When you have been paying for your long-term disability policy, you expect it to kick in when you need it the most. Unfortunately, many insurers commonly lowball offers. However, this doesn’t always mean the end of the road for your claim. You will improve your chances of obtaining the long term disability benefits you are entitled to by taking note of the tips below.
Understand Why Your Claim Was Denied
You must first carefully review the denial letter from your insurance company to understand what the issue was. The insurer usually explains why your claim was denied and identifies any missing information or policy provisions that influenced the decision. Sometimes this may not be the case, as some may give a single reason.
When you know the specific reason for the denial, you lower the chances of facing another rejection. It is also important to know other reasons that contributed to it in order to avoid making them again. This will ensure you place your focus on addressing the insurer’s concerns rather than submitting unnecessary information.
Review Your Long-Term Disability Policy
Every disability insurance policy contains specific terms and conditions that determine eligibility for benefits. Before appealing, take time to review your policy carefully. You want to pay close attention to what qualifies as long-term disability and coverage limitations.
While some policies define disability as being unable to perform your current occupation, others may refer to being unable to carry out any activities suited to your education level, experience, or training. Knowing which standard applies will help you when preparing your appeal.
Consider Working with a Long-Term Disability Lawyer
You don’t have to wait until your claim is denied for you to seek legal guidance. Legal help from the start will ensure you don’t repeat the same mistakes. With a skilled disability insurance lawyer, insurers will not take advantage of you.
They will evaluate your denial, identify weaknesses in your claim, and gather additional evidence that may otherwise be limited to you to build a strong case. An attorney can also know when to pursue further legal action.
Gather Strong Medical Evidence
Medical evidence is a crucial element of a disability claim. You will need to collect all documentation that clearly demonstrates how your condition limits your ability to perform your job. Helpful evidence may include:
- Physician reports
- Medical records
- Functional capacity evaluations
- Specialist opinions
- Treatment plans
You can ask your doctors to describe your functional limitations rather than listing your diagnosis. This will help increase the chances of your approval.
Submit a Thorough Appeal
An appeal is your opportunity to strengthen your claim by providing additional evidence and addressing the insurer’s stated reasons for denial. Your appeal should include:
- A detailed appeal letter
- Updated medical records
- Statements from treating physicians
- Supporting diagnostic tests
- Employment records if applicable
- Additional evidence addressing each denial reason
You must submit everything before the appeal deadline. When you miss the deadline, you lower your chances of pursuing benefits. This is particularly true when your policy is governed by federal regulations.
Endnote
When your long-term disability benefit has been denied, you don’t have to lose hope by thinking it is the final decision. You can improve your chances of securing the benefits you are entitled to by following the above tips. You should also seek guidance from an experienced attorney who will ensure you are not taken advantage of and protect your rights throughout the appeal process.
