Long Term Disability Questions
Long-term disability benefits are designed to provide financial support when a serious illness or injury prevents you from working for an extended period of time. These claims often involve detailed medical documentation, insurance policy requirements, and strict deadlines. Understanding how long-term disability coverage works, what evidence is needed, and how insurers evaluate claims can make a significant difference in the outcome. Below, you’ll find helpful information about the long-term disability process and answers to common questions.
If you need help filing a claim for and obtaining long-term disability benefits, we urge you to contact a disability lawyer at The Bernstein Law Firm PLLC. At our firm, we have a comprehensive understanding of the long-term disability benefits process. We have recovered millions of dollars in benefits on behalf of clients who have long term disability policies. Put our extensive knowledge and experience to work for you and get the benefits you deserve.
When applying for long-term disability through your insurance company, it is important that you consult with a disability attorney at the outset to determine what laws govern your case. The laws that govern your claim will be based on the type of policy you have and how it was obtained. Most long-term disability claims are governed by the Employee Retirement Income Security Act of 1974 (ERISA) or the state laws in which you reside. It is important in the claims process to be proactive, ensuring that your claim is properly documented with all relevant evidence substantiating your claim for disability benefits.
If you are seeking long-term disability insurance through your employer, you need to understand ERISA and how it affects your rights. Often, claimants go through the long-term disability administrative process with their insurance provider, are denied or terminated, and have exhausted all administrative remedies available to them. Their only option then is to file a lawsuit in federal court under ERISA.
Before you exhaust all of your administrative remedies, consult with a disability attorney at our firm to ensure that your claim is properly documented and handled throughout the claims process. If you are denied at the administrative level, we will file a lawsuit in court if we feel there is merit to your claim.
Have you been denied your claim for long term Disability Insurance Benefits? Do you need an experienced attorney to review your case? If so, we invite you to contact The Bernstein Law Firm PLLC to set up a consultation with a disability benefits attorney as soon as possible. If your claim has been denied, you may be under limited time constraints to request an appeal. It is important to contact us right away. We are an experienced disability benefits law firm and can help you get the benefits you deserve.
Denials of Disability Insurance Benefits Claims
We understand how important your long term disability benefits are to you. It can be devastating after waiting for months to get a response from your insurance company only to be told you do not qualify for benefits. Many claimants feel hopeless and get discouraged. You do, however, have options and we want to discuss them with you. You should start immediately by consulting with an experienced disability benefits lawyer at our firm. We can review your claim and give you an evaluation of your case. If you need to file an appeal with your insurance company we can assist you in presenting an appeal that is comprehensive and demonstrates the totality of your medical condition.
If after exhausting the appeals process, your insurance company continues to deny your claim, our firm is not afraid to take big insurance companies to court on behalf of our disabled clients.
Regardless of your situation, a disability benefits lawyer at our firm has the experience to help you pursue the disability benefits you need and deserve. If you have been denied benefits, let us put our experience to work for you.
Becoming disabled can be a devastating experience, leaving you with compromised health which makes it difficult or impossible to earn a living. To make matters worse, not only is your health affected but your ability to earn a living is compromised as well. Obtaining disability benefits, whether through the Social Security Administration or through a long term disability insurance policy is important for both your medical treatment and your financial security. If your applying for disability or your claim has been denied, you need experienced and dedicated legal representation from a disability lawyer at our firm. Whether you need assistance with the initial application process, or you have received a denial and need to file an appeal, we can help you.
How We Can Help with Your Disability Claim
At The Bernstein Law Firm PLLC, we are experienced an experienced disability law firm and have handled thousands of claims throughout the country. Our office can review your case and advise you on your legal rights and options in applying for and obtaining benefit claims. We can assist you in completing any forms that are needed and work with your medical providers to make sure that you provide your application is complete. Our office can supplement your claim with new or additional medical records and obtain further medical opinion evidence substantiating your disability. In the case of a denial, we can also consult with vocational experts for opinion evidence that will rebut the denial and prepare and submit an appeal on your behalf, representing you at any disability hearing. If your appeal is denied, we can continue taking legal action to help you obtain the compensation you need by ultimately filing a lawsuit on your behalf in court.
When you have a disability lawyer from our firm on your side, you can be confident that your disability claim will be complete, thorough, and will be monitored as it moves through the process. When you work with our firm, our experience and knowledge of the disability system will allow you to focus on your medical problems instead of fighting on your own for the benefits you deserve.
