At Bonnici Law Group, we understand that a long-term disability denial can feel like a major setback. One of the keys to effectively contesting such a denial is understanding why it happened in the first place. So, let’s dive into some of the most common reasons for long-term disability denials in San Diego, California.

1. Insufficient Medical Evidence

One of the most common reasons for disability denials is a lack of sufficient medical evidence to support the claim. Insurance companies need concrete proof that you’re unable to work due to your disability. This often includes medical records, doctor’s notes, lab results, and any other pertinent health information. If they find this evidence lacking or unclear, they might deny the claim.

2. Pre-existing Condition Exclusions

Most disability insurance policies contain clauses excluding pre-existing conditions. If your disability is related to a condition you had before obtaining the insurance policy, and it falls within the policy’s look-back period, your claim might be denied.

3. Not Meeting the Policy’s Definition of Disability

Insurance policies define disability in specific ways, and not all health issues qualify. Some policies require that you be unable to perform any job, not just your current job, to qualify as disabled. If your condition doesn’t meet your policy’s specific definition of disability, your claim may be denied.

4. Incomplete or Inaccurate Application

Even minor errors or omissions on your application can lead to a denial. Providing complete and accurate information is critical, including your medical history, work history, and the impact of your disability on your daily life.

5. Surveillance Evidence

Insurance companies sometimes employ surveillance techniques to confirm the validity of a claim. If they obtain footage or photographs contradicting your reported disability, they might use this as grounds for denial.

6. Missed Deadlines

Timing is crucial when filing a long-term disability claim. If you miss a deadline for submitting your claim or any requested information, it could result in denial.

If you’ve received a denial, it’s critical to get legal advice to understand your best course of action. At Bonnici Law Group, we can review your case, help you understand why your claim was denied, and guide you through the appeal process. Remember, a denial isn’t the end of the road but merely a bump that, with the right support and guidance, you can navigate successfully. Please reach out to us if you need assistance with your long-term disability claim – we’re here to help you fight for the benefits you rightfully deserve. Call us at (619) 259-5199, or click here for a free consultation.