If you have a severe medical issue that leaves you unable to work, you may be eligible for long term disability (LTD) insurance. Unfortunately, navigating LTD is often complicated. Many British Columbians find themselves denied LTD benefits even when they have valid conditions. Treatment noncompliance is just one of many reasons insurers may deny claims. This occurs when an insurer believes a claimant has not followed prescribed medical treatment plans, potentially impacting their recovery. However, treatment noncompliance isn’t simple. There are valid reasons someone may not be able to follow a treatment plan. If you were denied LTD insurance due to treatment noncompliance, it’s important to contact a lawyer to review your case so you can appeal within the two-year limitation period.
Can You Get Disability Without a Diagnosis?
Generally, you cannot get LTD without a diagnosis from a medical professional. LTD insurance companies rely on medical evidence from healthcare providers to decide if an applicant should be approved or denied benefits. Without any evidence, including a diagnosis, there’s no proof a claimant is truly unable to work.
Do You Have to Be On Medication to Get Disability?
Some conditions may require medication as part of a treatment plan. In those cases, claimants must take medication as instructed in their treatment plan in order to be approved for LTD. However, if your treatment plan doesn’t include medication but your doctors still believe your condition warrants disability, you wouldn’t be required to take medication to receive benefits.
Denied for Treatment Noncompliance
When you receive a diagnosis from a doctor, they will also provide a treatment plan for your condition. This may include courses of medication, therapy, or surgery. If you fail to follow your treatment plan while applying for LTD insurance, the insurer will argue your condition is not as severe as claimed or your condition could improve by following proper treatment. Both of these reasons ultimately mean LTD insurers don’t believe you should receive disability benefits.
Reasons Claimants Don’t Follow Treatment Plans
In most cases, claimants aren’t simply ignoring their treatment plan. Rather, there are several valid reasons that may prevent them from adhering to their doctor’s order.
Financial Constraints
If costs are not covered by your provincial plan, you may not be able to afford a specific treatment.
Negative Side Effects
Some treatment options, especially medication, may cause the claimant to have adverse reactions.
Lack of Access to Care
Geographical location, transportation issues, or limited availability of specialists in an area can limit a claimant’s ability to maintain their treatment.
Disagreement with Treatment Plan
Patients may have valid concerns regarding their treatment plan and be unable to work with their doctor to explore alternative options.
What to Do If Denied for Treatment Noncompliance?
If you are denied LTD insurance for any reason, it’s not impossible to collect benefits. However, it is important to act quickly. First, be sure to obtain a formal letter of denial from the LTD insurer. Do not allow the insurer to provide this information via phone call. Your letter should clearly state why you were denied benefits. In addition to this document, gather medical records, receipts, and other pieces of communication from your healthcare providers. Bring all evidence to a disability insurance lawyer who can help you understand your rights and options. After a denial, you will have two years to file an appeal. Stephens & Holman can help you handle this complicated process and fight for the benefits you deserve.