Personal Injury

Was your short-term disability claim denied after a paper review?

By Nainesh Kotak

Does this sound familiar? You stop working due to a physical disability or due to stress, depression or anxiety.

You complete your application for short-term disability benefits and send it to your disability insurance company. You have your doctor fill out a physician statement and send it with test results such as an X-ray, MRI or CT scan. You wait a few weeks and enquire from the case manager at the insurance company about a decision. You are then told that the insurance company’s own doctor has reviewed the medical documents that you sent and has concluded that you can work. You then receive a letter in the mail and learn that your application for short-term disability benefits has been denied.

You may be asking yourself how can my short-term disability insurance carrier deny my claim based on a report from a doctor who has never even met me. Unfortunately, this happens all the time. It’s not fair but many claims for short-term disability benefits are denied in this manner.

If your short-term disability claim is denied your application for long-term disability benefits will also undoubtedly be rejected. Nevertheless, you should still apply for long-term disability benefits if you remain off work.

If your claim for short-term disability benefits is terminated or denied you should retain a lawyer as soon as possible. You should avoid the unnecessary and biased insurance company internal appeal process. Your lawyer should obtain medical evidence from your treating doctors such as your family physician, specialists and therapists to support your claim. Your lawyer may send you to a specialist for a medical/legal opinion to demonstrate that you meet the test of disability as set out in your policy.

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