5 Reasons Why Your Long-Term Disability Benefits Are Denied

Long-term disability benefits provide financial support to individuals who are unable to work due to a disability. These benefits can be essential for maintaining financial stability and covering living expenses during a difficult time. However, many long-term disability claims are denied, leaving individuals without the support they need. In this article, we will look into five common reasons why your long-term disability benefits are denied and provide tips for avoiding these issues. Let’s dive right in.

Lack of Medical Evidence

Medical evidence is a necessary part of any long-term disability claim because it is essential for proving that you are disabled. Detailed medical records supporting your diagnosis and demonstrating the severity of your condition are essential. Without them, your claim may be denied by companies like Hartford. To ensure a smooth process, you should gather all relevant medical records for your insurance company. This includes hospital records, doctor’s notes, and test results. Consider obtaining a detailed statement from your doctor explaining your condition and how it specifically restricts your ability to perform the essential functions of your job. This extra step can strengthen your claim and make your benefits accepted.

Failure to Meet the Definition of Disability

Long-term disability policies are mostly based on certain definitions of disability. To get these benefits, you must fulfill the criteria outlined in your policy. A disability insurance lawyer can help you understand whether or not you meet these criteria. These definitions often focus on your ability to perform your specific job (own occupation) or any job you’re reasonably qualified for (any occupation). Failing to meet this definition can lead to a denied claim. For a smoother process, you need to understand the exact wording of the disability definition in your plan and collect detailed job descriptions outlining your regular duties. You should also compile medical records documenting your condition’s severity and limitations. Witness statements from colleagues or supervisors attesting to your work restrictions can also be of great help. This approach strengthens your claim and increases the chance of approval.

Pre-Existing Conditions

Pre-existing conditions can be a major issue when it comes to long-term disability claims. Insurance companies may argue your current disability stems from a pre-existing condition, not the one you’re basing your claim on. This can lead to a denial of benefits. To combat this, be proactive with your medical documentation. Gather detailed records showcasing the clear onset and progression of your current disability. You should also get a doctor’s statement that explicitly outlines how your current disability is unrelated to any pre-existing conditions. Additionally, highlight any declines in your pre-existing condition that contribute to your current limitations. When you incorporate the above, it increases the chance of a successful appeal if your initial application is denied. Hiring a disability insurance lawyer can also make the process a whole lot smoother.

Not Following Treatment Recommendations

Insurance companies can deny long-term disability benefits if you stray from your doctor’s treatment plan. This includes skipping doctor’s appointments, neglecting prescribed medications, or refusing recommended therapies. Such actions can be misconstrued as a lack of commitment to improving your condition, potentially jeopardizing your claim.

To avoid this pitfall, follow your healthcare team’s recommendations. Ensure you attend all scheduled appointments, diligently take prescribed medications, and actively participate in any suggested therapies. Furthermore, maintain detailed records of your treatment history. This can include appointment notes, medication logs, and physical therapy progress reports.

Late or Incomplete Claims

Late or incomplete claims are a major roadblock to long-term disability benefits. Missing deadlines or submitting insufficient documentation can lead to a denial, causing unnecessary stress and financial hardship. To ensure a smooth process, make sure you submit on time, familiarize yourself with your policy’s deadlines and submit your claim as soon as possible after your doctor confirms your disability. Be meticulous in gathering all required documentation. This may include medical records, detailed treatment plans, and employer verification of your inability to work. Don’t hesitate to contact your insurance company if anything seems unclear. Companies like Hartford of obligated to clear anything up that may seem ambiguous. Proactive communication and complete documentation go a long way in preventing claim denials and expediting the approval process. It is also important to hire a Hartford disability lawyer, if you are dealing with Hartford, as they have the knowledge and past experience to help you compile the necessary documentation needed for a disability claim.

Conclusion

Long-term disability benefits can be essential for maintaining financial stability during a difficult time. To avoid these issues, it is essential to understand your policy, gather all relevant medical records and submit your claim on time and with all necessary documentation. If your claim is denied by a company like Hartford, you may want to consider seeking legal advice and assistance. In this case, a Hartford disability lawyer can give detailed advice on how to go about your claims properly.