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Can my long term disability through my employer be denied because they are incorrectly saying my condition was pre-existing?

Richmond, VA |

I was diagnosed with a spinal condition and underwent major surgery with a long recovery. It is time to switch over to the long term disability plan through my employer. My employer is now saying that my condition "Might" have been pre-existing from before they adopted their long term disability policy. They are saying that my general practitioner "treated" me for my condition, which he did not. He misdiagnosed me with carpal tunnel. No treatment. I returned later with new symptoms. He referred me to a specialist who then provided correct diagnosis and surgery. Certainly, the long term dis. company has to go by the date of my actual diagnosis supported by medical imaging? I am not getting paid. Need help.

Attorney Answers 3

Posted

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Ben Glass is licensed in Virginia. He offers a number of free consumer book downloads at his site for information purposes only. You should consult an experienced, board certified attorney in your area. Obviously, no attorney client relationship is formed by participating in Avvo.

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Posted

The answer, most likely, depends on how "pre-existing" is defined in the policy.

Often have a pre-existing condition can mean that you received, or should have received, treatment, medicine, or testing for any condition during the preceding time period in question.

Look at the policy and/or consult with an attorney who handles disability claims to get more clarification.

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2 comments

Dennis Wayne Tackett

Dennis Wayne Tackett

Posted

Did the employer have a prior LTD policy in force?

Dennis Wayne Tackett

Dennis Wayne Tackett

Posted

Did the employer require each employee to fill out an application for LTD coverage?

Posted

A local Richmond lawyer would need to review the policy. Avvo has a "find a lawyer" tool

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