ERISA stands for Employee Retirement Income Security Act of 1974 (ERISA) and was passed to protect employee benefits for participating plans. Most long-term disability claims made against policies through your employer fall under ERISA guidelines. Under ERISA, certain specific procedures must be followed in the claims process before you can eventually file a suit against your insurance company in court.
Your policy will outline these specific procedures, including specific time limits governing various actions that need to be taken. An internal appeals process exists if your claim is denied which you must navigate. Because each policy has its own language and terms, it is important that you consult with an attorney about your particular ERISA long-term disability claim so that we can begin assisting you with a claim, appeal, or lawsuit as soon as possible. Most long-term disability insurance policies that are received through your employer are governed by the Employee Retirement Income Security Act of 1974 (ERISA). ERISA is a very complex law that governs the procedures set forth in applying for long term disability benefits through your insurance carrier.
ERISA limits your rights in the event you must file a lawsuit against your insurance company. Under ERISA, it is highly unlikely that you are not able to take discovery against the insurance company. Typical methods of discovery such as depositions and interrogatories are typically not allowed in ERISA claims. In addition, most ERISA claims are settled on motion without affording the plaintiff to appear in Court before a judge. All ERISA claims must be filed in federal Court.
Long-Term Disability Lawyer
A long term disability insurance policy is designed to pay you benefits if you become disabled. Depending on the policy you have, most policies provide you with a percentage of your salary which is paid to you in a monthly check. Most long-term disability insurance policies are either purchased through your work or provided to you by your employer. If your long term disability insurance policy was obtained through your employer than it is most likely governed by ERISA.
Having your long-term disability claim denied can be a financially devastating for you and your family. Our firm understands the importance of this situation and how vital it is to your financial security to obtain the benefits to which you are entitled. With representation from a long-term disability lawyer from our firm, we can assist you in any stage of your claim.
Many disability insurance companies use ERISA to create onerous tactics to deny the claims of those who apply for benefits. If you are applying for long term disability insurance, we urge you to consult with a long-term disability attorney at our firm about the specific facts of your case. At The Bernstein Law Firm PLLC, we have the experience in fighting for the rights of our clients who are wrongfully denied disability benefits from their insurance carrier. Whether you are making an initial application or have been denied benefits, we have the experience to handle your claim.
If you are self-employed or purchased your long term disability policy outside of your employment, there is a good chance that it is not governed by ERISA. Therefore, your claim is governed by the state law in which you reside. Typically, if a lawsuit needs to be filed in a non-ERISA claim, it is done so in state Court. Unlike an ERISA claim, non-ERISA claims are afforded the ability to conduct discovery, present witnesses, take depositions, and appear before a judge at trial.
If you have become disabled and need to make a long-term disability claim with your insurance company in a policy that is not governed by ERISA or if you have been denied in such a claim, it is important that you seek experienced professional legal assistance in the matter. We strongly recommend that you contact a long-term disability lawyer at our office for a consultation about your situation as soon as possible. At The Bernstein Law Firm PLLC, we have recovered millions of dollars in benefits for our clients who have long term disability claims. We offer extensive experience and knowledge in this field and can provide the representation you need in making an effective claim for the benefits you are entitled to receive.
Because each policy is different, it is important that you understand the policy terms and the state laws that govern your claim. A long-term disability attorney from our firm can go over your policy with you and assist you with the claims process, ensuring that it is thoroughly and properly documented before it is submitted to your carrier. We can also monitor your claim as it is processed, following up to make certain that it is not ignored. We will work diligently on your behalf to get your claim approved. If your claim is supported by your doctors and the objective medical evidence and still denied, we can represent you in the appeals process or take legal action in court against the insurance company if necessary. Our firm has extensive litigation experience representing clients who have been denied benefits. If your claim is denied, you should act quickly in taking the next step to fight for the benefits to which you are entitled to receive.
If you need to apply for long-term disability claim from a private insurance company, it is important that you fully understand the terms of your policy and the laws which may govern it. Whether your policy is through an employer or your own private policy, it is vitally important to be prepared to present an effective application from the start. Even with thorough preparation, and appropriate documentation, you should expect a fight and can still be denied. For this reason, we strongly urge you to contact a long-term disability lawyer at our firm before you even begin the application process so that your claim application is thorough and complete from the start. Our firm is fully-versed in disability law and has extensive experience in dealing with insurance companies. We know how these insurance companies work, the tactics they will employ to delay or deny your claim, what they require on claim forms, how to aggressively negotiate with them when appropriate, and how to litigate against them when necessary.
The Importance of the Claim Application
One of the most important aspects for success in obtaining your long-term disability benefits lies in the initial application process. Your claim must be strategically developed and prepared. All of your relevant medical evidence must be obtained as well as physician reports and sometimes vocational reports. The application should not be rushed and summarily completed. In preparing your application, you may not understand what is needed and how to obtain it.
