Your insurance policy or contract will set out the definition of “total disability” and the onus is on you, as the injured individual, to establish that you are disabled within that definition. Almost all insurance policies have two distinct definitions of what the insurer considers as “total disability”. The first definition is the “own occupation” definition and is generally limited to two years of benefits. During this time, you may qualify for benefits if your illness or injury prevents you from performing the essential duties of your own occupation. After the “own occupation” period, the policy definition changes to “any occupation” which provides the insurer a greater opportunity to deny benefits.

In order to establish that you are disabled, the medical evidence documenting your illness and injury and how it prevents you from performing the essential duties of your own occupation or any occupation is crucial.

Insurance companies deny disability claims for a number of reasons. The most common reasons include a lack of medical evidence supporting disability, a lack of medical evidence supporting disability at the change of definition, a change in your medical or functional status, a pre-existing condition or the failure to be under the regular and appropriate care of a physician and follow treatment recommendations.

Certain types of disability claims are also more likely to be initially denied than others. For example, insurance companies will often deny mental illness claims due to the subjective nature of the complaints and lack of objective findings from the physician. Our disability lawyers can provide you with experienced help on these claims.

If an insurance company has denied your claim for disability benefits this does not mean that the insurer’s analysis is correct or that you are not disabled or entitled to disability benefits. If you have been denied disability benefits, the disability lawyers at Zacharias Vickers can help you in resolving your denied claim by bringing forth the medical evidence required to prove your disability and ensure that your insurer is fulfilling their contractual obligations.

Our lawyers have experience in disability insurance matters such as yours and can provide you with the legal assistance you require to protect your rights and resolve your claim.

If you are denied disability benefits, you only have a limited time within which to take legal action. When that limitation period begins to run will depend on the facts of each individual case. Therefore, it is crucial to seek legal advice from one of our disability lawyers early in order to know what limitations periods are applicable to your circumstances and ensure you do not jeopardize your claim.