Skip to content

Helping Disabled Claimants Nationwide "Whatever It Takes" to Get Your Disability Benefits Paid

Facebook Twitter Get Updates

Free Phone Consultation Nationwide
CALL (800) 682-8331
Click to be called now

We offer no fee or cost unless you get paid

Can my long term disability claim be denied for a pre-existing condition?


Related Videos

Can My Long Term Disability Claim Be Denied for a Pre Existing Condition?

Disability attorney Stephen Jessup discusses if a claimant’s disability claim can be denied due to a pre-existing condition.

Your long-term disability claim can be denied for a pre-existing condition; however, it’s a very fact-specific analysis as to how it’s going to happen. For instance, on a private policy you purchased on your own, if you failed to disclose a medical condition on the application for benefits and then later on you file a claim for that same condition, the insurance company, in conducting their review of your entitlement to benefits, will get medical records. If they see that there is a condition that you didn’t disclose on the application, they will more than likely deny your claim for a pre-existing condition. On top of that, there’s a good chance that they’ll rescind the policy, no matter how old it is as for almost making a fraudulent misrepresentation on the policy.

Now on ERISA-governed group policies you get through your employer, for the most part, as soon as you become employed if there’s a waiting period to become eligible, you’re going to be covered under the plan. However, they do have pre-existing condition clauses contained therein. Usually a safe bet is if you haven’t filed a claim for disability within a year of being covered under your employer’s plan, more than likely you’re not going to fall into a pre-existing condition situation. However, all policies do differ, so if you do have questions, contact us and we can definitely review the policy for you.

There are 8 opinions so far. Add your comment now.

Tammie:

I failed to apply for short and long term disability with my employer’s insurance. I went back and requested to do so and was told to submit a FOI. I did so and it was denied. I am a paraplegic and am being denied. Is this legal and is there anything I can do. I do not need short/long term right now, but may in the future.

Attorney Stephen Jessup:

Tammie,

If you were not a covered employee under the policy at the time you applied there might be very little that can be done. Based on the information provided, I am uncertain as to what your legal rights may be. Please feel free to contact our office to discuss how we may be able to assist you.

Kelly Whittington:

Hi! My name is Kelly and I am trying to see if my husband insurance is trying to not pay what I think they should. My husband was just denied his long term disability as of yesterday. They gave him short term and discontinue in February, saying that they had to start the long term disability claim. They are saying that his medical condition is pre-existing but he has not had a lapse in insurance so I am not sure how they are claiming this. They owe us since Feb. 6 of this year so I am assuming they are not paying because of the amount of back pay they owe us. My husband has not worked since November and that is when he started receiving the short term. When he asked them why did he get short term and they said that it was over looked somehow that his condition was pre-exisiting. Just trying to see if we can fight this some kind of way? Help!

Jacquelyn:

I was denied an insurance claim through a financial company for a pre-existing condition. During May of 2013 I was having pain in my left heel I went to my primary Doctor and he only gave me pain medication the pain did not subside so I continued work in the meantime. I made a loan with this company around October of 2013. The pain increased so I decided to go to and othropedic in which he did an x-ray and found that I had and heel spur so he ordered me to wear a boot but the pain just worsened so he ordered an MRI then he found out that I had a torn tendon. Should I appeal this case?

Attorney Stephen Jessup:

Kelly,

Please feel free to contact our office. Many Short Term Disability policies do not contain pre-existing condition provisions, and for those that do, it requires a minimal amount of time with the company/coverage under the policy to overcome the provision. Long Term Disability pre-existing provisions are much more stringent.

Attorney Stephen Jessup:

Jacquelyn,

I am unsure if we can assist you. Is your inquiry regarding a pre-existing provision under a disability insurance policy?

Lea:

I am a nurse of 27 years have had arthritis for more than 10 years and took a pain pill and a muscle relaxer at night so I could sleep without pain. And rarely 1-2 times a yr I would have a bad week and go into the clinic for a steroid and an anti inflammatory injection. I have never missed a day from work because of the arthritis pain. Open enrollment in Dec of 2012 for the upcoming year 2013, I added the LTD to my benefits package. The pain became so much worse after a pretty bad fall at my house on an icy deck in Feb 2013, I ended up getting an epidural steroidal injection into my spine and it only got worse. Ended up in the hospital for 11 days, came home with surgeries to both right and left side joints, which has literally crippled me.

Attorney Stephen Jessup:

Lea,

Please feel free to contact our office to review your policy and discuss any potential disability claim you may have.

Add your comment

Please be advised that your comment will be public. Any information contained on our website is for informational purposes only and not legal advice. If you are seeking assistance with your claim, then please use our confidential Free Consultation form.



Your name will appear with the comment


Your email address will not be published

Please note: The comments are moderated.
Your comment will need to be approved before it will appear on this page. No off topic post will be accepted. Our attorneys may respond to your comment.

Subscribe without commenting:


Request a Free Consultation

Click here or call 800-682-8331 now!

We respond the same day.
We represent disability insurance claimants all over the United States.

Testimonials

Read what our clients say about us.

  • Ed T. Mr Dell and paralegal Merlin Bryan are an excellent team. It was a pleasure to have them working for me under what was a very stressful personal situation. They kept me...› continue
  • Ron K. I was on disability with a major insurance company for five years without any problems, upon a field rep's visit to my home, I let him know that I was planning to try to...› continue
  • O. Lee My experience with Dell & Schaefer has and continues to be, outstanding. First, I would personally like to thank Cesar for his experience and expertise in handling my...› continue

More Testimonials