If you discover that your disability claim is denied, it is important to recognize that you do have potential rights. The support of an experienced attorney can make a big difference in how you respond to this claim and how much compensation you could be entitled to recover.
Why Are Disability Claims Denied?
In most cases, these claims are denied because the carrier believes that you did not meet the grounds for a covered disability within your policy. This often falls down to the medical records in the case showing the impact the accident or disability has had on your life and your ability to work.
What Happens if Your Disability Claim is Denied?
If your claim is not approved, you will not receive benefits.
It can be devastating to receive the news that your short-term disability claim was denied, but you do have options available to you. If you had your sick leave approved by your employer and went off work on doctor’s advice, it can be very overwhelming to discover that the insurance company has denied your claim. There are several options available to you, but one of the most important is recognizing that you need to take action quickly.
What to Do When Your Disability Claim is Denied
Appealing the denial is the most frequent avenue people can pursue when they have been seriously hurt in an accident. Your insurance company will layout the specific practices that you need to follow to appeal a disability claim denial. You will need to ensure that the insurance company puts the reasons for the denial in writing, therefore, you can use this information as leverage to collect appropriate evidence about how to respond.
You’ll need to address the reasons given for the denial with as much evidence as possible and can typically do this by giving the insurance company the information or medical evidence as required to approve your appeal. In the event the insurance company denies your appeal, then you’ll need to move on to the next option. Another option if you have been denied in your short-term disability benefits is to apply for long term disability benefits.
How to Check Your Disability Claim Status
You can check your claim status by logging in to My Service Canada account to see where your application is currently at in the process. If you notice that the claim has been denied, it’s a good time to schedule a chance to speak with a lawyer.
Why Would You Need a Disability Lawyer?
If you are still unable to return to work after 15 weeks, you need to initiate an application for long term disability benefits. You should not ignore this possibility as many people unfortunately do. Many people are under the impression that if their short-term disability benefits were denied that they should not apply for long term disability benefits at all. While there is still a strong possibility that the insurance carrier will deny your long-term disability claim, you will need both that application and the denial in hand so that you can explore other options. If you initiate a claim for long term disability benefits and are denied as you expected, you have the opportunity to ask the insurance company to review their decision to deny your long-term claim.
Unless there is new information or details that you are providing at this point, it is unlikely that your appeal would be successful but hiring an experienced attorney can help you to accomplish that goal. If the insurance company still continues to deny your short term and long-term disability claim and you are not able to go back to work, then your next step is to initiate legal action against the insurance company. A disability lawyer should be contacted to discuss all of your options.
A disability attorney can tell you more about your individual case and what to anticipate and can help you to prepare for what is likely to happen as your case evolves. Although it is certainly very overwhelming and frustrating to be suffering from an injury and not able to get the benefits that you need, a disability appeals lawyer will help you to gather the necessary evidence, file the paperwork, and set yourself up for the best possible chance to recover compensation. Remember that when it comes to obtaining disability benefits, you are not alone.
FAQ
The average monthly disability cheque is estimated to be $1,258 per month. The amount of these benefits is heavily anchored on the average lifetime earnings, not on how severe the individual’s disability is or household income. If you have kept your annual SSI statement, you can be able to see the amount you are more likely to receive as injury compensation. The total amount of money a disabled worker can be paid is about 150% to 180% of the worker’s total benefits.
There are certain factors that automatically qualify you for disability. Authorities have listed a number of impairments, both mental and physical that will automatically qualify you for the SSDI benefits or the Supplemental Security Income, provided your condition meets the highlighted criteria for listing. Some of the impairments include: cardiovascular conditions like heart failure or coronary artery disease, musculoskeletal problems such as back injuries, senses and speech issues among others.
You can be denied for both short term disability and long term disability benefits at the initial stage of application and when you appeal each of these.
The appeal process takes a different period of time depending on the kind of case. Should you opt for the internal appeal route, it will take you a maximum period of up to six months, which is around 180 days after getting a notice from the respective insurance company that it denied your claim proposal. You have the freedom to file for an appeal as quickly after getting that notice. The denial notice will reach you within 15 days of the company receiving the initial claim for coverage.
You will be notified in writing that you have been approved for disability benefits, and this notification will also include details about the type and length of benefits.