There are many reasons why a claim reviewer will deny a disability insurance claim, three of which are listed below. You will also find information below about what you can do if your claim is denied so that you can get the money that you need.
Reasons Disability Insurance Claims Are Denied
Some common reasons why these insurance claims are denied include:
1. Not Disabled Due To Occupation
One of the first things a claim reviewer will do is to determine if your disability claim is due to your occupation. For example, you may claim you have carpal tunnel syndrome due to typing at your computer, but the claims reviewer may find you do not sit in front of your computer long enough to get this disability. The claims reviewer may state that your job does not have stressful or strenuous requirements but instead is much less demanding. The claims reviewer will determine this by looking at your job description and talking to your employer. If this is the reason your claim is denied, ask the claims reviewer to give you a detailed explanation of why they decided to deny the claim.
2. No Findings
Another reason a claims reviewer will deny a claim is they may find no objective findings that you are disabled. In order to approve a claim, the claims reviewer would have to have proof from a doctor. For example, blood tests, MRI results, x-rays, and much more. Because of this, make sure you submit all required medical documents that you can receive from your doctor to ensure the claims reviewer has the proof that is needed.
3. Pre-Existing Condition
If you have a pre-existing condition, your claim will likely be denied. For example, you may already have an injury, such as to your back, when you start your employment. Depending on your situation, the disability claim may require an approximate one-year waiting period. This means if you were treated for your condition within 12 months before your employment, it would be required pre-existing.
What You Can Do
If you feel your claim was denied unfairly, you should hire a disability claims attorney to help you. This attorney can learn the detailed reasons for the denial and then take steps to get your claim approved. For example, if the reviewer does not have enough medical proof, the attorney will contact your doctor to determine if they can provide more evidence to the claims reviewer.
The attorney can help you if you need to go to any kind of meetings, such as with the claims reviewer, to go over your claim. The attorney can also ensure that you fill all paperwork out correctly if you apply for your disability claim again.
For more information on disability insurance claims, contact your local attorney.