The Disability Claims Process
The disability claim involves completing several reports. A medical form will be need to be filled out by the treating medical professional setting out the diagnosis of the condition, the restrictions and limitations caused by the symptomatology, and any treatment prescribed. If the chiropractor is employed, an employer statement will be necessary, outlining the job duties and income information. If you are self-employed, financial evidence of lost income will need to be set out in an occupation statement. The third portion of the long term disability claim form is a claimant’s statement which sets out personal details such as age and other identifying information, work history, educational background and a description of your symptoms.
Common Disability Claims for Chiropractors
The profession of chiropractor is a physically and mentally demanding. Examples of health issues which can cause total disability include claims based on:
- Chronic pain
- Serious injuries such as traumatic brain injury, back injuries, carpal tunnel syndrome, frozen shoulder, rotator cuff tear and fractures
- Degenerative conditions such as multiple sclerosis, Parkinson’s disease or rheumatoid arthritis
- Mental health diagnoses such as post traumatic stress disorder, anxiety, depression or bipolar depression
Reasons Chiropractors’ Claims are Denied
Insurance companies deny disability claims for the following reasons:
- The application provides insufficient medical evidence
- The insurance provider’s in house medical consultant disagrees with your treating professional’s opinion regarding disability
- Failure to meet the time limits for submission of claim documents set out in the long term disability policy
- The case evaluation is based on an inaccurate view of the essential duties of chiropractic practice
- The insurance company may have an independent medical evaluation or a functional abilities assessment completed to dispute your claim
Challenging Disability Insurance Claim Denials for Chiropractors
It is not unusual for long term disability claims to be denied. However, if you know that you cannot perform the profession you have worked hard to achieve, it is worthwhile to have a free consultation to review your legal options.
The Appeals Process
Insurance companies usually offer an internal appeals process after denying a disability claim. Most appeals will be unsuccessful unless there is new or different medical evidence which can be submitted as part of the appeal. Otherwise, internal appeals are likely to be unsuccessful because the individual who denied your claim will be asked to reconsider their own decision. We will advise you whether an appeal is required under the insurance policy. Some policies require an appeal before a lawsuit can be brought against the insurer.
If you submit an appeal, an experienced disability attorney is the best way to get your claim approved. We will gather the medical records necessary to prove your inability to perform your own occupation. The insurer may have denied benefits because the average person assessing insurance claims does not understand the day to day tasks and demands of a practicing chiropractor.
Starting a Lawsuit
if the insurance company refuses to overturn your denied claim, we will start an action to seek payment of your disability benefits. Most long term disability benefits cases do not proceed to trial. A negotiated settlement may be in the form of a lump sum payment or admission of your claim for ongoing monthly disability benefits. If a resolution out of court is not available, our law firm has a proven track record of trying cases.
Benefits of Working with Our Long Term Disability Lawyers
LTD benefits are intended to provide income replacement when your physical or mental health prevents you from working in your profession. We know that legal fees are an expense which you cannot afford when you are experiencing a loss of income. This is why we provide a free consultation so that we can discuss your file and consider your options. Most files can be approached on a contingency basis and you will not be required to pay legal fees unless we achieve a settlement or court award for you.
March 6, 2025 
