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.