Being approved for short-term disability benefits from your employer or private insurer should be straightforward if you have a legitimate condition preventing you from working. Far too many claimants get unfairly denied the financial support they are entitled to. If your claim gets rejected, delayed, or reduced, it may be wise to enlist an experienced disability attorney to get the benefits you deserve. Receiving an outright claim denial is a major red flag. Disability carriers routinely deny claims hoping applicants will not appeal. Denials are often made for questionable or technical reasons that a lawyer challenges. Statistics show having an attorney boosts the chances of overturning the decision on appeal.
Take a close look at the written denial rationale provided by the insurer. If the reasons seem illogical or contradict your doctor’s recommendations, that points to an unwarranted denial. Disability lawyers know which denial reasons are bogus and dispute improper conclusions. Disability carriers must process claims within set timeframes, usually 45 days. If your approval is delayed excessively without justification, involve an attorney. Legal pressure speeds up the review and protects you if the insurer tries denying you after dragging its feet. It is reasonable for a carrier to request updated medical records during the claim review. Continuously demanding more forms and documents from you or your doctors can signal a fishing expedition for reasons to deny. A lawyer intervenes to hold the insurer accountable.
Benefits are less than expected
Make sure the monthly short-term disability payout you are offered aligns with your policy terms. Far lower benefits than anticipated may indicate unfair calculation errors or the use of outdated income data. A lawyer demands transparency on payment rate determinations. Insurers often cite pre-existing conditions like arthritis to deny disability, even when a distinct new injury or illness is disabling you presently. Make sure your policy defines “pre-existing condition” properly. If not, a lawyer fights denial based on an unrelated prior medical problem.
Private disability policies must pay benefits if health issues prevent you from working in your occupation. Policies through employers often only pay if unable to perform “any occupation.” Make sure denials based on being physically able to do different work are justified, not just cost-saving tactics. It is extremely common for long-term Social Security Disability claims to get denied if short-term disability was rejected initially. Overturning your STD denial can then improve your chances of getting SSDI later. Disability attorneys understand these interconnections. Disability insurers often require “independent” medical exams to evaluate claims. However, these doctors work for the benefit of the insurer. If their conclusions differ drastically from your doctors, involve legal counsel to contest them.
Surveillance is conducted without notification
Insurers sometimes conduct secret video surveillance on claimants to try to substantiate denial reasons. If you are denied due to footage you were never informed was being gathered, a lawyer may argue invasion of privacy. Even if your claim denial seems clear-cut, a disability lawyer may be able to force a settlement with the insurer. Skillful attorneys secure a lump-sum payout or stipulate partial benefits instead of long appeals. Their involvement often compels insurers to negotiate. Understand that most short term disability lawyers in brampton appeal end up in federal court if still unresolved after the mandatory internal appeal process. Disability attorneys recognize this likelihood.
Comments are closed.