It’s important to understand why long-term disability claims get denied.
The Employee Retirement Income Security Act (ERISA) governs all long-term disability policies provided by employers. Under this act, all disability applications are reviewed and evaluated by claims administrators, and unfortunately, they usually work with the insurance companies. Because of this, claims are often denied, even in cases where they clearly shouldn’t be. Whether valid or not, it’s important to understand the reasons for denials when applying for your own long-term disability benefits. The following is a list from our long-term disability attorney in Louisville of common reasons why LTD claims get denied:
#1. Inadequate Medical Evidence
It’s incredibly important to have a written statement from your doctor. This statement should include their opinion on any work-related limitations you have. However, you can’t stop there, your medical history has to not only show that you do in fact have a disability, it also has to show that you are getting regular treatment for your disability. You need to make it a point to attend all appointments and get the regular treatment you need. Additionally, claims are occasionally denied because the insurance company failed to request all necessary medical records. Ask your insurance company for a list of all of the records they’ve requested and received. If you notice any missing records, let them know.
#2. Failure to Qualify Under Your Policy’s Definition of a Disability
Before you take steps to apply for your benefits, check your policy’s definition of a disability. If you have an “own occupation” policy, your disability has to render you unable to handle the duties in your own specific occupation. If you have an “any occupation” policy, your disability has to render you unable to perform any job duties. It is also important to read over your policy for any excluded conditions.
Learn more when you stay tuned for our next blog.