminate the payments if their efforts to communicate with you are futile.

Inadequate evidence to support a disability claim

When filing a long-term disability, you need sufficient medical evidence to back up your claim. That includes medical records, X-rays, MRIs, blood test results, and a medical analysis showing why you may not be able to function normally. Providing the insurance company with a diagnosis report is insufficient to establish disability. The insurer is looking for information about the intensity, frequency, severity, and duration of the symptoms. In addition, their impact on your normal functioning. At times, insufficient evidence could also mean that the insurer disagrees with your doctor’s reports on your disability. As such, they may request an internal medical consultation.

No objective evidence to support your claim

The insurance company may sight ‘no objective evidence’ as the reason for the denial of your claim. Some symptoms such as chronic pain, mental illness, fibromyalgia,  and chronic fatigue are some instances of situations where there may be no objective evidence of disability. Your disability claim should be backed up by diagnostic imaging and objective tests such as MRI, X-rays, and blood tests. In most cases, the insurance company will include the requirement for objective evidence in terms of the policy.

The takeaway

Hiring a long-term disability lawyer can help you avoid common mistakes when filing your claim.

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