How To Proceed After Being Denied Disability Coverage

If you have been denied long term disability coverage, then you need to seek-out a member of the legal profession, someone that is familiar with denial letters.

Your denial letter should state why you were denied coverage.

• Did you need to offer more evidence of the fact that you have a disability?
• Did you submit an application while you were still undergoing treatment for your disorder/condition?
• Did the insurance company feel that you should not encounter great difficulty with switching to a different career?
• Did you neglect to enter all of your medical information in your application?
• Did you fail to provide the insurance company with clear answers to the questions on your application?

Be sure to note the date on which your denial letter was written.

That date is the starting point of an important timeline. It is the timeline that establishes the deadline for appealing the issued denial.

Decide what type of appeal you plan to use

• An internal appeal asks the insurance company to reconsider the decision.
• An external appeal involves taking legal action.

The role of the client’s attorney as the lawyer-client team prepare for the appeal hearing:

Gather whatever evidence can be used to refute the denial and look for evidence in the client’s insurance policy. Does it contain any phrases or longer statements that seem to apply to the client’s situation?

Visit the doctors that have cared for or examined the client. Visit any facilities where a test was performed on the person that has been denied the disability benefits. Visit any facility where an x-ray was taken. Obtain medical documents from each of those facilities.

Track down any witnesses and get their statements. Those could be some of the client’s friends, neighbors or co-workers. Ideally, each of them has seen how the client must struggle with doing everyday tasks, due to the fact that he or she has developed a disability.

A witness might also be able to offer comments that support a statement made by the denied co-worker, friend or neighbor. For instance, if a former employee has mentioned the effect of having to climb stairs repeatedly, a co-worker could testify to the need for the climbing of stairs in the client’s former job.

The attorney should warn about the dangers associated with posting pictures on social media networks. A posted photograph might cast doubt on the veracity of claims about the client’s inability to perform certain tasks. Insurance companies pay investigators to study what has been posted on various social networking sites.

The Personal Injury Lawyer in Brampton should explain how to proceed, if the insurance company has insisted on participation in a treatment program. The treating doctor should be informed about planned self-assessments of progress.

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