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Can a Long Term Disability Claim be Denied for a Pre-existing Condition

  • Synopsis: Published: 2010-09-18 (Revised/Updated 2016-03-20) - It is possible your long-term disability claim can be denied for a pre-existing condition. For further information pertaining to this article contact: Disability Attorneys Dell & Schaefer at diattorney.com.

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Quote: "If they see that there is a condition that you didn't disclose on the application, they will more than likely deny your claim for a pre-existing condition."

Your long-term disability claim can be denied for a pre-existing condition; however, it's a very fact-specific analysis as to how it's going to happen.

For instance, on a private policy you purchased on your own, if you failed to disclose a medical condition on the application for benefits and then later on you file a claim for that same condition, the insurance company, in conducting their review of your entitlement to benefits, will get medical records.

If they see that there is a condition that you didn't disclose on the application, they will more than likely deny your claim for a pre-existing condition.

On top of that, there's a good chance that they'll rescind the policy, no matter how old it is as for almost making a fraudulent misrepresentation on the policy.

Now on ERISA governed group policies you get through your employer, for the most part, as soon as you become employed if there's a waiting period to become eligible, you're going to be covered under the plan.

However, they do have pre-existing condition clauses contained therein.

Usually a safe bet is if you haven't filed a claim for disability within a year of being covered under your employer's plan, more than likely you're not going to fall into a pre-existing condition situation.

However, all policies do differ, so if you do have questions, contact us and we can definitely review the policy for you.

Information supplied courtesy of the experts at diattorney.com View several short video clips which answer your most common questions on disability insurance claims.

Related Information:

  1. How Often is a Disability Claimant Expected to Treat with a Doctor
  2. Most Common Reasons for a Disability Insurance Claim Denial
  3. How Long Will I Receive Disability Benefits Once My Disability Claim is Approved


Information from our Disability Insurance Claims: Questions and Answers section - (Full List).

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