When it comes to long-term disability claims, insurance companies often look for reasons to deny benefits. One of the most common ways that insurance companies deny claims is through pre-existing condition clauses stated in policies. However, since pre-existing conditions and other limitations are often broadly outlined, it leaves plenty of room for insurance companies to interpret limitations in their favor — and in many cases, leaves the claimant with a wrongfully denied claim.
Common Limitations in Long-Term Disability Policies
Besides a pre-existing condition limitation, the following are some of the most common limitations outlined in policies:
- Mental health limitations
- Alcohol and substance abuse limitations
- Suicide attempts
- On-the-job injuries
- Acts of war
How to Appeal a Denied Decision
While you have the right to appeal a denied decision, the process can be complicated as well as stressful — especially if you’re unfamiliar with ERISA laws. When appealing your claim, you must meet the following requirements:
- Appeals must be submitted within 180 days from the date of your disability denial letter.
- An appeal must be done in writing.
- Include all relevant medical documentation to support your appeal.
- Further medical evaluations such as an independent medical exam (IME) may be ordered to prove your disability.
Why it’s Important to Hire a Long-Term Disability Lawyer
Other documentation, medical testing, and requirements may be needed in your long-term disability case. Should your appeal be denied, your remaining option is to file a lawsuit for disability benefits against the insurance company that has denied your claim. Having an experienced ERISA attorney can increase your chances of receiving the benefits you deserve.
If you or a loved one have been denied long-term disability benefits, we can help. From new claims to appeals, we can handle all cases throughout the United States. Contact Dabdoub Law Firm today at (800) 969-0488 to learn more about your long-term disability options.