Disability Insurance Claim Denied

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Jul 16, 2021

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It is not uncommon for disability claims to be denied. Disability insurance benefits are not automatically granted because you have become disabled. disability claim has to meet certain conditions and policy requirements in order to be approved. If your disability claim is denied, you need to find out why and consider consulting with an attorney if you feel the company has made a mistake.

Why Your Disability Claim Was Denied

  • Elimination Period Not Fulfilled: Each disability contract has an elimination period. It is the period of time you must wait after becoming disabled before your disability benefits can start, and is typically 30, 60 or 90 days. Any denied disability claim should be closely reviewed to make sure the elimination period lapsed prior to the claim.

  • Self Reported Symptoms: Filing a claim without having symptoms confirmed by a doctor will result in denied disability benefits. If you are having migraines and they are preventing you from working, your disability insurance claim must have documented medical reports of these symptoms and documentation on how it creates your disability.

  • Preexisting Condition: Companies regularly deny disability claims because of a preexisting medical condition. If you have seen or been treated by your doctor in the past for any injury or ailment that is related to the condition leading to your claim, then your disability benefits may be denied. It is important that you speak with an attorney if your disability claim is denied because of a pre existing condition!

  • Your Disability Does Not Meet Your Policy’s Definition: One of the main reasons for denying a disability claim is that your injury does not fit the disability definition in your policy. If your policy states that your disability has to prevent you from being “gainfully employed” and you are able to work some job with your injury, then your disability claim will be denied. If your policy has an “own occupation” provision, then your disability must prevent you from doing your present occupation. If it does not, your disability claim will be denied. Make sure you understand your policy’s definition of disability before you file a disability insurance claim.

  • Lack of Medical Care: Since all disability insurance claims require a doctor’s input, it is critical to get the right type of care. If you are not under the care of a physician to treat the disability you allege, then your disability claim can be denied.

If your disability insurance claim was denied, make sure you get a full explanation from the company!

What To Do if Your Disability Claim is Denied

If your disability claim was denied, the best thing to do is consult with a disability insurance attorney. An attorney who is experienced with denied disability claims will be able to review the denial for any errors in the company’s decision. If the insurance company has wrongfully denied your disability benefits, an attorney can help you get the settlement that you deserve. If you speak with an attorney, make sure you remember the following:

  • Every interaction between you and the insurance company is important! Get anything the company says in writing, and keep copies of all correspondence. Do not be careless with documents or communications between you and the company.

  • Anything you say can be used against you! It is best not speak to an insurance company representative about the disability claim denial. If you feel the claim was wrongfully denied, contact an attorney and let them handle any future communications.

  • Work with the attorney! Do not simply drop off a file and let the attorney do all the work. Keep in regular contact with your attorney, and take care of any tasks that he or she assigns to you.

Disability attorneys offer free consultations, so it will not hurt to speak with one. If you would like to have an attorney review your denied disability claim for free, click here to fill out a case evaluation form.

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