You may be wondering why your long-term disability claims are suddenly denied.
There are several difference reasons and that is what our explains are about to explain to you today.
Remember that that is not the end. There are still so many things that you can do if your long term disability insurance denied. Keep reading to learn more.
The first reason is because there is insufficient medical evidence. That means that there are records that do not show what the claims are stating. That means that they do not match up to what the claim is saying. For example, if you are staying you broke your back in the claim but the medical record only states that there was a minor injury to your back, this is when they want to reevaluate your case and can end up declining it because the two do not match.
If you have a long-term disability case, it’s almost impossible to get all fo the medical treatment that is needed. With that said, they expect it. That means that you want to get all of the records and evidence to back up your claim.
You want medical records and to show that you have been seeing a doctor on a regular basis the entire time. If it is a mental health claim, you want to show that you have been seeing a psychiatrist or psychologist for a minimum of once per month.
If you have not been seeing one or seeing a doctor, then you are showing that you are not trying your best. This is another reason why you may be denied. Make sure that you are able to show evidence like x-rays, RMIs, CT scans, or any other tests that you may have had along the way.
Are there any missing medical records? The courts will do a complete scan of all of your medical records. If they find a section missing that does not support your claim, they may end up denying it based just off of that. If a doctor has not made a record of the process in which the medical records needs, you may be asked to show a copy. If there can be no medical record to show, you may be denied.
The main reason why someone is turned down for long-term disability is because of the doctor’s statement. This is the most important part of the evidence that you can show. If the insurance company doesn’t request the medical record, your doctor will need to state what happened and what is happening to you. It is a detailed option from the doctor to talk about your work limitations medically.
Although you should not rely on this form in order to get your long-term disability benefits, you also want to know that they can write one that will show evidence that you need to go on long-term disability for your work.
In order to get this, give your doctor a Residual Functional Capacity form which will show your exact limitations for your job. If your doctor refuses to do this, there’s a good chance the case will notice this, and you may be declined for long-term disability.
The next thing that can happen is failing to satisfy the LTD Policy. This is what shows you are disabled. They have defined it and if you do not meet their expectations, you can end up being declined because of this. It is a very complicated time.
The definition of disability can also change over time. This means that your insurance plan can go from own occupation or any occupation after a certain time frame. Most policies have two years of benefits and will start to either expire or change the status after two years aka 24 months.
If you are considered disabled then you are not able to do your duties at work. The term itself is very broad. It does not necessarily mean you cannot perform any duty; it simply means your duty at work.
For a long-term disability policy, it can change your medial condition. One example of this is a medical impairment such as alcohol is normally not in the coverage. You may even be subjected to testing. Again, this will be for the two months when long-term disability benefits are in play.
Another reason why you can be turned down for long-term disability is because it was a condition before you started. For example, if you experienced back pain and had been to the doctors plenty of times and then you started your job and your back got worse, you may not be eligible for long-term disability benefits.
Another way the case may be declined or stalled is if there is video evidence showing differently than what you have said. If you are in the process of putting in a claim, make sure that if there is any video surveillance, it can be completely looked at. This will ensure your story is correct and the courts don’t find any inconsistencies and a reason to decline you.
As you can see, there are many reasons why someone can be declined long-term disability benefits. The thing that they all have in common is being misleading to the courts. The courts are there to ensure you are telling the truth and you are receiving benefits because you are being truthful about not being able to get back to work. If they see any red flags, you may be asked some additional questions.
We hope this helped you understand a little bit more about long-term disability benefits and what you can be doing to ensure you receive the help you need and deserve.
