Employees who must stop working due to a health condition often do so at the direct advice of their healthcare providers. When this happens, they typically apply for short and/or long term disability benefits to help them secure income during their recovery period. Occasionally, however, employees are surprised to hear the disability insurance company has denied them disability benefits despite medical certification that they cannot work. If you find yourself in this position, you may wonder, “Is it legal for the disability insurance company to ignore my doctor’s opinion?”

While the disability insurance company may disagree with your treating physician’s conclusions, it may not completely ignore your doctor’s opinion. Case law supports that the insurance company must (a) review and consider your medical evidence and (b) explain why it disagrees with the evidence supporting your disability.1 The disability insurance company may have wrongfully denied you benefits if, among other things, it failed to do any of the following:

1. Credit your doctors’ opinions or reports
2. Logically analyze the opinions of your doctors
3. Identify the deficiencies in your medical reports
4. Contact your treating physicians to discuss its concerns

If you have been denied short or long term disability benefits in spite of medical evidence that you cannot work, we may be able to help. Our experienced Wisconsin disability benefits attorneys work hard to ensure that individuals are afforded a full and fair review of their disability claims. We represent individuals during the appeals stage and through litigation. Please contact our Milwaukee attorneys or Madison attorneys for a free evaluation of your case.

1 See, e.g., Black & Decker Disability Plan v. Nord, 538 U.S. 822, 834 (2003); Shields v. Matrix Absence Mgmt, et al., No. 6-cv-1314, 2008 U.S. Dist. LEXIS 73166, *26 (E.D. Wis. 2008); Key v. UNUM Life Insurance Company of America, 2008 U.S. Dist. LEXIS 64254 *20-21 (W.D. Wis. 2008) Crespo v. Unum Life Ins. Co. of Am., 294 F. Supp. 2d 980, 994 (N.D. Ill. 2003).

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