Finding out that your employer or the insurance company they work with denied your long-term disability claim can be devastating for many people suffering from an illness or recovering from an injury that affects their ability to work.
Knowing what you need to appeal to have the best chances of your employer or the insurance company approving your claim is a critical part of the appeals process. The more you understand what they are looking for, the better you can respond with the needed information.
Typically, an employer or insurance company denies a long-term disability claim for one of five reasons:
- You did not provide enough medical evidence.
- The policy does not consider you as disabled.
- You had a pre-existing condition.
- You do not receive ongoing treatment.
- Missed deadlines and missed paperwork.
Suppose you are thinking of appealing the denial of your long-term disability benefits. In that case, some reasons they deny claims are more accessible to overcome than others.
For example, it may be easier to overcome the denial of your long-term disability benefits by providing additional medical evidence that proves your disability and eligibility under the policy compared to addressing a pre-existing condition.
Remember the important tasks you will need to complete to appeal your denied claim:.
- Medical evidence specific to your illness or injury.
- A detailed personal narrative where you can provide context and explain the limitations you face every day.
- A statement from your employer describing your role at work and what the role requires of you.
- Other statements from people who know you, including family members and close friends, can also help. If someone is helping care for you, they can provide a statement explaining how they are helping you and what limitations they are helping you overcome.
- A letter or statement from an expert, such as a physical therapist or another medical care provider, details your illness or injury and how it now affects your ability to work.
- A vocation and employment expert can also assess your ability to work, considering your disability and how it impacts your ability to do your job.
Every appeal will be different, and your attorney will help tailor it to your situation. However, for any appeal, ensure that you are timely; the information you provide is detailed, as thorough as possible, and consistent over time.
The appeal of a denied long-term disability claim can be a significant disappointment. However, hope is on your horizon, in the right hands and with the correct information.
The stronger the case, the better your chances of winning the appeal, so you must ensure you follow the process, stay in close contact with your attorney and provide them with as much information as possible.