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Appealing a Denial of Disability Benefits from Tenet Healthcare

Osterhout Berger Daley > Insurance Companies > Appealing a Denial of Disability Benefits from Tenet Healthcare

If you have group-provided disability insurance from Tenet Healthcare through your employer, choosing to get the coverage may be a smart choice. Disability insurance may offer you a safety net if you are injured or become ill, leaving you unable to return to your job for a short duration or for a longer period of time. Some claimants are discouraged when they receive notices that their disability claims have been denied by Tenet Healthcare. If this happens to you, the experienced team at Osterhout Berger Daley is available to help you with your appeal.

Background on Tenet Healthcare

Based in Dallas, Texas, Tenet Healthcare is an investor-owned corporation that was founded in 1967. The company is multinational and owns facilities in both the U.K. and the U.S. Tenet Healthcare has more than 130,000 employees and is listed at number 170 on the Fortune 500 list.

Disability insurance from Tenet Healthcare

Tenet Healthcare offers group short- and long-term disability insurance options. Short-term disability from Tenet Healthcare is designed to pay a portion of your income after you have been unable to return to work for longer than the elimination period. This insurance will pay benefits for a set duration or until you return to work. If you also have long-term disability coverage, your benefits should kick in once you’ve completed the duration of your short-term coverage. The duration of payments that you might receive from your long-term disability coverage will be much longer than the period of payment for your short-term disability benefits. It will depend on the specific provisions of your policy but should be in terms of years as opposed to the months-long durations of short-term disability coverage.

More about Tenet Healthcare’s short-term disability insurance

As is commonly known, short-term disability insurance is meant to cover a portion of your income should you find yourself unable to work for a short amount of time due to an illness or injury. The specifics of your insurance should be in your Tenet Health short-term disability policy, but there are a few items to pay extra special attention to. Pay attention to the length of your elimination period. This is the time you’ll need to wait from the time you become disabled, until the time you’re able to start receiving your benefits. Your policy should specify whether this time is 7 days, 30 days, 60 days, etc.

You’ll also want to find out what Tenet Healthcare considers to be a disability. Some insurance companies will consider certain illnesses and injuries to be pre-existing conditions and won’t cover those under the short-term disability policy. There may also be some situations where the insurance company will cover the disability if you follow certain requirements. For example, if the injury happened while under the influence, the insurance company may place a stipulation in the policy stating that you must participate in a rehabilitation program for a period of time while you collect benefits. If the requirement is not followed, the insurance company will deny the claim. Make sure that you read your policy carefully to understand everything that you’re entitled to and all the stipulations that the insurance company puts in place. This will help your odds of having your claim accepted by Tenet Healthcare.

More about Tenet Healthcare’s long-term disability insurance

Long-term disability is nearly identical to short-term disability, but the percentage of income is bigger, the length of time that you’re able to receive your benefits is longer, and the elimination period is also longer. If you happen to get both the short-term and long-term disability policies together, you may be able to go through the elimination period for the long-term plan while you’re collecting benefits from the short-term plan. You’ll also want to read through the policy carefully to understand how Tenet Healthcare defines “disability”. Be sure that you’re situation doesn’t fall under a pre-existing condition, exempt disability, or one with a requirement. Understanding your policy will help you for the claims process.

What you need to know about Tenet Healthcare’s disability claims

You’re going to want to make sure that you fill out the disability claim forms completely and accurately. If any part of the disability claim form is incomplete, this will give insurance companies an easy excuse to delay or deny your claim. You don’t want to give them a justifiable reason to do this as this will only prolong the time it will take to receive the benefits you need.

How to submit a disability claim to Tenet Healthcare

You may be able to submit your disability claim through Tenet Healthcare’s online portal, but you may want to speak to a representative to under this insurance company’s process for submitting a claim. Once you understand the process, you should receive or be able to download three forms: one should be for your statement of the disability, another should be for your employer’s statement of the disability, and the last should be for your attending physician’s statement of the disability. You may also be required to sign authorization forms that will allow the insurance company to receive your medical records. Make sure that all of the paperwork is completely and accurately filled out. Again, if any part of the paperwork is not submitted or complete (including your signature on the authorization forms), you will be giving the insurance company a valid reason to delay or deny your claim.

What to do if Tenet Healthcare delays your disability claim

If you feel like your claim is being delayed, you’re going to want to get in touch with customer service and request a status update. If the representative tells you that you need to submit more paperwork, do so. If your claim still doesn’t move forward after 10 more business days, it may be time to reach out to an experienced disability lawyer. Experienced disability lawyers, like those at Osterhout Berger Daley, can identify tactics insurance companies use to delay disability claims. Our experienced lawyers can help move your claim along so that you can get the benefits you need.

What to do if Tenet Healthcare denies your disability claim

If Tenet Healthcare decides to deny your benefits claim, it will notify you by a letter that will be mailed to your home. It is important for you to read your letter carefully. It will explain why Tenet Healthcare denied your claim and will tell you how you can appeal as well as the deadline for doing so. This deadline is very important. If you fail to meet it, you will be foreclosed from ever trying to recover your benefits from Tenet Healthcare in the future. You are also unable to file a lawsuit against the company in court without first exhausting its own internal process of appeal.

Once you receive your letter, contact the company and ask it to send you your entire file. Tenet Healthcare must give you a copy of your file if you ask for it. Bring your file and your notice of denial into Osterhout Berger Daley. One of our experienced lawyers will review all of the information and offer you some guidance about what to do next. Listening to and following your knowledgeable lawyer’s advice is important. He or she understands how to build strong appeals cases and will be dedicated to helping you to win.

Our team of experienced attorneys.

Appealing a denial from Tenet Healthcare

Your lawyer might ask you to help with your appeal by doing certain things. You may be asked to secure written opinions about the limitations you suffer because of your disabling condition from your former employer, your medical professionals, your acquaintances and your family members. Your lawyer may also want you to undergo additional medical tests and to submit to more evaluations. All of these things are important because they can help you to add more information to your file that supports the basis for your disability claim. Contact Osterhout Berger Daley today to schedule a consultation with one of our experienced disability lawyers.