Dealing With Appeals Process Following Denial of Long-Term Disability

A disabled worker does not face the prospect of dealing with the appeals process until the insurance company has asked for that same worker to complete specific tests. One test show whether or not the tested individual can perform the tasks associated with his or her own occupation. Later, a second test checks to see if the same person can perform the tasks associated that match with his or her education and experience.

If those tests indicate that the tested worker lacks the ability to undertake any occupation, then that tested employee can apply for long term disability. If the insurance company issues a denial in response to that particular application, the denied worker has reason to consider using the appeals process.

Proofs required during the appeals process

• Proof that the applicant has developed the reported condition. It should be permanent impairment or a chronic condition, such as chronic pain.
• Proof that the applicant has attended the medical exam and the testing. A series of x-rays and MRIs can add to the evidence in support of the applicant’s claim.
• Show that some form of treatment has been sought and used.
• Show that applicant has displayed a readiness to undertake those efforts that seem able to mitigate the symptoms associated with the diagnosed condition. Proof that an effort has been made to determine the cause for that same condition.

Useful evidence

A diary that gives the date for appearance of any symptom associated with the disabling condition. The evidence that the disabled person tried to modify his or her work habits in any way, in order to diminish the effects of the disabling condition. The side effects of condition that can affect job performance and completion of daily tasks

• Sleep deprivation
• Loss of appetite
• Decreased interest in self-care
• Decreased interest in leisure activities

Treatment for such problems can be found by speaking with a psychologist. A readiness to seek treatment helps to strengthen the applicant’s argument, concerning his or her eligibility for long term disability benefits. The personal injury lawyer in Sarnia know that it appeals process does not examine the applicant’s potential in areas outside of the reported education and experience.

The insurance company does not have to know all the avenues of interest that the applicant has pursued in the past. It is best not to offer evidence of such avenues, possibly by using social media. Exposure of such avenues could result in a demand for other tests, in an attempt to minimize the extent of the claimed disability.

Emphasize the way that the reported disability hampers completion of specific tasks. Those would be the tasks normally assigned to someone that is tackling a job similar to any job that the disabled and denied applicant has held in the past.