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Most Common Reasons for a Disability Insurance Claim Denial

  • Published: 2010-09-17 (Revised/Updated 2016-03-20) : Disability Attorneys Dell & Schaefer (diattorney.com).
  • Synopsis: A list of the most five common reasons for a long-term disability claim denial.

Main Document

Quote: "The disability carriers often want to see you go to the doctor on a monthly basis, however, you're not required to go that often."

Claimants often ask me what are the most common reasons for a long-term disability claim denial, so I have put together a list of the most five common reasons.

1 - Number one is when you're definition of disability could change from own occupation to any occupation.

2 - Number two would be if the disability carrier conducted video surveillance of you.

As you go through our website, you can see that we've done multiple videos on video surveillance, and I would encourage you to check those videos out.

3 - Number three would be if your attending physician is not cooperating in filling out the paperwork for you or is not filling out the paperwork appropriately, that could also be a problem.

4 - Number four would be if you are not getting the appropriate treatment or not seeing the doctor often enough.

The disability carriers often want to see you go to the doctor on a monthly basis, however, you're not required to go that often. As a rule of thumb, we generally say that if you have a physical condition, you should go to the doctor at least once every three months; if you have a psychiatric condition that's disabling, you should go at a minimum of once a month.

5 - The fifth reason that a claim is most commonly denied would be for objective evidence versus subject of evidence.

The disability carrier would say you just don't have enough objective evidence to support your claim, and that would be something like you don't have an MRI, you don't have a CAT scan, you don't have a lab report, you don't have an X-ray. The problem is that there are many disabling conditions where you're just not going to get any objective evidence to support your claim, so the carrier puts your back against the wall, which is a problem.

All of these issues that I've just mentioned, you can view other videos on our website for additional information and you're always welcome to call us with any questions.

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From our Disability Insurance Claims section - Full List (32 Items)

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