when to hire an attorney - long term disabilty insurance denials

by Dr. Merlin Reilly DDS 7 min read

If you've been injured or become ill and can't work, and your long-term disability (LTD) insurance company denies you benefits, it's in your best interests to get an attorney. Unlike a disability claim with the federal government (Social Security disability), long-term disability insurance companies are not impartial.

If you've already filed your initial application and have been denied, it is critical to hire an attorney to help with your administrative appeals. Both group and individual LTD policies contain strict timelines, often 180 days, to appeal a denial, so don't delay.

Full Answer

When should I hire a long-term disability attorney?

If you have long-term disability (LTD) insurance and become unable to work, you should hire an experienced LTD attorney as soon as possible to maximize your chances of success. Filing a long-term disability claim, especially when you have employer-provided group coverage, is a process fraught with danger for the unrepresented disability applicant. A single missed …

Should I hire a lawyer after a disability claim is denied?

Another reason for denial is the consumer filing or submitting relevant information passed the given deadline. Most claims governed by ERISA (Employee Retirement Income Security Act) give 180 days after the initial denial to appeal. After the denial is when a long-term disability (LTD) lawyer should be contacted.

What does a long term disability insurance lawyer do?

Jun 25, 2021 · Policy Reasons That Individual and Group Disability Insurance Companies Use to Deny Valid Claims. Most clients wait to contact an ERISA attorney or disability lawyer until after their disability insurance company has wrongfully delayed or issued a bad-faith denial of benefits.

What happens if my long-term disability claim is denied?

Jan 30, 2016 · You need a highly qualified long term disability lawyer that deals strongly and effectively with multi-million dollar insurance companies. Your attorney must be skilled at negotiations, complex appeals procedures, and litigation in both state and federal courts. National long term disability lawyer with more than 20 years of experience. Attorney Marc Whitehead …

What percentage of long term disability claims are denied?

More than half of all claims for long-term disability benefits are denied. If you've been diagnosed with a serious medical condition that prevents you from returning to work, and your claim for benefits was fairly denied, Preszler Injury Lawyers may be able to provide you with assistance.

Is Long Term disability retroactive?

LTD Benefit payments are paid in arrears on a monthly basis based on your date of disability. LTD Benefit payments that are payable for retroactive claims will be paid immediately following claim approval.

What is the waiting period for disability insurance called?

the elimination periodThe waiting period, also known as the elimination period, is the number of calendar days since your disability began that must pass before benefits become payable. The probationary period determines when you're able to file a claim.Sep 7, 2020

Is long term disability insurance optional?

Coverage is mandatory. Permanent salaried employees are eligible and automatically enrolled in the LTDI plan beginning the first day of the pay period after the employee completes three consecutive months of employment without absence due to illness or disability, except for casual illness.

Can you collect long term disability and Social Security at the same time?

Can you get Social Security Disability Insurance and long term disability at the same time? Yes, it's possible. If you qualify for Social Security disability benefits, your benefit amount will not be reduced if you are also receiving individual LTD benefits.

Is my long term disability taxable?

If your employer pays the entire premium for your long-term disability insurance, then your long-term disability benefits are likely taxable. This means that while your employer pays the premiums for your long-term disability insurance, you will have to pay income taxes on the benefits you receive through your policy.Dec 23, 2020

What is an example of a presumptive disability?

Examples of disabling conditions that may qualify you for Presumptive Disability include total deafness, total blindness, amputation of the leg at the hip, confinement to bed or a wheelchair, a stroke resulting in the inability to walk or use one hand, cerebral palsy, muscular dystrophy, certain cancers and other ...Dec 2, 2010

What does pending mean for disability?

It just means they are still in the process of writing up your decision. This is neither good nor bad. Wishing you nothing but the best. Butterfly (not verified)Oct 18, 2017

How does long-term disability work?

Long-term disability insurance LTD benefits are paid for a much longer period of time than short-term, usually for up-to two years if you cannot work at your regular job or occupation. If, after two years you are unable to work at any job, you may continue to receive benefits until you turn 65.

Do I get a t4 for long term disability?

If you are collecting benefits under a disability insurance plan, when the benefits are tax-free, you will not receive a T4A. If you have paid a portion of the premiums, the T4A you receive will be for the gross amount of the benefits received, but you can deduct your contributions to the plan.Oct 29, 2021

Can you have 2 LTD policies?

Owning multiple separate disability insurance policies is often referred to as a combination plan, or “stacking.” The goal of stacking is to create the best possible disability coverage with multiple policies.Aug 3, 2017

What is basic AD&D?

Basic AD&D insurance provides additional benefits to employees if they were to die or suffer dismemberment in an accident while employed by Leidos in an eligible fringe package.

Long Term Disability Insurance Denial Results

Call the team here at Sadaka Associates now at 1-800-810-3457 to talk to an attorney about your potential long term disability insurance denial.

Common Policy Points

If a person seeking a benefits plan is not careful they could find themselves in an inadequate policy. Some providers have more options that cover short-term disability and others have more diverse policies concerning long-term disability. Each provider can cover similar aspects in terms of policy, but the exact limitation may range.

Employee Retirement Income Security Act

People in need of disability coverage initially file with their insurance company. There are several providers who carry and support a range of claims. These insurers have benefits for short-term disability plans and others have policies to handle long-term claims.

