Why was I denied Long Term Disability?

If an insurance company denied your Long Term Disability claim, it doesn’t mean your claim isn’t legitimate. In many cases, Long Term Disability is denied for reasons that can be prevented. At Fields Law Firm, we want to help you take the steps necessary to get the coverage you need.

Whether you’re applying for Long Term Disability benefits for the first time or you’ve been denied and need help with your appeal letter, you’re not alone. At Fields Law Firm, our Long Term Disability lawyers know what you’re going through, and we’re here to answer your questions.

It costs nothing to get answers to your questions –

3 Reasons Long Term Disability Claims Get Denied

Insurance companies often deny Long Term Disability coverage due to:

  1. Failure to meet the policy definition of disability.
    The definition of disability can vary depending on your policy, and some policies have stricter guidelines than others. In addition, some medical conditions – like those related to substance abuse – may be excluded from qualifying you for benefits. Our Long Term Disability lawyers can review your policy and help you understand your rights.
  2. Insufficient medical evidence.
    Your claim may be denied if insurance company claims administrators are missing medical records that help prove the severity of your medical condition. We can help ensure the insurance company has all of the evidence they need to make the right decision about your claim.
  3. Video surveillance and social media.
    Insurance company investigators can deny your claim if surveillance or social media posts show you engaged in activities that seem too strenuous for someone suffering from your injury or illness. Even if you feel like you’re able to perform certain tasks, it’s a good idea to stick to your doctor’s orders at all times.

These are just a few of the reasons an insurance company may deny your Long Term Disability claim. The Long Term Disability lawyers at Fields Law can review your policy, your rights, and help you get the benefits you need, no matter where you are in the claims process.

Long Term Disability Denial Overturned

A security guard from Minnesota began experiencing panic attacks and anxiety. Her symptoms worsened and eventually she was unable to sleep for more than an hour at a time. She was forced to stop working. She applied for Long Term Disability benefits from the disability insurance company but was informed that she did not meet their definition of “disabled.”

Upset and worried about her lost income, she contacted the Long Term Disability attorneys at Fields Law for help mounting an appeal against the insurer. Our attorneys reviewed the medical record and contacted our client’s doctors to obtain reports detailing symptoms and treatments.

The medical records from the initial decision were reinforced with the new reports and ultimately the Long Term Disability insurance company overturned their decision. Our client was awarded backpay and ongoing benefits. She was happy to have her benefits paid and to continue her treatment without the fight against her insurance company.

What is the most common reason why Long Term Disability benefits are denied?

There are a number of reasons that someone may have their Long Term Disability benefits denied. However, the most common reason that our Long Term Disability attorneys see insurance companies use is that the claimant fails to meet the “definition of disability”, according to how that term is defined in their policy.

This is frustrating to many people applying for Long Term Disability benefits because a person can feel “disabled” in his or her own mind and then be unable to understand why the insurer saying that the person is not disabled.

Some people wonder, “How can the insurance company say I don’t meet the definition of disability if my doctor says that I am disabled?”

Our Long Term Disability attorneys understand that “disabled” means something different to everyone. To prove that you are disabled according to your Long Term Disability policy, you must look for the definition of disability in your policy. Nearly all Long Term Disability policies will contain a definition section. A Long Term Disability attorney at Fields Law can help you find this section and then help you to identify information to support that you are in fact disabled as defined by your Long Term Disability policy.

For instance, some definitions of disability may state something like this:

Disability means that as a result of Injury or Sickness, you are unable to perform the Material and Substantial Duties of your Own Occupation.

Under this definition of disability, if someone fails to tell the insurance company which material job duties that he/she was unable to perform, that person might be denied Long Term Disability benefits. It may sound like there are just too many technicalities in a Long Term Disability policy. In some ways, this is true, but that is exactly why it is helpful to have a Long Term Disability attorney help when a disability insurance company denies your benefits.

How can a Long Term Disability attorney help if I receive a denial letter?

Receiving a denial letter from the Long Term Disability insurance company does not mean you are no longer eligible to receive Long Term Disability benefits. The denial letter should include information about how to appeal the insurance company’s decision.

This is your opportunity to convince the insurance company to change their mind about paying Long Term Disability benefits. Having a Long Term Disability attorney on your side to help guide you along the appeal process will ease some of the stress, so that you can focus on taking care of yourself.

A Long Term Disability attorney can also help you to identify information that supports your disability. Not only can an attorney identify the helpful information (such as medical records, doctor’s reports, job analysis surveys and expert opinions), but an attorney can also help to gather and submit the information to the insurance company.

A Long Term Disability attorney can also write legal and factual arguments to submit with the other information they have gathered. The goal is to get the insurance company to realize that it made a mistake in denying benefits in a compelling way that presents undeniable facts.

If the attorney is successful in doing that, then the insurance company will overturn its original decision and begin paying benefits, including any backpay for benefits you should have already received. If not, these documents may be the only records considered by the judge in a Long Term Disability lawsuit.

If an insurance company denies your Long Term Disability benefits, let us help you fight back. Our Long Term Disability attorneys are here to answer your questions and help you get the benefits you need and deserve.