What if the insurance company disagrees with your doctor?

On Behalf of | Aug 2, 2022 | ERISA Disability Benefits

You believe that you have a disability. Part of this is because you can see how it impacts your life on a daily basis. But part of it is simply because you went to your doctor for treatment, and you have an official diagnosis that shows you are in fact dealing with a long-term disability.

However, things begin to get complicated. The insurance company disagrees with your doctor’s diagnosis. You’re shocked. The insurance company has no medical background, and it’s just a financial institution. What do you do now that they don’t agree with a medical professional?

You may have to appeal the decision

Unfortunately, this does happen from time to time. Insurance companies are always working to avoid paying out as much as possible, and so they may not believe that the treatment recommended by a doctor – if it’s very expensive – is what you really need. Some sources claim this is happening more often all the time.

But it could also happen with disability cases. The insurance company might disagree with the extent of the issue, claiming that it doesn’t impact your life enough to actually be a disability. Or they may disagree with how long it’s going to last, thinking that the diagnosis is overstating the length of those issues and how long they’re going to keep you out of work.

At a time like this, the evidence that you can get to back up your claims becomes very important. You may need to get a second opinion from another medical professional. The whole process can be long and complicated, so make sure you know exactly what steps to take.