5 Reasons Your Long-Term Disability Claim Will Be Denied

Getting injured or becoming disabled can have a drastic effect on your income. Professionals who have secured a long-term disability insurance policy will be able to file a claim to help cover a portion of their lost wages. However, there are many LTD claims that are denied, often for the simplest of reasons. We have put together a list of the top five reasons a long-term disability claim may be denied.

The Condition Was Pre-Existing

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When looking at the standard disability insurance policy, you will note that there are some exclusions. The same holds true for long-term disability insurance. Pre-existing conditions are typically excluded from coverage under every policy. For those who become disabled due to a condition that either started before the coverage date or is a result of a condition that started before the coverage date, the claim for benefits will be denied.

Surveillance Shows A Disability Doesn’t Exist

It is common for an insurance provider to have a private investigator look for holes in a person’s claim. This may be as simple as checking to see if a person is actually disabled to having them watched secretly to ascertain the severity of the disability. Pictures, videos, or other proof that a person’s disability is non-existent or not as extreme as reported may result in a denial or cancellation of benefits.

Denial Due To Being Based on Mental Health

Most long-term disability policies have clauses regarding how long they will pay benefits for a mental health condition. For most, the maximum is 24 months. Anxiety, bipolar disorder, and depression, among other ailments, are legitimate, but harder to prove via lab reports and medical testing. These conditions can also be exaggerated or faked easily, which makes proving limitations difficult. These claim types are often subject to frequent denials.

The Claimant Finds Gainful Employment

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LTD benefits offer some income coverage, but it is often not enough to cover the cost of living. As a result, many claimants will find part-time or even full-time jobs to bridge the gap. However, LTD claims imply that you are unable to work at all, so if a claimant is found working, their benefits or claims will be denied. If the injury that resulted in becoming disabled was due to a work accident, it is important to speak with a personal injury attorney to get fair compensation.

The Claim Was Filed Late

There is a specific time limit under which a person can file a long-term disability claim. Too often, professionals allow that filing window to pass, which results in a denial of benefits. It is important to provide both notification and documentation of the disability as soon as possible to secure LTD benefits.

Get Help Securing Your Long-Term Disability Benefits

Those who believe they have a valid disability claim but are facing denials still have options. EIRSA and personal disability lawyers are able to help with both simple and complex disability benefits cases. They will help professionals gather evidence, file their claims, and even fight for approval in the event of improper denials. 

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