It is not uncommon to see people submit claims for disability only to be denied. And it can be discouraging to start the complex process all over again. But, the best way to make sure you are approved the first time around is to make sure you are avoiding common mistakes and seeking professional legal help from a disability lawyer.
If you are having trouble getting a disability insurance claim approved, these are the top seven most likely reasons you are not seeing success:
1. You and Your Doctor are Not on the Same Page
If you do not have your doctor’s approval or support before applying for disability, it could be difficult for any disability insurance company to accept your application. Sometimes you and your personal doctor may be in agreeance, but your insurer will need you to see a doctor designated by them or your employer before approving your claim.
2. Clerical or Technical Errors
There are a lot of applications, forms, and documents that need to be filled out to incorporate every aspect of your claim. If you miss a page or forget to submit supplemental evidence for your disability, the process can take much longer or end in outright denial. The key here is to be as organized and thorough as possible before you submit your claim.
3. Not Meeting the Required Eligibility
You must have worked a certain amount of hours and lost at least a certain percentage of income from your disability in order to qualify for disability insurance. You must also have contributed to the Canada Pension Plan for a number of years to seek benefits.
4. You Do Not Meet Your Insurance Company’s Definition of Disabled
The definition of disability is different depending on your insurance company. Make sure you fit within your insurer’s definition.
5. You Have a Pre-Existing Condition
You can get disability insurance with a pre-existing condition, but it can be harder to get your claim accepted if you are currently suffering from that pre-existing condition, or if you file a claim regarding mental illness.
6. Your Online Profile Tells a Different Story
Insurance companies will oftentimes look through your social media to make sure you are telling the whole story. If you say you broke your arm and are not able to work, but they see you post about a rock-climbing trip you took, your insurance can use that as a reason to deny your claim.
7. Insurance Policy Exclusions
There are certain types of conditions you cannot receive coverage for, which are called exclusions. This includes health conditions, but also risky activities, sports, or hobbies.
Contact a Personal Injury Lawyer
It is best to seek the help of an experienced personal injury lawyer before going through the process again. You only have two years after an injury or illness to get disability benefits, and the appeal process can take months. A personal injury lawyer will be able to review your documents and make sure your applications are all correct to expedite the process and get you the disability insurance you need.
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.