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Columbus Long Term Disability Insurance Issues

Long term disability insurance policies, or LTD, are designed to provide relief to those who are most vulnerable. Unfortunately, the insurance companies who provide and administer these policies can deny a claim for any number of reasons.

Making matters worse, the Federal government’s ERISA laws prevent aggrieved applicants from bringing a case to a Federal courthouse until a lengthy appeal process is completed within the insurance company’s own structure.

Consult an experienced long-term disability lawyer that can educate you on common long-term disability insurance issues in Columbus that can prevent you from receiving deserved benefits.

Reasons Why Claims are Denied

Claims in Columbus may be denied for any number of reasons. Perhaps the most common is that the applicant did not provide adequate medical evidence to support their claim. While many people believe that a diagnosis of a serious medical condition is enough to classify them as disabled, the fact of the matter is that that a mere diagnosis is not enough.

In order to maximize the chance for a successful claim, this diagnosis must be supported by months of medical records, medication treatment schedules, x-rays, MRIs and other doctors’ notes.

Some insurance companies may even employ agents to observe the applicant in public places. This is done in an attempt to catch the applicant performing physical labor or leading an otherwise healthy life. While certainly distasteful, there is nothing illegal about observing people in public locations.

Preexisting Conditions

Only when insurance groups cannot deny that all avenues of treatment have not resulted in a substantial improvement, will they be inclined to approve an application. One of the other common long-term disability insurance issues in Columbus is the denial of claims filed by employees with preexisting conditions. Unlike health insurance policies, LTD policies can be denied based on the presence of a preexisting condition.

Issues with Appealing a Denial

It is not uncommon for an application to be denied on a first pass. All insurance companies are required to have a structure in place for reviewing a denial.

In fact, the Federal Government’s ERISA laws make it advisable for companies to do so since this prevents applicants from appealing a denial directly to a Federal court. A case must first be reexamined by an appeals board run by the insurance company itself. With the exception of new evidence being admitted, this examination will likely result in the same denial, since the insurance company is unlikely to rule against itself.

This procedure makes it extremely time-consuming for people to have their case heard by an impartial judge. Many claims can take over a year from initial application to being heard in Federal court. Since many people are facing financial difficulties stemming from the illness or injury, this can place people into dire straits.

Taking Steps to Prevent these Issues

A person’s best defense to avoiding common long-term disability insurance issues in Columbus is to prepare an application that is both thorough and clear. An effective application will indicate exactly when the illness or injury occurred, what treatment was obtained, where this treatment was administered, and its effects on the applicant’s ability to work.

This will be accompanied by extensive medical documentation outlining the reasons for a diagnosis and the lack of improvement felt by the worker. By following these steps, all of which can be handled by a skilled attorney, applicants can avoid many of the long-term disability insurance issues in Columbus that result in LTD applications being denied.