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Saturday, September 28, 2013

Early retirement due to a disability? Fighting long-term disability denial

Understanding the long-term disability insurance process is key in disabled retiree planning
High household income is cause for disability insurance denial
By Valerie Stout Cyrus

Despite having paid into the system your entire working life, you may face a long and difficult road before you are approved for long-term disability benefits. In fact, most people like you face rejection after rejection before they are finally approved, often after several years of battling the legal system and nearly exhausting themselves and their financial resources during this process.

If you have already embarked on this disability application process or intend to soon, you would do well to understand the common tactics that insurance companies use to delay or refuse your benefits. Knowing the practices by which these companies often abide can prepare you for the battle that must be waged and assist you in advocating for yourself fully. 

Looking able-bodied 

Besides medical examinations to evaluate your health, many insurance companies will also hire investigators to observe you while you go about your daily routine. If during those visual evaluations they may determine that you look healthy enough to work because they saw you performing tasks that are equivalent to the tasks that you would normally do at work. 

The adjusters will argue that you look healthy, have good color to your face, and can talk and walk seemingly just fine; therefore, you must be able to go out and hold down a full-time job. However, long term disability denial cannot be based on physical appearance because there may be medical treatment that an individual must endure for a long period of time in order to remain healthy.

You can battle against this rejection by bringing every shred of medical documentation about your disability and presenting these medical records to your insurance company. If they see a doctor’s statement about your disability not being related to your physical appearance, the adjusters may be more willing to reconsider your case. 

Having sufficient financial resources 

If you have money saved in your bank account or have a spouse who is working to bring income into your household, your insurance company may quickly deny your claim. The adjusters may say that you do not need any supplemental money right now and that you can live off what you have saved and what your spouse earns.

However, this money that you have saved can go very quickly if you must use it to pay your mortgage, buy groceries, and pay other expenses. You also should not be penalized because your spouse works and earns an income. You can dispute this rejection by showing evidence of your present and future expenses and arguing that your lack of income indeed will hurt your family’s budget.

Despite your best arguments, the insurance adjusters will more than likely stick with their original determinations and ignore any evidence you present to them. When you want to make a significant impact with your claim and sway the adjusters to your favor, you would fare better if you hire a claims attorney. 

Hiring a claims attorney 

Insurance adjusters literally bank on you not knowing the laws surrounding claims and long term disability insurance. When you have an attorney representing you, your lawyer can use the state’s laws regarding these matters to your benefit and be more successful in presenting your claim to the adjusters. If they continue to deny, your lawyer could file a lawsuit against your insurer. Most insurance companies do not want to go to court; they likewise disdain of negotiating with attorneys. You can likely get your claim settled quickly if you hire an attorney.

When you have no success in making a claim against your long term disability policy, you may wonder what strategies you can use to your advantage. Rather than battle each one of the common practices insurance companies use to deny you, you can fare better when you retain legal counsel to assist you.

About the author: Valerie Stout Cyrus is a freelance writer who frequently researches insurance claims. She has found that Marc Whitehead and Associates assists individuals who have experienced long-term disability denial by demonstrating to the court that their defendant is in fact disabled and entitled to full payments from the insurance company.

* Image license: Diane Griffiths; CC BY 2.0