ERISA Experience You Can Rely On.

What if my long-term disability pay is denied?

by | May 17, 2021 | Erisa, Long Term Disability Claim Denial

When you have put years of hard work in for your employer, you expect to not face problems when you need to use your long-term disability coverage. You signed up for your workplace long-term disability insurance a long time ago and have paid your share of the premium. Now, that you will be out of work because you are facing a long recovery after back and neck surgery, you expect to use those long-term disability benefits. Yet, when you make your first claim, the insurance company denies your benefits. What are you supposed to do now?

Long-term disability benefits denied

If you face a denial of your long-term disability benefits, it could be for several reasons, including:

  • You didn’t provide enough hard medical evidence documenting your disability and that you are under the care of a regular care physician.
  • Your claim relates to a pre-existing condition and you haven’t completed a 12-month waiting period to make a pre-existing condition claim.
  • You don’t fit your policy’s definition of being disabled.
  •  Your claim documentation includes errors.
  • You haven’t agreed to an independent medical exam or the results of your independent medical exam don’t prove your disability.
  • The insurer disputes the severity of your disability.
  • The insurer investigates you, video taping you or using evidence from your social media, to dispute that you are disabled.

Yet, even if an insurer denies your claim for one of these reasons, you could still be eligible for your long-term disability benefits. Your long-term disability benefits must meet ERISA standards, which are complex and not easy to understand on your own. 

Getting help with a long-term disability claim

If your workplace long-term disability provider denies your benefits, you should consult an attorney who understands these benefits and ERISA standards. An attorney will be able to help you bolster your disability claim and help you prove your disability prevents you from working.

With an attorney’s help, you may be able to get your long-term disability pay approved. Then you can focus more on your recovery and hopefully eventually getting back to work.