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Denial of employer-provided long-term disability benefits

On Behalf of | Jan 31, 2023 | Erisa, Long Term Disability Claim Denial

Employers sometimes offer long-term disability insurance as part of a group benefits plan, which provides financial help if you suffer an injury or develop a disabling medical condition that prevents you from working.

Suppose your employer offers a long-term disability insurance policy. In that case, it usually consists of a percentage of your salary paid for a set number of years or until you can return to work.

Denial of claims

Sometimes long-term disability insurance companies deny claims for many reasons, including:

  • The policy does not cover your condition.
  • You lack necessary documentation and evidence.
  • There are inconsistencies in your claim.
  • There are inconsistent statements from your doctor.

During their review, insurance companies will ask for information about your situation and ask you for permission to contact your medical providers so they can make a decision about your claim.

Insurance companies will want to know more about the following:

  • Your diagnosis
  • Details of your condition
  • Statements made by your doctor

Doctor’s statements are important because your doctor is closest to you and the one making the diagnosis. The insurance company will deny your claim if your doctor believes you can work.

Developing a disability is a challenging and life-changing situation for anyone.  Obtaining long-term disability insurance may be challenging, as well. Before you submit your claim, ensure that you have everything you need and if there is any documentation you lack, make sure you request it from the appropriate person.