If you have a long-term disability insurance policy, you likely believe that you will be covered if you are seriously injured or suffer a medical condition that prevents you from working at your job. Unfortunately, many insurance companies attempt to deny the valid claims in an attempt to protect their bottom lines. At Osterhout Berger Disability Law, we are proud to advocate for the residents of Butler, Pennsylvania in order to help them to recover the benefits that they rightfully deserve.
Appealing a Denied Claim
When you file for benefits and send in your claim, it will trigger the company’s investigative process. During the investigation, your company may interview you, review your documents and ask you to submit to an independent medical exam. It may also have an insurance investigator surveil you. When the company makes its decision, it will notify you. If the company denies your claim, you will receive a letter that tells you why the company did. The letter will also tell you that you have a right to appeal. It is important that you do not ignore your appeal right because if you don’t file an appeal, you will be foreclosed from seeking benefits based on your disability again from the company. You are also unable to seek a legal remedy through the court process unless you first appeal the company’s decision through its internal process.
Common Issues & Recommendations
When you decide to appeal, it is important that you seek the help of an experienced long term disability attorney with Osterhout Berger Disability Law. We can help you get a complete copy of your file, which will be needed when you file your appeal. It is important that you do not miss the listed deadline for appealing in your letter. You should also not stop seeing your doctor or getting treatment for your condition. If you have already been approved for benefits through SSDI or workers’ compensation, you will want to submit proof of that as evidence that your condition is deserving of benefits. Try to keep oral communication with your company to a minimum, and ask that all communication about your claim be conducted in writing. Make certain that you submit your documents via certified mail so that you can have a record of its receipt. It is important that you are not dishonest about the severity of your pain or symptoms. If you are, it will be difficult for you to prove that you are not malingering, which may be fatal to your appeal.
Getting the Benefits You Deserve
In order to help you to win your appeal and receive your benefits, our attorneys may ask you to do several things. We may want you to get additional medical tests or exams. We may also ask you to get copies of all relevant diagnostic tests. If we later have to file a lawsuit after exhausting your company’s in-house appeals process, we will only be allowed to rely on the record of your claim. By trying to add as much favorable evidence to your file as possible, we can build a strong case that your appeal should be granted.
We may want you to get letters from your doctor and others who are familiar with how your symptoms prevent you from being able to complete the tasks that are required by your job. It may also be a good idea for you to keep a symptom journal in which you rate your pain each day and talk about your symptoms and how they are affecting you. All of this information may help you to ultimately receive approval of your claim. Contact Osterhout Berger Disability Law to schedule a consultation with one of our experienced disability attorneys today.
Call us today for a free consultation: 866.438.8773