My doctor says I am disabled, my insurance carrier disagrees
If it comes time to make a disability claim, there is no denying the fact that you will be required to consult with a medical professional. This person will examine you in an attempt to help determine if you are disabled and unable to return to work.
Even if your doctor states that you are disabled, your insurance carrier may disagree.
Your insurance company will review your coverage and make an eligibility decision based on the definition of “disabled” as outlined by your policy.
You may need to communicate with your doctor to ensure that your injury or illness is reported in the appropriate manner.
Your insurance company is not required by law, under ERISA, to accept your doctor’s suggestion that you are unable to work. There are times when an insurer will require “objective medical evidence” to accompany the information provided by your doctor.
There are also situations in which your claim could be denied due to a coverage issue, such as the date of enrollment or the belief that your condition was pre-existing. If this happens, you should learn more about the company’s claims and how to refute them.
If you are truly disabled and have the right to collect disability benefits, you should do whatever it takes to get the money that is owed to you.
Those who find themselves in this position can learn a lot by visiting our website and reading the pages associated with this subject matter. Our “FAQs” page touches on many topics associated with the denial of a disability insurance claim.