5 Common Reasons Why Your LTD Claim May Be Denied

Denied Disability

When you have an injury or condition that renders you unable to work, you can apply for disability benefits. But what happens when your short-term disability benefits are about to end but your condition hasn’t gotten any better? When this happens you will likely consider applying for long-term disability (LTD) benefits.

But before you are approved for LTD benefits, your insurance company will review your medical records and related documents to make a decision. Since the goal of your insurance company is to make money, it wouldn’t be in the company’s best interest to approve all claims. Therefore it’s not unreasonable that your insurance company may find a reason to deny your claim. Here are 5 common reasons why your LTD claim may be denied.

1. You didn’t include enough medical information.

Your insurance company will likely want more than just your completed medical forms that they provide. Instead it will probably desire all of your hospital and treatment record, employment records, tax returns, and anything else related to your disability. The company will want to know your full history before your disability as well as your health history after your diagnosis.

2. Your claim wasn’t submitted within the time limit allotted.

LTD policies, which are drafted by insurance companies, include specific periods of time during which you are allowed to file a claim. That’s why it’s so important to apply as soon as you receive word from your physician that you should not go back to work. The sooner you apply the better your chances of meeting the allotted time limit.

3. You failed to properly complete your LTD forms.

The mandatory forms that you need to fill out in order to file your claim are undoubtedly complicated. The forms are time consuming and complex, which is why your doctor or employer likely won’t care to fill them out for you. So when you do it yourself there’s a good chance that you’ll do so incorrectly.

4. They don’t find evidence of a disability. 

Sometimes the insurance company and their medical advisors don’t believe that what you are dealing with amounts to a disability for purposes of LTD. Although certain disabilities are completely objective, such as paralysis, others such as debilitating back pain, depression, or anxiety aren’t so easy to prove. Additionally, the insurance company may feel that what you are suffering from shouldn’t prevent you from working.

5. You have a pre-existing condition.

Most LTD policies contain a provision that prevents individuals from receiving benefits if their condition was pre-existing. Under such provisions you are prevented from receiving benefits for conditions that you reported within a certain period of time prior to filing for LTD (usually 3-6 months). You are also commonly prevented from receiving benefits if you file for them within 12 months of receiving LTD coverage.

Cariati Law Can Help

If you or a loved one wishes to apply for LTD benefits or has recently been denied LTD benefits, you may not even know where to begin. Therefore it is a good idea to consult with an experienced and knowledgeable Ontario Disability Attorney. At Cariati Law, our top Disability lawyers will handle your case for free – you pay nothing until we do. Contact one of our Toronto Disability Lawyers at 905-629-8040 today!