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Why Your Disability Claim Was Denied

Posted by Kotak Law Office on May 29, 2018
Posted under Vlogs

Disability lawyer Nainesh Kotak has a wealth of experience winning disability claims cases. With experience, one gains an improved understanding of the nuance of each case - that's what seperates the best lawyers from the adequate.

However, there are broad steps that almost anyone should take to avoid denial of your disability claim:

  1. Know how 'disability' is defined in your disability insurance policy
  2. Understand how pre-existing conditions are treated by your disability insurance policy
  3. See your doctor often
  4. Submit your application for disability benefits on time
  5. Follow your doctor's advice
  6. Avoid social media posts that mitigate the apparent impact of your condition

 

NO ONE EXPECTS THEIR LONG TERM DISABILITY CLAIM TO BE DENIED

You never imagine that one day you may have a disability, whether physical or psychological, that prevents you from working.  Nevertheless, you hoped that if you could not work due to sickness, illness, or injury your disability insurance company would honour its obligations and pay your benefits.

Claims adjusters routinely deny long term disability claims. They may say that there is no objective medical evidence to support your claim.  They may say that your circumstances have changed or that the definition of total disability has changed.  They may say that they have damaging surveillance or that your social media posts are proof that you can work. They may say that you haven’t followed suggested rehabilitation or treatment.

When these situations occur it important that you retain the services of a competent, experienced, and well qualified long term disability lawyer.

DISABILITY CLAIM LAWYER NAINESH KOTAK EXPLAINS WHY YOUR 
DISABILITY CLAIM WAS DENIED

If you have a disability plan through your employer you expect that you will be paid monthly benefits if you become disabled and are unable to work. Unfortunately, your application may be viewed by your disability insurance company with a negative light. Disability claims managers and administrators deny claims on a regular basis.  Often the denia3l is proven to be unjustified. 

Disability insurance companies may have an internal appeal process.  Our experience has been that the appeals process simply delays your case as the disability insurance company continues to deny your claim.  It is important to know the reason for your long term disability claim denial.

Some of the reasons stated by your disability insurer are:

  1. There is insufficient medical evidence.  Sometimes your doctor hasn’t address how your medical condition affects your ability to work.  Often your disability insurer simply ignores your doctor’s opinion.
  2. You have failed to seek appropriate treatment.  Most disability insurance policies require you   to seek appropriate medical treatment including consulting with specialists and undergoing therapy.  Disability insurance companies often do not understand the toll that consumption of too many medications may have on your sleep, appetite, mood or function.
  3. Your condition doesn't meet the definition of disability under the disability insurance policy.  Every disability policy will have a definition of disability.  Usually, for the first two years the definition is that the person has to be unable to perform the essential tasks of their pre disability employment. After two years, the person has to be totally disabled from performing any gainful occupation for which they are suited by education, training or experience.
  4. Many disability insurance companies will retain private investigators to follow you and video you.  If you have told your disability insurance company that you cannot do certain activities and you are shown to be doing these activities your claim may be denied by your disability insurer.

SOCIAL MEDIA

If you are active on Facebook, Twitter, Instagram, Linkedin, Snapchat or any other form of social media and you have made a disability claim you should be aware that your disability insurance company may be gathering information about you.  While traditional forms of investigation such as hiring private investigators are still used, examining your social media activity is a cheap and quick way for your disability insurer to investigate and even discredit your claim.

Unfortunately, your social media activity can be taken out of context.  For example people tend to post happy pictures and not the moments when they are suffering from depression or pain.

Public social media profiles are easily accessible to third parties and Courts have ordered the production of Facebook pictures even when settings are private.

We suggest that you be mindful of how your social media activity can be used by your disability insurance company against you. Ask yourself is the picture you are posting really a true depiction of yourself and what you are going through. Ask yourself if your settings really need to be public.

Courts will frown upon a deliberate deletion of social media accounts that occurred just because you are in a dispute with your disability insurance company. Be mindful of the risks of what you post being taken out of context. Certainly do not discuss on social media your meetings with your disability lawyer as those discussions are subject to solicitor/client privilege.

KOTAK PERSONAL INJURY LAW/DISABILITY LAWYERS CAN HELP YOU
We understand that being denied disability benefits can be frustrating and devastating. Your time to fight your disability insurance company is limited. Please do not delay in calling long term disability lawyer. We have successfully sued numerous disability insurance companies including: Manulife, Sunlife, Desjardins, Great West Life, Blue Cross, AIG, SSQ, RBC, Industrial Alliance and more.
Call your trusted long term disability lawyers at 1-888-GOKOTAK or (416) 816-1500. Our consultation is free and we don't get paid until you do. We can meet you at our offices, at a coffee shop, your home or a local court house. We represent disabled people throughout Ontario including Toronto, Mississauga, Brampton, Milton, Georgetown, Orangeville, Oakville, Burlington, Hamilton, St.Catharine's, Niagara Falls, Stoney Creek, Kitchener/Waterloo, Cambridge, London, Windsor. Markham, Pickering, Oshawa, Peterborough, Keswick, Kingston Ottawa and other locations.
Disclaimer: This article is intended to supply general information to the public. We make every effort to ensure the accuracy of this information. However, as laws change quickly, the reader should always ensure the accuracy and applicability of such information with respect to their particular case. The information contained in this article cannot replace a thorough and complete review of the reader's situation by competent legal counsel who has had an opportunity to review all of the facts.
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Related blog posts

Why Your Disability Claim Was Denied
Eligibility and Applying for Long-term Disability Benefits
What To Do If Your Claim For Short Term Disability Benefits Has Been Denied
No One Expects Their Long Term Disability Claim To Be Denied
 
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