Lack of objective medical evidence can ruin your ERISA/ Long Term Disability insurance (LTD) claim. Many LTD claims are denied because they lack objective medical evidence. This makes winning your claim and overturning a previous denial very difficult. It is important to understand why the definition of objective medical evidence is so important to your case.
The actual definition of objective medical evidence varies by policy, and it can be very dangerous for your claim if it is not defined clearly in the policy. Generally speaking, objective medical evidence refers to test results, MRIs, or other types of documentation. However, there are many illnesses that are impossible to ‘test.’ Fibromyalgia and chronic fatigue are types of conditions that cannot be validated through objective medical testing.
If your policy does not explain what is considered objective medical evidence, then your insurance company can use this ambiguity to deny your claim. Though not your fault, often without objective medical evidence you will be unable to provide evidence of your disability.
Under the Employee Retirement Income Security Act (ERISA), you have a legal right to appeal the wrongful denial or termination of disability benefits. Unfortunately, you have the burden and responsibility of proving your claim.
Managing an appeal on your own can be risky, especially if you have a severe physical or mental illness or injury. If you feel overwhelmed or that your case is too complicated to handle on your own, you should seek guidance from a legal professional.
If your ERISA or Long Term disability claim has been rejected and you feel your long-term disability claim was improperly denied, call (800) 345-0535 or (417) 883-5886 to talk with our team of Long Term disability lawyers in Missouri. We will likely ask you to fax or email our office your denial letter as well to best evaluate your case. This consultation is free, so make sure to have your letter on hand.