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Reasons Your Orlando Long-Term Disability Claim Might Be Denied

Social Security Disability Requirements in Florida

Long-term disability (LTD) insurance will provide some replacement income if you are disabled and can no longer work due to an accident, illness, or another disability condition or event. You can purchase long-term disability insurance on your own, but some employers offer it as a benefit as well. Unfortunately, having access to benefits isn’t a guarantee that your claim will be approved. Many LTD claims are denied the first time around, which is why you need an Orlando elder lawyer who can help.

If you received an LTD denial, the Law Offices of Shea A. Fugate, P.A., can help. Contact our office right away as you only have a limited amount of time to file an appeal. You typically have around 180 days to file an appeal. While that sounds like a lot of time, you need to gather all the necessary evidence to support your case. If you miss the internal appeal deadline, you won’t have the opportunity to present your best evidence.

To better understand LTD claims, here’s a look at some of the most common reasons long-term disability insurers deny claims.

Lack of Sufficient Documentation

In many cases, LTD claims are denied because there isn’t enough evidence presented to make a decision. It doesn’t mean your claim isn’t valid, only that you didn’t provide them with enough evidence to prove you deserve benefits. That is one reason why hiring an Orlando long-term disability lawyer from the start is recommended. We can ensure all the necessary evidence is submitted the first time around.

Erroneous Documentation Provided

You want to make sure you provide enough information, but it has to be the right documentation. If you send in something misleading or knowingly not correct, the insurance company will also deny your claim. Even seemingly minor errors or a genuine mistake can be enough to warrant a denial.

Your Condition Isn’t Covered

Not all LTD policies cover the same conditions. That is especially true with employer-provided long-term disability policies. You should familiarize yourself with the policy language and make sure you have a complete evaluation of your condition. You need to document all symptoms, when it first started, when you first sought treatment, etc. It is possible that your condition could involve multiple diagnoses. Or, some of your symptoms could be covered under the policy, while others are not. The way your doctor describes your condition and your symptoms when submitting your claim could mean the difference between getting an approval or receiving a denial.

Severity of Condition Disputed

Your condition could be covered, but that doesn’t mean the insurer will agree with how severe you claim your state is. Disputes over the severity of the condition can be very subjective. That is one reason why documenting your claim and symptoms are so important.

Some health conditions are only considered disabling when they reach a certain severity level, so your condition might not be severe enough to warrant coverage.

Contact an Orlando Long-Term Disability Lawyer

There are numerous other reasons that an LTD insurer might deny your claim. To learn more and prepare to file an appeal, contact the Law Offices of Shea A. Fugate, P.A., today to schedule an initial consultation.


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