An experienced long-term disability attorney can assist you in completing your application and gathering the relevant evidence that must be presented in support of your claim. Our firm can work with your doctor and other medical professionals in helping to document our condition. We can advise you as to how you can supplement your application with evidence which will substantiate your claim. An experienced long-term disability attorney from our firm has the experience to assist you in maximizing your chances of being successful at the application level.
If you need assistance with an administrative review of your long-term disability claim, it can be extremely helpful to retain the services of an experienced attorney who is familiar with this process. We advise you to consult with the long-term disability attorney at the Bernstein Law Firm, PLLC for competent legal help with an administrative review of your claim or any matter pertaining to it. Our firm has helped thousands of clients with every aspect of disability claims and the claims process throughout the country.
An administrative review of your ERISA long-term disability claim will be necessary following any decision from the insurance company that you wish to challenge, such as a claim denial or a termination of your policy. If your claim was denied, you can request an administrative review by the insurance company. The administrative review is an internal claims process in which you must appeal your claim prior to filing a lawsuit against the insurance carrier. There are deadlines for requesting an appeal and getting an administrative review of your denial which is stated in your policy. In accordance with ERISA, any claim that is denied must provide the claimant with certain information from the claims reviewer, such as specific reasons for the denial, what additional information may be necessary to validate the claim, and what steps must be taken to have the denied claim reviewed.
Under the ERISA law, a claimant must exhaust the administrative review process, following the procedures laid out in his policy, before he or she can file a lawsuit against the insurance carrier for benefits relief. If you file a lawsuit against your insurance company, the courts are typically limited in their review of your claim to the evidence that was submitted to your insurance company during the administrative review process Any additional evidence that was submitted to the insurance carrier prior to the filing of a lawsuit is typically precluded from being introduced to the Court. Because of the importance of the administrative review to your case, it is often crucial to have the legal assistance of a long-term disability lawyer from our firm to assist you in during this process.
If your long-term disability claim through your insurance carrier has been denied, your next step is to file an administrative appeal with your insurance company. Because the administrative appeals process can be a complex procedure, it is highly recommended that you engage the services of an experienced disability lawyer. A long-term disability lawyer at The Bernstein Law Firm PLLC has the experience to assist you with the appeals process. Our extensive experience and knowledge can prove to be an invaluable asset in this very important process. We strongly urge you to contact our offices to set up a free and discuss the merits of your disability case.
If your claim has been denied, you should pay close attention to the deadline to file your appeal. The time periods for appealing a denial are usually noted on your denial letter from the insurance company. Time is of the essence and the quicker you begin working on your appeal, the better chance you have of making sure that your appeal is comprehensive and fully describes your medical condition and its impact on your ability to work.
The appeals process gives you the chance to rebut the denial of your claim. It also provides you with an additional opportunity to include evidence in your favor into the administrative record. This may prove invaluable if you are once again denied and need to file a lawsuit in Court. This is an extremely important process in your pursuit for benefits. It is in your best interest to have a long-term disability attorney from our firm review your case.
The administrative record of your long-term disability claim is the complete file that your insurance carrier maintains concerning your application for benefits. The administrative record contains all of the medical evidence, employment, and occupational information that you have submitted to the insurance carrier to substantiate your claim. Your case, both in the appeals process with the insurance company and in any subsequent court case, rests solely on the information that is contained in this record. If your claim has been denied, or if you are in the initial stage of applying for benefits, it is crucial that the information submitted to the insurance company to prove your disability is thorough, complete, and effective. That is why we recommend that you work with the long-term disability attorney at our firm. We have a thorough understanding of disability law and extensive experience dealing with insurance companies in the pursuit of legitimate claims on behalf of our clients.
How important is the administrative record of your claim? If your claim is governed by ERISA, and you need to file a lawsuit after exhausting the administrative review process, the court will most likely only be allowed to review the information that exists in this file. Generally, once the appeals process is completed, no additional evidence can be added to your file, regardless of how relevant it is to your claim. The Courts will not be allowed to review any evidence that was not submitted to the insurance company during the administrative review period.
When you work with a long-term disability lawyer from our firm, you will benefit from our experience in filing your appeal. When submitting an appeal there are many important aspects of your condition as a whole that need to be submitted to your insurance carrier. Depending on the availability, we will attempt to obtain your medical history as it pertains to your disability, statements from family and friends as to your limitations, treating source opinions (if available), and sometimes vocational expert opinions who are able to look at your limitations caused by your illness and render an opinion as to your ability to engage in work.
