Written by Reginald Chan on March 2, 2021

What You Should Do If Your Claim for LTD Benefits Is Denied

If you are injured in an accident, you are entitled to compensation for your injuries. Different types of accidents like car crashes, workplace incidents, and slips and falls can cause permanent injuries. If you suffered a permanent injury, you can file a long-term disability (LTD) claim to get the compensation that you deserve. However, the insurance company can deny your claim, but there are certain measures that you can take. Read on to learn what you should do if your claim for LTD benefits is denied.   

Get a Copy of Your Policy

If you are employed and get injured at work, your employer is legally required to compensate you. To make sure that your claim will go smoothly, you must get a copy of the company’s group insurance policy to familiarize yourself with its LTD policy plan documents. Alternatively, you can request the documents from the insurance company in writing. These documents can only be sent via certified mail. If you are denied compensation or if the employer in question claims that the injury was your fault make sure to carefully study the company’s policy plan documents so you can write back a denial letter. Take note of the reasons stated for the denial of your initial claim. The letter should explain when you can file an appeal and should contain the information required to approve the case.  

Hire a Lawyer.

It is possible to file a compensation claim on your own, but the process can be tricky. Dealing with insurance companies can be challenging since they aim to protect their interests. If your initial LTD claim is denied, you can hire a professional injury lawyer to handle your case. Seasoned lawyers at marksandharrison.com/our-locations/fredericksburg-office/ explain that it is vital to work with an experienced attorney to increase your chances of getting a fair settlement. Your attorney will handle all the paperwork, and will explain the statute of limitations in your state so you can better understand your LTD case.

Investigate Your Case

Your lawyer will investigate your case to determine why your claim was rejected. The attorney will collect evidence from different accident experts to determine how much you should get. It is vital to set your administrative record with favorable details that can help support your claim before exhausting the internal insurance appeals process. Under the ERISA law, you may not provide any new evidence that was not initially provided to the insurance company. Your attorney will interview you to get more details to use in your case. This is why you must always try to provide correct information that may not be disputed by the insurance company.   

Track All Missing Records 

The administrators and insurers may fail to get all the medical records necessary for your claim. With the help of your lawyer, try to find out the records that may be missing. You must also confirm, with the claims representative, the information that may be required. You should also find out if medical tests could help since insurance companies usually cite the lack of substantial evidence as to the major reason for denying the claim. For instance, blood tests or x-rays could improve the chances of getting better results in your case if they display an injury, infection, or illness that might have been caused by the negligence of your employer or being exposed to harmful materials in the workplace. 

Expert Testimony

You can also try to obtain letters or expert testimonies from non-medical professionals like family members to bolster your claim. These letters will contain observations from your family members about any limitations or changes in your lifestyle that were a direct cause of your disability or injury. You should also request that your doctor provides written opinions concerning work-related limitations caused by your injuries. Your attorney can craft specific questions that can help the physician write an expert opinion about your condition. Your doctor may charge a small fee to complete LTD paperwork, but it is worth it. The physician’s opinion is crucial when trying to convince the insurance company to approve your disability claim. 

Appeal a Denial

You can take your case to trial if the insurance company insists on challenging the figure requested in a personal injury claim. Experienced attorneys know how to prepare the paperwork and file a lawsuit that will be tried in the law court. When the case goes to court, a judge will preside and offer a final verdict. Therefore, you should make sure that you have everything that is needed to win the case before you file a lawsuit. 

When you are seriously injured in an accident and you suffer permanent injuries, you can claim LTD benefits. However, these benefits can be rejected by the insurance companies involved. When your claim for LTD settlement is disputed, you should hire an experienced injury attorney to review your case. It is vital to establish the reasons why the claim was denied and take corrective measures to appeal the verdict.   

Article written by Reginald Chan
A meticulous entrepreneur by nature and a serial entrepreneur. Founded a few awesome startups including Marketing Lancers, WP Maven and TheMarketingHuddle.com. Reginald is a sought-after success coach, digital marketing consultant and TEDx speaker from Asia. Currently, he teaches others how to make money online for free.

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