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Common Reasons Why Long-term Disability Claims are Denied

You have filed a claim to get long-term disability benefits and you are confident that it is going to be granted. But you soon find out that your claim has been denied. Why did this happen? Firstly, insurance companies are businesses, so they may be denying your claim in bad faith just to save money. Secondly, your claim may have a flaw in it that has forced the insurance companies to deny it.
According to the website of Fields Disability, denied claims can be appealed, so insurance companies can reconsider their decisions. That is a good thing, especially if the denied claims are legitimate. But why are claims denied anyway? Below are some of the most common reasons why.

You are not disabled

It is a disability insurance, so obviously, only those who are disabled can enjoy its benefits. But what counts as a disability? That will depend on your policy with the insurance company. You have the right to get a copy of this policy and review it, so you will know what traits account for a disability.

You are not getting regular treatment

This kind of insurance often requires you to have regular visits to a specific physician, to emphasize the legitimacy of your disability, severity of the medical condition, willingness of the patient to be cured, the duty of the physician to make that happen, and the personal and financial hassle of it all. There may be some wiggle room to what counts as regular, but usually, it means bi-weekly or monthly.

You don’t have enough proof of disability

You cannot just file a claim and declare that you are disabled. You have to prove that you are disabled and that it is preventing you from working long-term. The best proof is to have medical records. Two problems can arise from here. First, you may have enough medical records but have failed to properly present them to the insurance company. Second, you may not have enough medical records because your physician is not properly documenting your treatment.

You are still able

Medical records and physician opinions should be very specific on your condition and what your limitations are, because if the insurance company has found out that the claim is not accurate, the claim may be denied or your approved coverage may be cancelled. There may be instances where insurance companies hire investigators to make sure that you are truly disabled and not able to do what you claim you are not able to do.

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