Dealing with a disabling injury or illness is tough on you and everyone around you. The last thing you want is to have a long-term disability (LTD) insurance company deny your claim. LTD insurance pays benefits every month when your covered disability prevents you from working. Sadly, a lot of LTD claims are initially denied but approved on appeal. Indeed, a lot of companies that offer disability insurance deny claims at first, no matter their merits. Thus, if your claim has been denied, there is still hope.
In general, an LTD denial can be appealed. With preparation and persistence, as well as help from a skilled disability lawyer, you will increase your chances of having a successful appeal.
Common Reasons for LTD Denial
To prepare an appeal after your LTD claim was denied, you must understand the reason for the denial in the first place. You can be denied LTD benefits if the policy does not cover your medical condition, your disability does not occur long enough to be eligible for benefits, you failed to receive regular medical attention for your condition, you failed to prove your disability, and you did not file your claim correctly.
Steps to Take When Appealing an LTD Insurance Denial
After you understand why the insurer denied your claim and familiarize yourself with the appeals process, you can start building your case. First, you need to collect any missing information. Did the denial result from a technical problem such as a missing form? If so, you must complete this form and include it in your appeal. Ensure the insurer does not miss your medical evidence.
But insurance providers may not secure all the medical records related to your claim. Determine which records the insurer used for making their initial decision. If something is missing, inform your representative. Get a confirmation of the date and time the insurer requested and received your medical records. Then, collect any missing records and make sure your appeal includes them.
Hire an LTD Attorney
An LTD lawyer will help increase your chances of securing the benefits you are entitled to through a successful appeal. They will secure additional medical evidence or solicit options from your treating doctors or vocational experts. An insurer and plan administrator may take your disability case or appeal seriously if you have legal representation. If you choose to hire an LTD attorney, ensure they specialize in ERISA law.
