Denial of Disability Lawyers Help You to Appeal Insurance Company Decisions

Denial of Disability Lawyers Help You to Appeal Insurance Company Decisions

Denial of Disability Lawyers


Did you know that a large percentage of short-term and long-term disability claims in Canada are denied? The exact number isn’t known, but a 2018 investigation into CPP disability claims found that a whopping 67% of all LTD claims were denied. It’s estimated that the percentage would be similar in the private insurance sector. However, in the case of CPP, nearly half of those who were initially denied coverage had that decision reversed on appeal – raising the question of why their claims had been denied in the first place.

Why Was My Claim Denied?


If your short term or long term disability claim has been denied, you should know that this is not uncommon. Insurance companies routinely deny these types of claims. They represent large expenditures for the company, so insurance industry employees may be instructed to deny long-term disability claims whenever possible. Here are some reasons why your claim may have been denied:

  • Missing paperwork. Insurance companies are very particular about having paperwork filled out exactly. This means that you must use the right forms, and fill them out correctly. Since they are quite complicated, it’s easy to make a mistake.
  • Time.Filing an insurance claim must be done on a rigid timeline. If you miss any deadlines, your claim can be denied.
  • Missing medical records. You must provide all pertinent test results, x-rays, specialists’ reports, and other medical information.
  • Proof of treatment. You must also prove that you have followed doctor-recommended treatments. This can include taking prescription medications, undergoing chemotherapy, doing physiotherapy or occupational therapy, following a specific diet, exercising, etc. You should continue with any treatments that are providing even a small amount of relief, proving that you are doing your best to maximize your health.
  • Pre-existing conditions. If you had a health issue prior to the issue your claim is based on (ie, if you had diabetes, then became disabled due to a heart attack), the insurance company may use this as a basis to deny your claim.
  • Dishonesty.If you are found to be lying about any of the facts of your claim, it will be denied. (This will also make your appeal more difficult.) Be aware that insurance companies regularly check social media to see if your activity there contradicts information you’ve submitted. In some cases, they may even use surveillance.
  • Policy exclusions. Some policies have provisions that mean they can exclude you if your disability was caused by your own behaviour, ie, drinking or taking drugs.
  • Definitions.One of the most common reason that claims are denied is the failure of the illness/condition to meet the definition of short-term or long-term disability.


Fighting Back Against Claim Denials


If your LTD claim has been denied, it’s time to find a law firm to help you appeal. Many times a good personal injury lawyer with experience in denial of short term and long term disability claims can pinpoint what went wrong, and will work to reverse the decision. Making the transition from work to being on disability can be very stressful, and a personal injury lawyer can provide you with hope and emotional support during this time. Not only that, but these lawyers usually offer a free initial consultation and they work on a contingency basis, meaning you don’t have to pay hourly fees up front.

Don’t let them deny your benefits! Fight back, with a good lawyer on your side by contacting an experienced lawyer who has dealt with denial of disability claims in the past.