Legal Help with Disability Claim Denials for Dental Hygienists
If you are a dental hygienist who has become disabled from working, we can help you at any stage of the disability claim process. We can assist with your application for benefits or handle the appeal process if your claim is denied. If the insurer continues to refuse to pay your claim, our long term disability lawyers will start a lawsuit to challenge the insurance company’s decision.
Understanding Disability Insurance: What You Need to Know
Many dental hygienists are self employed and may have purchased a private disability income policy. Alternatively, as an employee or a member of an association such as the Canadian Dental Hygienists Association (CDHA). The policy will set out the definition of disability which applies to the claim for benefits as well as the amount of the monthly benefit and duration of the benefit period.
Own occupation coverage provides a benefit if the disability claimant becomes unable to perform the essential duties of a dental hygienist. Some policies will pay benefits for a limited period such as 24 months on an own occupation basis. The definition of disability will then change to the more restrictive test of any occupation. In the any occupation period, the definition of disability will be satisfied if the claimant cannot perform any job for which they are suited based on their education, training and experience. It is important to hire a legal professional who has experience in the complex world of long term disability law. Your lawyer will obtain your claim file, the long term disability policy and will provide valuable insight regarding your disability case.
Filing a Successful Disability Claim
A successful application for disability benefits requires medical evidence supporting total disability from performing the substantial duties of your job or occupation. If the policy defines disability as being prevented from performing any occupation, the claim needs to focus on that definition, providing medical records which support that definition. It’s important to hire a lawyer with extensive experience dealing with long term disability benefits and insurance companies to avoid mistakes which result in denied claims.
Most Common Reasons for Dental Hygienist Disability Claim Denials
Disability insurance companies deny claims for various reasons, including:
- The claim is supported by insufficient medical evidence of total disability
- Failing to follow your medical doctor’s recommended treatment plan
- The insurer claims that the disability is caused by an excluded pre-existing condition under the policy
- Claims can also be denied on the basis of missed deadlines for submitting evidence of disability and the insurer’s required claim forms
- The insurance company’s in-house medical doctor disagrees with your treating doctor’s opinion of you ability to work
- The long term disability claims adjudicator does not understand the nature of the duties of a dental hygienist
Challenging a Denied Disability Claim – The Appeal
Most insurance companies will encourage you to follow their internal appeal process when your disability claim is denied. Our long term disability lawyers will schedule a free consultation to go over your options. Most policies do not set out an internal appeal process and an appeal is not required. However, it is important to get skilled advice from an experienced lawyer who will review your disability policy to determine if an appeal is required. We can gather the medical records to support your claim and appeal the insurer’s decision. Even in the case of a missed deadline or where the insurer is alleging that your claim is excluded as a pre-existing condition, it is entirely possible that the denial will not be solid.
How Our Disability Lawyers Can Help Dental Hygienists
If your appeal is denied despite all of the evidence which supports your claim, we will start a lawsuit to require the insurer to deal with your claim in a settlement. Most disability lawsuits end with the insurer paying something in a settlement. If a suitable settlement is not available, we will pursue a court award that recognizes your disability.
March 6, 2025 
