What Should You Do When Your Disability Claim Is Denied?

Disability insurance only partially replaces your regular income. There may be various reasons why you need it, such as an injury or illness that prevents you from continuing to work. You may also need to avail yourself of disability benefits to bear your cost of living.

However, to receive your benefits you need to apply as soon as possible as the application process can take months.

Now, even if you’ve followed all the guidelines, your claim can still be denied. A disability lawyer can help represent your case, but let’s first try to understand the situation.

Reasons for Your Disability Claim Being Denied

First, you need to understand why your insurance company denied your claim. There are a number of possible reasons.

  1. They may have felt that the medical documentation you provided didn’t provide enough facts to support it.
  2. They may say that you aren’t “completely disabled” and are able to perform the essentials of your job.
  3. Their own medical consultants and doctors may attempt to prove that your disability claim isn’t genuine.
  4. They may not be convinced that you fulfilled the qualifying or waiting period and applied too early. You need to be disabled for a specific period of time before you can make your claims.
  5. If your medical issue hasn’t been properly diagnosed, they may not believe your claim as they cannot determine what your actual physical restrictions are.

Different Types of Disability Claims: What to Do If You Are Denied

There are different government programs, such as Employment Insurance (EI) and the Canada Pension Plan (CPP), to help make living with a disability easier.

  1. Social Security Disability Case

If your social security disability claim is denied, you should appeal within 60 days. This can be done through the help of a lawyer or independently. The key is to make sure that your appeal is on “official records” as soon as possible.

Make sure you carefully check on what grounds your claim was denied so you can file the appeal accordingly. A disability lawyer is your best guide through the entire procedure and can help you get justice. The earlier you appeal, the better your chance of winning the case.

  1. Canadian Pension Plan Disability Benefits

The Canadian Pension Plan is a monthly payment scheme for workers who have contributed to it throughout their working years. But are you eligible?

You are entitled to its benefits if you’ve contributed to this plan for a specific number of years and are under 65 years of age. People who have suffered severe and prolonged mental and physical disabilities that prevent them from working on a regular basis are entitled to this benefit.

To make sure you get the maximum benefits, it’s best to apply as early as possible as the approval process can take several months. 

  1. Long-Term Disability Claim

If you’re a long-term disability insurance policyholder and receive a letter of denial, what should you do? First, identify the appeal deadline to enforce your employment rights. To plan the appeal accordingly, gather all the relevant documents and identify which benefits you can claim. Analyze the letter of denial to frame the appeal letter accordingly.

How Can a Disability Lawyer Help?

Filing for disability benefits can be a complicated and confusing process, and not all applicants will know how to fill out the necessary paperwork or procure appropriate medical documentation. You may not need a disability lawyer to represent you to get your benefits, but hiring one can improve your chances for a successful disability claim in many ways.

  1. They Represent You at Appeals

When your initial claim has been denied, a disability lawyer can represent you at appeals. They will communicate with your doctor or other medical professionals to collect and submit proper medical evidence. Your attorney will also guide your testimony so the judge better understands how your disability has affected your work and life.

  1. They Are Experienced in Managing Disability Claims

Disability claims are challenging and lawyers familiar with Canadian rules and regulations surrounding them are more likely to get your claims approved.

Whether your disability claim has been denied by your insurance provider due to the aforementioned reasons or not, hiring a disability lawyer is sure to strengthen your case.  If your claim is legitimate, their experience and ability to provide correct evidence at the right time is more likely to win your benefits.