Why Was My Long Term Disability Claim Denied?

There are many reasons insurance companies deny long-term disability claims. As attorneys who practice nearly exclusively in this area, we see the same denial rationales over and over. If you have been denied and your insurance company cites one of these reasons, call us and we can help you.

  • No Medical Documentation - Though insurance companies often ask you to complete an authorization form so that they can request medical records, ultimately, you hold the burden of proving your disability. If the insurance company doesn’t receive the records they need, they will deny your claim. It is always best to gather your medical records from all relevant treating providers to be sure your insurance company receives them.
  • Pre-Existing Condition – Most long-term disability policies have a provision excluding payment of benefits for conditions that are deemed “pre-existing” under the policy. Sometimes insurance companies stretch this exclusion to apply to cases where it is not truly warranted. Our firm has helped overturn numerous denials where the insurance company cited the pre-existing condition exclusion to deny benefits. This exclusion can be a tricky one, so it is best to seek the assistance of a disability benefits attorney before you appeal.
  • Mental/ Nervous Condition Limitation – Most long-term disability policies limit payment of disability benefits for mental or nervous conditions to 24 months. Insurance companies often use this limitation to terminate benefit payments even when it is not so clear that the disability is due to a mental health condition. There is significant case law about how this limitation can and cannot be applied, so if you think it has been wrongfully applied in your case, consult with a disability attorney.
  • Subjective Condition/ Lack of Objective Medical Evidence – Insurance companies commonly deny long-term disability claims for conditions that are primarily subjective, meaning the symptoms cannot be proven via traditional objective evidence like an MRI or X-ray. Most long-term disability policies, however, do not require objective evidence to prove disability. Thus, when an insurance company cites to this reason for denying your claim, they are in the wrong.
  • Lack of Doctor Support – The most important piece of a long-term disability claim is the support of your doctors. If your doctors do not agree that you are unable to work, you are unlikely to be successful with your claim. The insurance company will send questionnaires/ forms to your doctors to get their opinion regarding your disability. You can help your chances of approval by talking to your doctors before you file for long-term disability benefits to be sure they support your claim.

Our Disability Attorneys Can Help You

Disability insurance law is complex. Hiring an experienced disability attorney is important. Because all disability lawyers at this law firm focuses on disability insurance claims, the firm has significant experience with every major disability insurance company and the myriad reasons they deny claims.

The firm can help at any stage of your disability insurance claim, including:

Because federal law applies to most disability insurance claims, our lawyers are able to represent clients across the country.

Call to speak with an experienced disability attorney. Consultations are always free.

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