When you apply for long term disability insurance, you may be asked to submit to an independent medical exam. Most insurance policies contain language that allows the insurer to request an independent medical exam. Most of the time, if you do not attend the independent medical exam you will receive an automatic denial. The independent medical exam is a physical examination by a physician who has been chosen by your insurance carrier. The purpose of this exam is to provide written medical evidence which can be used by your insurance company to support its decision concerning your claim. If you have been asked to attend such an exam by your disability carrier, you should consult with the long-term disability lawyer at our offices who can advise you on important issues concerning this exam.
The independent medical exam is generally an opportunity for the insurance carrier to arm itself with evidence that can be utilized to support a denial. The independent medical doctor who examines you has no interest in treating your condition. They are only ascertained by your insurance company to support a decision in your claim.
The medical doctor who will examine you should be provided with all of the information regarding your claim, including the in-house medical evaluations of your insurance carrier which are generally biased in favor of a denial. Based upon our experience, it seems as though the goal the independent medical examination is to attack the credibility of your claim.
It is not uncommon for your insurance carrier to place you under video surveillance when one is either applying or receiving long term disability benefits. The insurance carrier will hire a private investigator to follow you and record your activities for a period of time. Video surveillance is a powerful tool for use by insurance companies and has been successfully used in court cases to support insurance company denials. If you represent to your insurance carrier that you have trouble walking, bending, lifting, carrying, or engaging in other physical activity, you may be placed under hidden surveillance by an insurance investigator. If you believe you are being videoed in this fashion or if your insurance carrier has asked you to make a statement concerning video surveillance that it has obtained, it is critical that you seek the advice of an experienced long term disability lawyer. The long-term disability attorney at our firm can provide invaluable assistance concerning the matter of video surveillance.
Many insurance companies utilize the video surveillance to discredit the applicant. Courts have found that video surveillance is not always reliable. Video surveillance often does not show an accurate picture of a disabled person’s abilities, limitations, or pain. While it may be a valuable tool in combating legitimate insurance fraud, its misuse can result in the denial of a valid claim backed by objective medical evidence.
Video surveillance may be conducted against you at anytime during the long term disability process. The insurance carriers are always looking for ways to either deny applications or terminate claimants that receiving monthly payments. The long-term disability claims lawyer at our offices has extensive experience in handling long term disability claims and can provide the legal guidance and representation you need in dealing with your insurance carrier.
If you have exhausted the administrative appeal process with your insurance carrier and they refuse to pay your claim, you can then initiate a lawsuit against them. If you are in this position, we encourage you to contact The Bernstein Law Firm PLLC and schedule a consultation with a long-term disability attorney in our office. Our firm has extensive experience in this area of law.
If your claim has been denied after completing the administrative appeals process, it is to your advantage to have the matter reviewed and evaluated by our long-term disability lawyer who can advise you on your legal rights. If a lawsuit against your insurance company is pursued, our firm will keep you fully updated on the progress of your case and will work diligently to achieve a favorable outcome. We are not afraid to take large insurance companies to court and have considerable experience in doing so.
If you need legal assistance with the issue of a Social Security Disability offset for your long-term disability benefits, we strongly advise you to schedule a consultation with a long-term disability attorney at our firm at your earliest convenience. Our firm is dedicated to helping the disabled and their families in obtaining and keeping the benefits they need and deserve. We have many years of experience in dealing with all of the legal aspects and issues involving long-term disability claims and denials and have recovered millions of dollars in benefits on behalf of our clients.
Many long-term disability policies are written to include an offset provision for other income you receive, such as Social Security Disability payments. This means that your disability insurance company can reduce its benefit payments to you by the amount that you receive from the Social Security Administration. Because it can take up to 2 years to be approved for Social Security Disability benefits, your long-term disability insurance carrier may require that you sign a repayment agreement in which you agree to return any overpayment to them once you do start receiving Social Security Disability. Many times when you are finally approved for Social Security Disability, you will receive a sizeable lump sum payment representing your past due benefits for the period you waited to have your claim approved. Depending on your circumstances, your long term disability insurance carrier may be entitled to the past due payment you receive from the Social Security Administration. If you are unfamiliar with your long-term disability policy, this may come as an unpleasant surprise. You may not have known about the offset provision or be able to repay such a large sum immediately.
If you are involved in an offset issue, it is important that you talk to our long-term disability lawyer about your case to find out what your legal rights and options may be. We are not afraid to take big insurance companies to court when appropriate to protect the rights and benefits of the disabled.