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What to Do When Your Claim Is Denied

Applying for disability benefits or insurance is never a pleasant matter. At every step of the process, there are forms upon forms and all kinds of hoops to jump through. It is almost as if they try to make the process as difficult as possible. The system is deliberately set up this way to help deter those who simply want to scam it.

For those of us who are not scam artists or lazy deadbeats looking for a free ride, it is an intimidating process. When you know that you are legitimately disabled and unable to work, you assume that others will know it as well and act accordingly. But they often don’t.

If you have disability insurance, and your company is not paying you what you are entitled to, then you need a good disability lawyer. Having someone on your side who can navigate the system and all its nuances will make the whole process much easier. And much like an auto insurance company, many of these health insurance companies will not pay out easily.

Without representation of some kind, you are basically at the mercy of the company. They might help you out or they might not, but in any case, they probably won’t give you what they are actually supposed to. At that point of the process, the most important thing to remember is to save copies of every document that you get. Good documentation is key to winning in court, as the judge cannot just take anyone’s word for anything.

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For private disability insurance El Cajon CA has several excellent practitioners of disability law that you can avail yourself of. Make sure that whichever company you choose is willing to go all the way and take the matter to a jury trial if necessary. Since matters of insurance are governed by state law, a jury trial is an option if your insurance company has defrauded on their obligations.

Disability benefits are a little different, but once again we have a situation where those in charge are unlikely to pay unless you know how to deal properly with them. For an idea of your chances, take a look at the statistics contained in this report.
As you can see, about 53% of disability benefit claims are denied. Only 20%-30% of applications are accepted initially. By the time you factor in all the appeals and reconsiderations, it averages out to an acceptance rate of about 45%.

So, your chances with the government are a little better, but still not that high. At best, you can hope for a 50/50 chance without some kind of representation. To understand why this is so, just look at how many people are applying for these benefits every year. Of those who are denied, you can bet that some of them were not really disabled. Still, if the industry experts are to be believed, most of these denials result from a failure to follow proper procedures.

If you choose to go it alone, all I can say is do a lot of reading and good luck to you!

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