Policy Definition & Video Inconsistency

Each provider has a set of guidelines that the consumer agrees to abide by, or criteria that must be met in order to qualify for disability coverage. When some of these standards are not met, this can lead to the provider deny their claim even if the consumer has a legitimate case.

Misinformation and Missed Deadlines

Those fortunate with insurance lean on those companies to give them peace of mind when they need financial support. In many cases, these companies will pay partial or no money to their consumers. These denials can be made for several reasons.

Providers of Disability Coverage

Different providers have various policies that can help you when an accident occurs. Be sure to investigate them to see which provider has the best plan for you.

What Should You Do about Your Case?

Call the team here at Sadaka Associates now at 1-800-810-3457 to talk to an attorney about your potential long term disability insurance denial.

What is long term disability insurance?

Long term disability insurance provides benefits so you can pay your bills, keep a roof over your head, and continue to cover your basic needs and expenses. You need these insurance benefits as soon as possible, which means you should seek legal help from a disability claims lawyer from the very start of your claim.

How many credits do I need to get Social Security?

People age 62 and older need a minimum of 40 work credits, at least 20 of which were earned during the past ten years, to qualify for Social Security Disability Insurance. Younger workers can achieve eligibility with fewer credits. You earn a work credit by working and paying Social Security taxes.

Can a general practice lawyer handle ERISA?

If you’re thinking about hiring a long term disability lawyer or ERISA lawyer, understand that disability law differs significantly from personal injury law. A general practice attorney should not handle cases involving individual or group disability benefits. You wouldn’t hire a cardiologist or family practice doctor to perform brain surgery, so be very careful not to hire a lawyer who doesn’t focus on individual and long-term disability insurance to handle your valid disability claim.

How long does a disability last on Social Security?

According to the Social Security Administration, “the law defines disability as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment (s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”

Is disability insurance complicated?

In fact, disability insurance law is so complicated that few attorneys will find success in this specialized field if they take other types of cases. This especially is true when a complicated and continually evolving federal law, the Employee Retirement Income Security Act (ERISA), is involved.

Can I file a disability claim online?

While many individual and group disability insurance companies make it “easy” to file a disability claim online, avoiding bad-faith delays or denials or maintaining your disability benefits over the long term is difficult.

Can I get SSDI if I am totally disabled?

Federal Social Security Disability Insurance (SSDI) – You may qualify for SSDI benefits if you’re (1) totally disabled—that is, you can’t engage in any meaningful work; (2) you paid enough into SSDI; and (3) you have enough “ work credits ” based on your age . “Work credits” are the way the federal government determines if you’ve worked long enough to claim disability benefits.

Take these steps if your long-term disability claim is denied by the insurance company

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Appealing a Denial: The First Steps

Get a copy of the policy. If you haven't already done so, obtain a copy of the LTD policy plan documents, including the summary plan description. You should be able to get this from your company's human resources department (if your employer provides group insurance) or directly from the insurer.

How to "Stack the Record" With Favorable Evidence

It's essential to "stack the administrative record" with favorable evidence before exhausting your insurer's internal appeals process. Under ERISA law, federal courts usually refuse to consider any evidence that wasn't already presented to your insurance company or plan administrator in their internal appeals process.

Getting Help

If you've exhausted all of your administrative appeals (reviews within an insurance company) and your case still has not been approved, the final step for most claimants is to file a lawsuit in federal court.

Why do insurance companies hire private investigators?

Some insurance companies will hire a private investigator to follow you around and take pictures of your daily activities. This common approach is meant to build a case against you with the judge that you are capable of more significant activity than your claim indicates.

What can an attorney do for insurance?

An experienced attorney will be able to request information from your insurance company about your claim and engage your doctors and caretakers. Your attorney will also get to know all the people involved to best build your case. In partnership with you, they will make things easier for you and harder for the insurance company.

What does a long term disability attorney do?

A long-term disability attorney will help you avoid any pitfalls.

What to do if denied long term disability?

If you have been denied on your long-term disability claim, talk with Roy Law Group’s compassionate team of experts . We do disability law and nothing else. You are not an attorney – do not let their army of attorneys take from you what you rightfully deserve.

You Do Not Have To Take No For An Answer

Insurers commonly deny or terminate disability claims and appeals. They hope that this will discourage you from further action so that they do not have to pay you. There is a variety of reasons an insurer might deny your claim, including:

Why Hire An Attorney?

We can ensure that you don’t miss any crucial steps during your appeal process. We know how complex these matters can be, and jeopardizing everything over a small oversight is not worth the risk. For example, once you complete the appeal process, you cannot add to or alter the administrative record.

Is An ERISA Lawsuit Right For Me?

Your insurance company is supposed to help you in your time of need. But when it denies or terminates your LTD benefits, it can leave you feeling angry. You have every right to feel this way.

Defend Your Benefits With A Strong Litigator

Bad faith denials are commonplace, since most insurance companies expect you to give up without a fight. Some insurers deny or terminate your benefits in the hopes that you do not pursue legal action so they can avoid paying you. Other insurers expect a lawsuit and will fight aggressively to keep you from the benefits you deserve.

Do Not Take On Your Insurance Company On Your Own

If you need help protecting your disability benefits, don’t leave things to chance. If you or a loved one has had their insurer deny or terminate their long-term disability (LTD) benefits, work with an experienced ERISA attorney who can help.

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Long Term Disability Benefits Attorneys

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FREQUENTLY ASKED QUESTIONS

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