Why Was Disability Claim Denied

Why Was My Disability Claim Denied?

Having your disability benefits claim denied can be devastating. Long term disability insurance is an important employment benefit that is provided to many employees as a key term and condition of their employment. If you’ve ever asked yourself, why was my disability claim denied, we have answers for you.

The value of long-term disability insurance is that it provides employees with replacement income if they unexpectedly suffer a disabling illness or injury and are unable to work for an extended period of time.

Insurance Claim Long Term Disability Denied Toronto Lawyer

Insurance companies routinely deny legitimate claims. You are not alone.

Under long term disability insurance, it is typical for an employer to pay insurance premiums, while the insurance company pays the employee benefits when he or she becomes disabled.

Unfortunately, this arrangement provides insurance companies with a powerful economic incentive to deny an employee’s claim for benefits because paying out claims costs the insurance company money, that entail raises the employers premiums and hurts employers and insurance company profits.

As a consequence, the disability claims application process is difficult to navigate and insurance companies routinely deny legitimate claims for benefits or suddenly and unexpectedly discontinue benefits. During these times, hiring a disability lawyer is crucial to having enough power and resources to take on employers and insurance companies.


Here are the Top Three Excuses that Insurance Companies Use to Deny an Employee’s Claim for Disability Benefits:


1. You Did Not Provide Sufficient Medical Evidence.

An employee who makes a claim for disability benefits will often be bombarded by endless requests for further and better medical evidence. These requests allow insurance companies to delay paying benefits and also have the effect of wearing down and frustrating employees who are already in a vulnerable position due to their medical circumstances.

Tip: Make sure that when speaking with your doctor, they provide enough explanation as to their assessment and are not reluctant to explore all the medical grounds including: your patient history, review of the test results, and the judgement of the clinic trial.


2. You are Suffering From Symptoms, But You are Not Totally Disabled.

Why was my Short Term Disability Claim Denied Toronto Employment Law

Stuck in a lengthy appeals process? Call us today.

Shockingly, it is not unusual for a junior level claims advisor, who has little or no medical training, to question and second-guess a doctor’s prognosis that an employee is totally disabled.

Tip: Once getting that medical evidence requested from your doctor, insurance companies may still claim that there still is not “sufficient evidence” stating that you qualify to receive disability benefits. Follow the link to find a related article to this issue.


3. Work-Related Illness is Not Covered by Your Disability Benefits Policy.

An insurance company has no right to deny a disability claim for benefits for a work-related illness, unless the insurance policy contains a specific exclusion which has been clearly communicated to the employee.

Tip: When there is a conflict between the employee’s benefits booklet and the actual insurance policy (which an employee never sees), the benefits booklet will prevail.


Contact Us to Find Out How We Can Help You with Your Denied Disability Claim

If your long-term disability claim has been denied or you are stuck in a never-ending appeals process, you should contact us as soon as possible.


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