Awareness around mental health conditions has certainly grown in recent years, as have attempts to provide support to an increasing number of mental health patients by governments and employers. However, we still have a very long way to go, as evidenced by the routine denial of long-term disability claims by insurers. If you are struggling with mental illness and need to apply for LTD benefits as you are not currently able to work, or if your claim for LTD benefits was denied.
It’s important to know that denials are routinely an insurance company’s first decision on an LTD claim. Do not get discouraged and give up. If you have a legitimate claim, a disability lawyer in Toronto can still get you the benefits you deserve.
It is imperative to meet with a lawyer as quickly as possible, however, as there is a time limit on your options, and once the window closes, it is next to impossible to do anything more. The information you get from this post will give you a basic understanding of why insurance companies deny LTD claims for mental illness and what you can do about it.
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The Most Common Reason Insurance Companies Use to Deny a Mental Health Disability Claim
Mental illness and other medical conditions that cannot be measured or observed through traditional tests and imaging equipment like blood tests, X-rays and MRIs are referred to as “Invisible” disabilities. They also include physical conditions like:
- Chronic pain
- Soft tissue injuries
- Traumatic brain injuries (TBI)
The most common reason insurance companies give for denying these claims, despite Physicians’ Statements by highly trained and qualified medical experts that confirm a patient’s disease or injury, is the lack of observable and testable symptoms. They assert then that the only basis for the diagnosis is the insured’s subjective description of the pain or mental illness they are suffering.
If you received a similar-sounding denial letter, you might have gotten the impression that your claim has no chance of success. But a long-term disability lawyer knows how to put together a claim that judges and juries would find convincing. It is commonly only when a reputable long-term disability lawyer notifies an insurance company that they are on the case that the insurance company will consider paying LTD benefits.
What to Do if Your LTD Claim is Denied
The first step is to hire a disability lawyer and provide them with a copy of the denial letter.
Your lawyer will then take over communications with the insurance company on your behalf and connect you with experts who will assess you and provide the evidence you need to refute the insurance company’s denial.
All you need to do moving forward is attend your appointments, be honest at all times and follow your physician’s and your lawyer’s instructions. The vast majority of claims against insurance companies for denying LTD benefits settle long before they see the inside of a courtroom.