Long-term disability claims are scrutinized very closely by insurance companies. Even when your own doctor supports your disability, claims are often denied.
Insurance companies are looking for “objective” evidence of a disabling condition such as:
Any type of scan (bone, CT, CAT)
Often these test results don’t provide definitive evidence, however, the more information regarding the medical reason for your disability, the higher your chance of being approved for disability benefits.
TIPS for SUPPORTING YOU CLAIM:
Having your doctor(s) support your claim for disability.
Having your doctor(s) prepare the Attending Physician Statement(the document that an insurance company usually requires from your physician/specialist to start your application for benefits).
Adding additional information beyond the form’s questions.
These tips may enhance your chances of being approved.
Even after you have provided all the necessary documentation that the insurance company has requested, they may still deny your claim on the basis that there is “insufficient medical information” to support your disability. A denial of this nature can be extremely confusing when a family physician or specialist has provided a letter to the insurer in which a clear diagnosis of one or more medical conditions is indicated.
TIPS TO REMEMBER:
It is important for your physicians and specialists to consider all of your symptoms (physical and psychological).
How these symptoms affect your ability to function in all aspects of your life.
Functional ability is an essential component in analyzing whether an individual meets the test for disability contained in the applicable insurance policy or plan.
Embarking on the long-term disability claims process with your group insurance company can be an emotionally trying process. Endless requests for medical documentation and updated information can be difficult to deal with when you are trying to cope with physical or psychological impairments. We can help!
It is, however, important to bear in mind that every disability insurance policy is unique, and an assessment of disability must take place in the context of the definition contained within the applicable insurance policy or plan. Most disability insurance policies contain more than one definition of disability that an applicant must meet before they can be entitled to ongoing benefits.
The foregoing does not constitute legal advice. If you have unsuccessfully appealed your claim for disability benefits or your benefits have been terminated at the “change of definition”, you may want to consider whether you require legal assistance to further advance your claim. Contact Share Lawyers and put our experience to work for you.
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This searchable database contains information about disability, critical illness and life insurance claims, and what you can do if you are denied or cut
off of your benefits. It is a collection of the most common questions we receive from our clients. General answers have been provided by our lawyers.
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