It Doesn’t Take Much for an ERISA Disability Claim to Be Denied
The Employment Retirement Income Security Act (ERISA) of 1974 set minimum standards that employer-provided disability insurance plans have to follow. Unfortunately, insurance companies are not exactly eager to pay out any claims, despite ERISA's requirements.
It takes very little for a claim to be denied. Here are some of the most common reasons you may be denied the disability benefits you desperately need:
You Don't Meet the Policy Requirements
Some disability plans allow generous benefits to disabled employees. You simply have to show that you are unable to continue working in your chosen profession (even with reasonable accommodations) to qualify for benefits.
Many plans, however, require you to show that you're unable to do any kind of work, not just the job you are accustomed to doing. If you don't know what your policy allows, you may not know how to present your case in order to qualify.
Your Medical Condition Isn't Clearly Documented
Medicine is not an exact science, and not every condition is easy to detect on lab tests. Fibromyalgia and chronic daily migraines, for example, are both serious disabling conditions — but a diagnosis often relies on a medical practitioner's skill in detection and the patient's own self-reported symptoms.
An insurance company may reject a claim based on the lack of evidence — even though you've done everything you can to get a diagnosis and get treatment. Sometimes it takes extra steps to convince the insurance company of the veracity of your claim.
You Made Mistakes on Your Application
A simple mistake on your application is enough to get a rejection — and set you down the long road to an appeal. Some of the more common mistakes include things like errors in your statements about your diagnosis or symptoms, missed deadlines, contradictory evidence from your medical providers, and missing information about your treatment or doctors.
You can't assume that the insurance company will do anything to assist you with your claim. After all, it's to their advantage if your application has mistakes or missing details.
How Can an Attorney Help With Your Disability Claim?
Whether you're filling out an initial application for benefits or you're looking at a rejection letter with your appeal rights listed on it, an experienced disability insurance claim attorney, like Scott E. Shaffman Attorney At Law, can help you submit a complete, accurate request for benefits the first time. If you're facing an appeal, the attorney can help you understand the specific reason that your claim was denied and plan a strategy to overcome it on appeal.
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