Disabled woman with crutches.

6 Reasons Why Your Long Term Disability Claim May Be Denied

Replacement income from long-term disability insurance can provide tremendous relief in uncertain times. Long-term disability (LTD) insurance provides wage replacement to people who can’t work due to disability. However, policy coverage alone does not guarantee the approval of long-term disability claims.  

When filing for LTD, claimants are pitted against insurance agents whose job is to save their company money by delaying or denying claims. Experienced disability attorneys offer protection against insurance bad-faith practices, and best position your claim for approval. 

Phoenix, Arizona disability attorneys can help you avoid common reasons why your LTD claim may be denied. They understand the tactics used by insurance companies to delay or deny claims and will put their skills to work for your best interest.

6 Common Reasons Long Term Disability Claims Are Denied

Although it is possible for claims to be denied for various reasons, here are six of the most common ones:

1. Incomplete applications 

Applications with missing paperwork, such as medical records and doctor statements, are considered incomplete. Claims lacking critical support documents are often delayed or denied due to insufficient medical evidence supporting the claim.

2. Pre-existing conditions

Medical conditions linked to symptoms, diagnosis, or treatments before a coverage effective date are considered pre-existing conditions. Insurers may deny claims that can be linked to pre-existing conditions. 

3. Not meeting the insurance policy definition of “disability” 

Insurance policies define which disabilities are considered coverable and which are not. They may also specify how many months of coverage will be provided for some specific conditions. 

If a person’s disability leaves them unable to perform their job requirements, or the duties for any occupation, disability plans generally provide coverage. However, exclusions are often noted, such as for pre-existing conditions or substance abuse.

4. Statement of the treating physician

Insurance companies give considerable weight to the opinion of treating physicians. Doctors should provide comprehensive written statements detailing the work limitations resulting from your disability.  

5. Medical condition has improved 

If the medical condition precluding the claimant from working has improved, the insurance company may attempt to delay, reduce, or deny claim coverage. 

6. Missed Deadlines 

Filing deadlines for both initial claims and appeals of denied claims must be met. Failure to meet deadlines can jeopardize your right to a claim or forfeit your right to an appeal. 

Additionally, prompt response to document requests and early production of evidence is vital. Failure to include evidentiary documents in the administrative record will bar them from being introduced into court proceedings. 

Having an experienced long term disability attorney on your side is essential. It is an unfortunate truth that some insurance companies are more concerned with profits than the well-being of the disabled.

Contact a Phoenix, AZ Long-Term Disability Lawyer Today

Navigating disability insurance is a daunting task. Long-term disability lawyers are best suited to work on your behalf during the claims process, fighting against big insurance and bad-faith practices. 

If you are an Arizona resident preparing an initial LTD claim, have already filed your claim, or have been denied coverage, our Phoenix, AZ long-term disability attorneys can help. Our legal team is skilled in all aspects of long-term disability claims and appeals and will get you the compensation you deserve.  Contact one of our disability attorneys today