Learning that your insurance company has denied your claim for disability benefits can be extremely disappointing. However, that does not mean you should accept the decision.
If your disability claim has been denied, you will likely be given the opportunity to appeal the decision by providing additional information for the insurance company to review. Unfortunately, in many cases, an appeal will simply delay the matter rather than result in a positive outcome.
These failed appeals are often the result of common mistakes made during the appeal process. Give your own appeal the best chance at success by understanding these avoidable errors.
In today’s post, NOVA Injury Law will be guiding Atlantic Canadians through the top five mistakes to avoid when appealing a disability claim to ensure they can receive the benefits they deserve.
1. Exaggerating Your Symptoms
The denial rate for disability claims within both the private and public sector can be discouraging. It may be tempting to exaggerate the symptoms of your disability on the claim form in order to strengthen your claim.
You may have had your disability for a long time, and fear that your claims advisor will not understand why you can no longer work. Your pain may be intermittent, and you may be concerned that the insurance company will not understand why it prevents you from working. Although your fears may be legitimate, exaggerating your symptoms is not the answer, as it could ultimately lead to your claim being denied.
Insurance companies are eager to weed out “invalid” claims, and they will not miss out on an opportunity to do so. Exaggerating your symptoms could regrettably result in your claim reaching the “invalid” file.
2. Not Understanding Your Disability
Although exaggerating your symptoms is discouraged, downplaying the effects of your disability can be just as damaging for your claim.
Many of our clients understate their disability because they hope the insurance company will be more apt to approve their claim. Others have let their optimism get in the way of providing a true account of their medical condition. Both of these approaches will cause problems and delay the route to claim approval.
With that in mind, it is crucial that all the medical information you give to your insurance company is complete and accurate. Read all the information prior to submission and ask yourself whether it is an honest account of your challenges. However, remember that your doctor will never have the same level of familiarity with the workplace as you do. You must educate your doctor about your work duties and why you can no longer complete your usual tasks. Any information you provide about your disability will be used to make a decision on your claim, so that information should be accurate and supported by your doctor’s findings.
3. Not Following Your Doctors’ Treatment Plans
Most disability policies contain a provision that requires claimants to be under the continuous care of a medical doctor. Many also require the claimant to be participating in reasonable treatment. Do not let the insurance company deny your claim because you gave up on treatment due to the frustration of the disability claim process.
To avoid facing a denial from the insurance company for being non-compliant with the provisions of the policy, you should make all efforts to ensure you are attending appointments, considering reasonable treatment options, and following your physician’s recommended treatment plan.
Having said this, if you disagree with your physician’s opinion, you may want to consider getting a second opinion to ensure you remain under the care of a supportive and understanding physician.
Maintaining regular check-ups and rescheduling any missed appointments with your treatment providers will go a long way in your disability claim. However, if access to medical care is preventing you from complying with this requirement, you should document all your efforts to obtain appropriate treatment.
If you cannot obtain the necessary treatment, you should also document the reasons why, if possible. Otherwise, it will be far easier for an insurer to deny your claim for failing to receive proper treatment.
4. Waiting too Long to Hire a Lawyer
The importance of seeking help from a disability lawyer cannot be overemphasized. Many claimants feel overwhelmed, as most of their energy is spent trying to overcome their disability. It is understandable that the work involved in filing a disability claim may fall below other priorities.
However, waiting too long to involve a lawyer in your claim may make the process even longer and drawn out. It is in your best interest to find an experienced disability lawyer and involve them at an early stage. In addition to moving your claim along more smoothly, a lawyer can also advise you on other resources that are available to you.
At NOVA Injury Law, our experienced disability lawyers are ready to assess your situation and use that information to tell you how long your case is going to take, what the value of your case will be, or if you should consider a buy-out of your policy. We know how important communication is in any claim process, which is why your lawyer will be available throughout your case to let you know what to expect next and where your claim stands. If you are interested in receiving professional help with appealing your disability claim, call us now to book a free case consultation.
Trust Your Lawyer
While seeking help from a disability lawyer early on in your claim is an important first step, the work does not stop there! Failing to trust or follow your lawyer’s advice throughout the entire appeal process is another easy mistake that can hurt your appeal. It is important to appreciate the value of an experienced lawyer when it comes to following a disability claim through to resolution. A good lawyer can add their experience and make the process easier for you only if you put faith in them and allow them to do what they do best.
5. Giving Up
If you are unable to work because of a disability and you have already gone through the extensive claims process only to be denied, you may understandably feel ready to give up. Many others who have gone through this process failed to take action because they were tired of fighting and ready to accept defeat.
This is exactly what insurance companies want you to do. Insurance companies will often deny disability claims in cases where benefits should have been awarded in hopes that the disabled worker will give up on their claim and the insurance company’s money.
This tactic of denying claims is disheartening and discouraging for disabled workers, but that does not mean that you should give up on your claim.
The appeal process can be lengthy and overwhelming, particularly for someone attempting to navigate a new disability and keep their symptoms in check. Although it may be difficult, we encourage you to carry through with your claim and not to lose hope. You should not miss out on your right to disability benefits before exhausting all options and resources available to you.
This battle is not something that you have to do alone. An experienced disability appeal lawyer can help you level the playing field against large insurance companies and ensure you receive the benefits you are entitled to. The bottom line is that you should not give up, as perseverance may yield positive results.
Get Support for Appealing Your Disability Claim
The best thing you can do for your claim now is to have the help of an experienced disability lawyer. Our disability lawyers only practice in the areas of disability and injury. This means that we know how to fight against insurance companies and achieve excellent results for our clients.
Our legal team will help you navigate through the law and help ensure that your injuries and damages are accounted for. Dealing with denials of disability benefits is something we do every day. We help our clients get access to the compensation they need so that they can focus on their recovery.
You can learn more about how we handle disability claims here.
If you or someone you know is appealing a claim for disability benefits, and are located in Halifax, Bedford or the wider Nova Scotia area, call NOVA Injury Law today for FREE CASE REVIEW at 1-800-262-8104. We also serve other areas of Atlantic Canada, including Prince Edward Island. Contact us today and tell us more about your disability benefits claim – we are here to help!