Filing a long-term disability claim through MetLife can be a stressful and overwhelming process, especially when you’re already dealing with a health condition that limits your ability to work. Unfortunately, many claimants are met with unexpected denials, leaving them without the financial support they need. Understanding the reasons for these denials and how to avoid them can make a significant difference in the outcome of your case.
At Newfield Law Group, our team of experienced MetLife Long Term Disability Insurance Claim Lawyers has helped countless clients successfully navigate the claims process and overcome denials. In this blog, we’ll explore the top reasons why MetLife denies long-term disability claims and how working with a knowledgeable attorney can improve your chances of approval.
1. Lack of Sufficient Medical Evidence
One of the most common reasons for a denial is the lack of adequate medical documentation to support your disability claim. MetLife requires detailed and thorough medical records that clearly show the severity of your condition and how it impacts your ability to work. Simply having a diagnosis is not enough. The insurance company expects to see:
- Physician reports detailing your symptoms and limitations.
- Specialist evaluations that provide further insights into your condition.
- Diagnostic test results, such as MRIs, CT scans, or X-rays, that confirm your diagnosis.
If MetLife believes the evidence is insufficient, they may deny your claim. We work with claimants to ensure that all relevant medical information is submitted, including obtaining statements from treating physicians that clearly describe your functional limitations.
2. Failure to Meet MetLife’s Definition of Disability
MetLife’s definition of disability varies depending on the specific policy you hold. For some claimants, being unable to perform the duties of their own occupation qualifies as disabled. For others, the definition may shift after a certain period, requiring that you be unable to work in any occupation for which you are reasonably suited based on your education and experience.
If MetLife determines that you do not meet the policy’s definition of disability, they will deny your claim. This can be a complex issue, especially when policies transition from “own occupation” to “any occupation.” Our MetLife Long Term Disability Insurance Claim Lawyers are skilled at interpreting these policies and helping claimants demonstrate that they meet the specific criteria for disability under their MetLife policy.
3. Insufficient Evidence of Continuing Disability
Even if your initial claim is approved, MetLife requires ongoing proof that your condition continues to prevent you from working. This is known as continuing proof of disability, and failure to provide sufficient updates can result in the termination of benefits. Claimants often face denials because:
- They haven’t submitted updated medical records.
- Their physician reports do not indicate ongoing or worsening symptoms.
- They miss or fail to attend required Independent Medical Examinations (IMEs).
We help our clients keep their benefits by ensuring they continue to provide the necessary medical updates and maintain open communication with their healthcare providers.
4. Surveillance or Misleading Evidence
Insurance companies, including MetLife, often use surveillance tactics to investigate claimants and find inconsistencies in their disability claims. For example, if you are claiming that you cannot walk without assistance, but are caught on video walking unaided, MetLife may use this as grounds for denial. Additionally, social media posts or photos showing activities that conflict with your claimed disability can harm your case.
It’s important to understand that insurers look for any reason to deny a claim. That’s why it’s critical to be honest about your abilities and consistent with your medical records. Our attorneys at Newfield Law Group help protect clients from surveillance tactics by offering guidance on how to handle such investigations.
5. Pre-Existing Conditions
If MetLife determines that your disability is related to a pre-existing condition, they may deny your claim. Most policies have a pre-existing condition clause, which excludes coverage for medical conditions that were diagnosed or treated within a certain period before the start of your policy. Even if your condition worsened after your coverage began, MetLife might argue that it was related to a pre-existing condition.
Our experienced metlife disability lawyer knows how to counter these claims and provide evidence that your disability was not pre-existing or that the condition has worsened to a point that it should qualify under the policy’s coverage.
6. Missing Deadlines and Administrative Errors
MetLife’s claim process is full of strict deadlines, from submitting initial claims to providing additional documentation and appealing a denial. Missing a deadline, even by a single day, can result in an automatic denial. Furthermore, administrative errors, such as incomplete forms or incorrect information, can lead to unnecessary delays or rejections.
We handle the entire claims process, ensuring that all deadlines are met and paperwork is completed accurately, giving your claim the best chance for approval.
How Newfield Law Group Can Help
Facing a denial from MetLife can be discouraging, but it’s not the end of the road. With the help of our skilled metlife disability attorneys , you can appeal the decision and fight for the benefits you deserve. We understand the intricacies of MetLife’s policies and procedures, and we have a proven track record of successfully helping clients overturn denials.
Our team will:
- Analyze your denial letter to understand the reasons behind the decision.
- Gather and submit additional evidence to strengthen your appeal.
- Represent you in any hearings or legal proceedings related to your claim.
Conclusion
Dealing with a long-term disability claim can be a stressful and overwhelming process, especially when MetLife denies your claim. By understanding the common reasons for denials and working with a qualified attorney, you can improve your chances of securing the benefits you need. We’re here to provide the guidance and support necessary to help you navigate the claims process and fight for your rights.
Contact Newfield Law Group today at 877-406-7883 for a consultation and let us help you get the benefits you deserve.
This blog provides a comprehensive overview of the reasons why MetLife denies long-term disability claims and how Newfield Law Group can assist clients in overcoming these challenges. It uses the keyword “MetLife Long Term Disability Insurance Claim Lawyers” in a meaningful and relevant way to attract potential clients.