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Most Common Reasons Disability Claims are Denied

Disability Insurance is a good thing to have. You can get it privately, through your employer and through social security. Each policy that is out there is different and can have different terms and costs. Terms can be related to the disability that is covered, the length of time you are covered (Short or long), percentage of income paid, and work restrictions (own-occupation or all-occupation). All of these terms are reviewed at the time of a claim and they can be denied and not paid. Here are the main reasons why this may happen:

Medical Evidence

When an injury or illness occurs and claim is filed, it is important that medical evidence is provided. If you see a physician and can prove that you can’t work, then you may have a chance. Evidence such as medical records and doctors notes are key. A note excusing you from working or saying you are not medically able to can help your case. Even if you have this, they may not see it as enough for their purpose.

Previous Denials

If you have previous denials than the current claim could be denied. It is not a good look if you look like someone who is claiming to be disabled and unable to work all the time. They may think you are cheating the system. If anything, it may be in your best interest to appeal a denied claim rather than submit an additional claim.

Follow the Rules

Your claim could be denied if you fail to follow the rules. You need to follow the treatment plan provided by your doctor. If you don’t do this then it may seem like you aren’t serious about recovery and it also doesn’t help the claims assessor determine if your condition is legitimate if you are unwilling to cooperate with the treatment recommended. The only way around this is if you tell them during the appeal why you did not follow the doctors plan.

It is also important to follow the rules of the insurance company/social security. If you don’t cooperate and don’t provide them with the necessary information then the claim will easily be denied. When submitting a claim be sure to have all of the information to avoid unnecessary denial. 

When you have disability insurance you obviously want to be able to file a claim and get a pay out. Be sure to look at these reasons to avoid being denied.



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