How To Do A Long Term Disability Appeal

By Carol Jackson

There are times when an insurance claim is being denied by the company provider. They sometimes find reasons, especially those in fine prints, to deny the claim. To do a long term disability appeal, you must first understand why it has been denied before writing an appeal letter.

To help in proving your counter case, you need to gather knowledge on the insurance policy you got. Learn all these things. Be persistent in pursuing it. Patience is the key to gather the evidence you need for a counter against their claims and reasons. You need to do this before the assigned deadline for your appeal.

What reason they come up with may be, understanding it should be a priority before you can build a substantial case. Their denial letter and each section on it should be read thoroughly. Call them and inquire as to what each of them mean. Remember, you are doing this so you will have important information. It would be prudent if you are polite in conversing with them.

If there are parts that you know yourself are incorrect, highlight them for further evidence. When their reason for denying it is because the medical records you submitted are insufficient, ask what other documents do they substantially need. Also add if there are specific lab tests and medical results they particularly need in your records. It might be that what your physician wrote on the medical certificate was not enough for them. Inquire as to why that is so your physician, and even you, can expound it to them.

Most companies would reason out that they did not find your disability to affect your work. If this is the reason detailed on their letter, let them know the duties and responsibilities you have in the company. Include a copy of your official job description and specification you got from the human resources department. This is so they know that your reason is valid and should not have been denied in the first place.

Your physician can help you in gathering further evidence. As a medical practitioner, he knows how this disability can affect your physical and mental capabilities. Always ask specific and particular question in regards to your condition. Have him explain how this can affect your routine every day at social functions, home, and work. Record and list it all.

Read the section on disabilities in your insurance policy contract and read on what they mean about disability. There are times that your definition is different on their definition. Theirs may either pertain to inability to do any work or to go back to do your own work.

If your definition matches with theirs then carefully read once again the insurance contract. Do cross matching between it, your gathered evidence, and their letter. It may give you the fighting chance to get your insurance claim and win the case.

Lastly, to ensure that they cannot deny you a second time, ask for the assistance of lawyers. They can review your counter claim and affirm it if it is substantial enough for your appeal. With their help, you can avoid any delays and lessens any errors in regards to paperwork. They also know how to craft the letter of appeal so you can persuade the insurance company to retract their decision.

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