Has your disability claim been denied? You might not need to hire a lawyer right away — and I’ll explain why.
Too many online resources will have you believe that hiring a lawyer is the best way to go; indeed, some say it’s your only option. Some articles state outright that if you don’t hire a lawyer, you will lose your case.
This is simply not true — and that’s coming from a law firm!
Each disability claim is as unique as the person filing it. The most important thing to consider when making your decision is your context. Your age, your current stage in the disability claims process, and the amount of money the insurance company has spent on your case (e.g. hiring a doctor) are all factors to consider when you’re making this choice.
There are times when you will be able to do it yourself, and times when that won’t be your best chance at success.
This article is part of our Ultimate Guide to Long-term Disability.
When you can do it yourself
If you’re early on in the process, you have time on your side and a couple of chances to get it right. There are a few situations where you’re better off trying to get things done on your own:
- the initial application
- the first internal appeal, where your claim has never been approved or your claim was denied, but the insurance company has identified very specific information they need to see to reconsider it.
If you’re applying for the very first time, you can certainly do that on your own. There are plenty of websites that feature lots of free resources, helpful tips, and information (including the site you’re on right now!)
If you read your denial letter carefully, you should be able to see exactly what has gone wrong in the application that caused it to get denied. Sometimes, what you’re missing was just a simple oversight, a missing document — an issue that is easily remedied.
Once you know what’s missing, it’s simply a matter of filling in the gaps. This might mean speaking with your doctor to confirm or clarify your medical history, or providing them with additional information that was left out.
When a lawyer can help
Plenty of people worry that hiring a lawyer to help with their appeal does nothing but make the insurance company mad. You might ask yourself, “If I am eligible, and I know that I’m telling the truth, why do I need a lawyer?”
One answer to that question is that sometimes you aren’t able to do it all on your own. There are certain hurdles that disability lawyers are experienced with that you aren’t. For example, if the denial letter is unclear about what you’re missing or where you went wrong in your application, or if it is full of vague or tricky statements, you might not be able to make sense of it — but a disability lawyer surely can.
Here are some other situations where hiring a lawyer makes the most sense:
- The insurance company denied your application and one or more appeals
- The insurance company denied your claim based on surveillance they gathered
- Your claim was denied based on a pre-existing condition or other exclusion clause in the policy
- The insurance company denied you after paying for assessments or medical opinions about you that it views as favourable for them
- The insurance company denied you at the point when your claim changed covering disability from your “own occupation” to “any occupation”
If you have been rejected several times already, remember that at some point the insurance company will stop giving you the chance to appeal, and you might benefit from having a knowledgeable lawyer in your corner.
Which should I choose?
Well, that’s ultimately up to you — there’s no one-size-fits-all solution that I can give. Just remember:
- Context is everything.
Your disability claim process is going to be entirely different from anyone else’s. Ultimately, you’re the best judge of your own situation. Don’t let someone tell you that you need a lawyer, because you might not.
- Whatever you choose, there is information available to help you succeed.
You’re certainly welcome to prowl around our website for resources and information. If you have a question that we haven’t answered yet, feel free to get in touch with us.
You might also be interested in: