A denied disability claim is not the desired outcome for claimants who are suffering due to injuries that prevent them from working. Below are the reasons why many of disability insurance claims are denied. This information is important to prevent a denied disability claim or before you begin an ERISA appeal for your denied claim.

1. Video Evidence

For many ERISA claims, insurance companies will hire private investigators to follow you for a certain period of time and collect video evidence. If the claimant, which is you, claims that you are not able to perform certain tasks or require assistance to get around, the video evidence will determine if that is or is not the truth. The insurance company is able to gather this information without your knowledge. This will prompt the need for an ERISA appeal by your disability attorney.

2. Compulsory Medical Examinations

Based on the verbiage of your insurance policy, many insurance companies are able to request a compulsory medical examination with doctors that they have hired. These exams can be an Independent Medical Exam (IME) or a Functional Capacity Exam (FCE). During the FCE examinations, the claimant has their abilities tested for several hours to determine if they are actually able to perform certain tasks. The hired gun doctor will focus on areas that are affected by a claimant’s disability. 

The IME exams are often much shorter and the doctors ask a few questions and perform an exam. The doctor will focus all of their attention on the affected area, working it to see how far the disability stems. In both of these cases, the doctors are paid by the insurance company and have a tendency to write reports that are in favor of the insurance company.

3. Change in Policy Definition

When referring to the change in policy definition, this is the way that disability is defined by the insurance company. For many insurance companies, disability refers to the inability to do your work for a period of 24 months. Once the 24 months expires, the definition of disability shifts to other components such as income and total physical ability.

At this point is often when private investigators are utilized to determine if the claimant is able to move forward with a disability claim or pursue some form of occupation. Prior to the expiration of this time frame, the claimant may be sent again for another compulsory medical examination to determine the legibility of the disability.

4. Improper Documentation

In a denied disability claim, one of the major reasons is the documentation provided by the physician. When doctors take notes in your medical file, that information will be sent forward to the insurance company. Many appeals are based on improper documentation where the physicians made a mistake in the record or did not outline specific issues due to rushing. Because of inconsistencies in notes or the mention of a good day, the insurance company can take that information and deny your claim.

In order to prevent improper documentation, a disability insurance attorney at Dell & Schaefer will always review your medical records and communicate with your doctors regarding your claim and the proper completion of forms. Our attorneys always review doctor’s notes and records to maintain consistency.

5. Inaccuracy During Filing

Many claims are denied initially due to the claim forms being filled out improperly from the beginning. Do not expect the insurance company to notify you of these errors. These are ground for a denied disability claim and an ERISA appeal will need to follow. When filling out these forms, it is essential to reach out to a disability insurance law firm LTD to prevent such a detrimental mistake. Having a disability insurance lawyer acting as your advocate can ensure that these mistakes are not made and appeals may not be needed later during your claim.

This can also be done with inaccuracies from doctor reports. As the claimant’s advocate, all of this information can come to the disability attorney’s office and be reviewed before they are sent forward to the insurance company. If something is not correct, it can be sent back and corrected before moving forward.

Speak With a Disability Insurance Lawyer Today!

Disability Insurance Attorneys Dell & Schaefer have the ability to serve and represent across the nation. Your initial consultation with us is always free. Give us a call today or contact us online through our contact form.

Please call our disability attorneys for a free consultation on this or any matter relevant to your disability claim. Expect a same-day response to your consultation and there is no fee for our services unless you are paid from your claim. No state is too far, as we can represent you anywhere in the country.