Jun 10, 2019
The purpose of long-term disability coverage is to provide income replacement when you are too sick or too injured to work. Many Canadians have long-term disability (LTD) coverage through their employee benefits plan, but self-employed persons and others who aren’t covered through a group plan, must obtain individual LTD coverage from a disability insurer.
Unfortunately, LTD insurance providers sometimes deny benefits to persons who are genuinely disabled and unable to do their job due to the effects of an extended illness or injury. This circumstance typically places a huge financial burden on the claimant and their family, in addition to the stress and challenges brought on by their medical condition.
When benefits are denied, you naturally want to resolve the situation as quickly and painlessly as possible, and claimants have two options for appealing a denied claim: you can continue to appeal your claim through the insurer’s internal appeal process, or you can seek representation from a disability claims lawyer. At Dietrich Law, our disability claims lawyers have successfully resolved many disability claim disputes for clients who were unable to work but had their long-term disability claim unfairly denied or terminated. Additionally, our expertise and knowledge of the disability claims process enables us to give you a realistic assessment on the viability of making a successful claim given the circumstances of your disability and to help determine what, if any, further evidence is needed.
If your LTD claim was denied, it’s important to carefully read your denial letter so that you fully understand the reason for denial and know the deadline for appealing your denied claim. If the claim was denied due to a failure to include medical documentation or tests, or because the insurer requests clarification from your doctor, you may be able to resolve the oversight fairly quickly, assuming they agree, by obtaining the necessary information and submitting it with your appeal. If the reason appears unclear or vague, you should call your disability claims representative to obtain a clear understanding of what was lacking or deemed problematic in your claim.
Here are the most common reasons why a long-term disability claim may be denied.
In any of the following circumstances, you are far more likely to obtain owed benefits if you seek advice and representation from a disability claims lawyer who has proven experience winning claim disputes against LTD insurers: