Why is my Long Term Disability claim denied if my doctor says I am disabled?
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      Disability

      Why is my Long Term Disability claim denied if my doctor says I am disabled?

      Why is my Long Term Disability claim denied if my doctor says I am disabled?

      Has your doctor diagnosed you with an illness or condition that prevents you from working? You applied for benefits with your Long Term Disability insurer. Your application contained an Attending Physician’s Statement which indicated your physician’s medical opinion that you are unable to work. Your insurer received and reviewed your application and denied your claim, notwithstanding, your physician believes you are unable to work based on his or her medical assessment of you. If you are in this situation, it’s vital to consult with a lawyer.

      There are many reasons the denial of an application for long term disability benefits can occur. The most common is failure to provide supporting medical documentation of your illness or condition. It is your responsibility to ensure your physician has provided the supporting medical records. It is important that you follow up with your physician to ensure the records have been provided in a timely manner to the insurer, failing which, your claim will be denied. Obtaining and providing the required medical records will likely re-instate your claim to the review process.

      Another reason for denial is a late notice of claim. Your insurance policy is a contract which sets out timelines in which certain steps must be taken. If you do not meet certain timelines your rights may be affected. Your policy sets out the timeline or limitation period for serving notice on the claim for benefits. Policies vary and must be reviewed carefully. The right to make a claim for benefits is not open ended. You are required to serve notice of the claim within the timeline or limitation period set out in the policy. Failure to do so may prevent you from obtaining your benefits.

      There are many reasons why you may not have served notice of your claim quickly and within the timelines of the policy. Insurers rely on the fact that applicants who are denied because of late notice of claim probably will not dispute the denial. If you are an applicant for long term disability benefits who has been denied because you failed to file the notice of claim within the timeline set out in the policy, you need a knowledgeable disability lawyer to help you fight the denial. The Court has the discretion to overlook the late filing when certain legal arguments are presented suggesting it is inequitable to deny you your benefits. We have successfully obtained long term disability benefits for our clients who have found themselves in this position.

      For more information, visit our section on disability. If you have any questions, book a free consultation or call 1-855-446-7765 for immediate assistance.

      Disclaimer: The content of this article is a general guideline made available for educational purposes only and is not intended to be used as legal advice for the reader's specific situation nor in general. By reading our blog and website content, the reader acknowledges the above and understands there is no lawyer-client relationship created between you and Himelfarb Proszanski through this content. To get specific legal advice, we encourage you to book a free consultation with one of our lawyers to clarify the legal aspects of your situation.