In Arizona, having a pre-existing condition can significantly impact your long-term disability claim. A pre-existing condition is any health issue that you had prior to obtaining your disability insurance policy. Insurance companies often scrutinize these conditions closely, as they can use them as a reason to deny your claim. For instance, let’s say you have a history of back problems and later suffer a debilitating back injury at work. The insurance company might argue that your disability is due to your pre-existing condition, not the workplace accident.
This can make it more challenging to secure the benefits you need. However, Arizona law provides some protections for individuals with pre-existing conditions. The state follows the “active treatment” rule, which means that if you have not received treatment for your pre-existing condition within a certain period before your policy started (usually six months), it cannot be considered a pre-existing condition.
What If My Disability is Aggravated by a Pre-Existing Condition?
In some cases, a pre-existing condition might not be the direct cause of your disability, but it could exacerbate your condition. For example, suppose you have a pre-existing heart condition, and you suffer a stress-related heart attack at work. In this case, your pre-existing condition didn’t directly cause your disability, but it may have made it worse. Under Arizona law, if your disability is aggravated by a pre-existing condition, you may still be eligible for benefits. However, the insurance company might try to reduce your benefits, arguing that your pre-existing condition is partially responsible for your disability. In such cases, an experienced attorney can advocate for your rights.
Can I Get Long-Term Disability Benefits if My Pre-Existing Condition Worsens?
Yes, you can potentially receive long-term disability benefits if your pre-existing condition worsens due to a work-related incident or accident. However, you’ll need to prove that your work incident significantly contributed to the worsening of your condition. Let’s say you have a pre-existing condition of arthritis, and a work-related accident leads to a severe worsening of your condition, leaving you unable to work. In this case, you may be eligible for long-term disability benefits. However, you’ll need to provide medical evidence showing that your work accident significantly worsened your arthritis. A talented attorney can help you gather the necessary evidence and present a strong case to the insurance company or in court if necessary.
What if I Have Multiple Pre-Existing Conditions?
Having multiple pre-existing conditions can make a long-term disability claim more complex, but it doesn’t automatically disqualify you from receiving benefits. Each condition will be evaluated individually, and the cumulative impact of all your conditions on your ability to work will be considered. For example, suppose you have pre-existing conditions of high blood pressure and osteoarthritis, and you suffer a work-related injury that leaves you disabled. The insurance company might argue that your high blood pressure and osteoarthritis contributed to your disability. However, with the help of an experienced attorney, you can gather medical evidence showing that your work injury is the primary cause of your disability, despite your pre-existing conditions.
What if the Insurance Company Denies My Claim Due to a Pre-Existing Condition?
If the insurance company denies your long-term disability claim due to a pre-existing condition, don’t lose hope. Arizona law provides avenues for you to challenge this decision. An experienced attorney can help you appeal the denial, presenting evidence to counter the insurance company’s claims. For instance, suppose you have a pre-existing condition of diabetes, and you suffer a disabling injury at work.
The insurance company denies your claim, arguing that your diabetes contributed to your disability. In this case, your attorney can help you gather medical evidence showing that your work injury, not your diabetes, is the primary cause of your disability.
What if I Didn’t Disclose My Pre-Existing Condition When I Got My Insurance?
If you didn’t disclose your pre-existing condition when you obtained your insurance, it could complicate your long-term disability claim.
Insurance companies often require policyholders to disclose any pre-existing conditions when they apply for coverage. If you fail to do so, the insurance company might argue that you misrepresented your health status and use this as a reason to deny your claim. However, even in these situations, you may still have legal options. For instance, if you weren’t aware of your pre-existing condition when you obtained your insurance, or if you can prove that your disability is unrelated to your pre-existing condition, you may still be able to secure benefits. An experienced attorney can help you navigate these complex situations, advocating for your rights and striving to secure the benefits you need.
What Role Does an Experienced Lawyer Play in Long-Term Disability Claims?
An experienced lawyer can play a crucial role in your long-term disability claim, especially if you have a pre-existing condition. They can help you understand the complexities of Arizona law, gather the necessary evidence to support your claim, and advocate for your rights against the insurance company. For instance, suppose the insurance company denies your claim, arguing that your disability is due to a pre-existing condition. In this case, your lawyer can help you appeal the decision, presenting evidence to show that your disability is not related to your pre-existing condition. A talented lawyer can negotiate with the insurance company on your behalf, striving to secure the maximum benefits you’re entitled to. They can also represent you in court if necessary, fighting for your rights and interests.
If you have been involved in a situation that has led to long-term disability, call Roeschke Law today at 800-975-1866 for a free consultation!