If you’re unable to work for an extended period of time due to a medical or mental health condition, you may be able to file a claim for disability benefits through your insurance company. These policies are often offered through employers as part of a benefits package. Alternatively, individuals may purchase their own long-term disability (LTD) coverage.
LTD policies typically pay out between 50 to 60% of your pre-disability wages in the form of monthly cash benefits. However, getting your disability claim approved can be challenging, particularly because insurance companies use a number of tricks to avoid paying out on these policies. A skilled long-term disability benefits lawyer can assist you with the initial application and any appeals you may need to file.
At Bross & Frankel, we are skilled at handling all types of disability claims – including long-term disability. We aren’t afraid of taking on the big insurance companies to help you get the money that you deserve. Contact our law office to learn more or schedule a free claim review with a New Jersey disability attorney.
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What Is Long-Term Disability Insurance?
Long-term disability (LTD) insurance is a type of insurance policy that can protect your financial security if you can no longer work due to a disability. It is different from workers’ compensation, which provides money and other benefits for work-related injuries and illnesses. These policies offer coverage for a wide range of mental health and medical conditions that are not linked to your job.
Most people purchased LTD coverage through their employer’s group plan. Typically, these plans are governed by the Employee Retirement Income Security Act of 1974 (ERISA). If you purchased an LTD policy on your own, then any disputes would be governed by state law.
ERISA sets out specific standards that insurance companies must follow when making a decision on a claim for benefits. ERISA plans must also have an appeals process. Individually-purchased plans are governed by the terms of the policy.
While each policy is different, LTD coverage usually provides a percentage of your monthly income (often 50 to 60%) if you can’t work because of an illness or injury. Generally, you can apply for LTD benefits after you have been out of work for a set period of time (typically 6 months). If you have a short-term disability policy, then that will typically cover the period of time between when you first became disabled and when the waiting period for LTD benefits is over.
Long-term disability insurance is a critical way to protect your income and is a smart part of any financial plan. Unfortunately, insurance companies often unfairly delay, deny, or terminate LTD benefits. This can leave policyholders in the lurch as they struggle to maintain financial stability while dealing with bad faith tactics and wrongful termination of benefits.
An experienced long-term disability lawyer will analyze your policy and put together the necessary documentation to support your claim. With an attorney by your side, there is less of a chance that your claims will be unfairly delayed or denied. Your lawyer can also appeal any denial of benefits using the procedures set forth in ERISA or the terms of your policy.
How Can a Long-Term Disability Insurance Lawyer Help Me?
Insurance companies are in business to make money. Year after year, earnings reports show that insurers are raking in record profits. Too often, these profits come at the expense of their insured.
Insurers use a number of tactics to delay paying out on an LTD claim or to deny an application outright. For example, your insurance company might deny your claim because you aren’t “disabled,” even though you have submitted medical records to prove that you are disabled and unable to work because of your disability. They often use their own hired gun physicians to quickly review your file and deny your claim on the basis that you aren’t actually disabled or that you can still work.
Other common tactics used by insurance companies include:
- Arguing that your disability is a pre-existing condition that is excluded from coverage;
- Misstating your job duties to claim that you are able to work;
- Repeatedly requesting more information to delay making a decision on your claim; and
- Terminating benefits when you are still disabled and unable to work.
A long-term disability attorney can help ensure that you get the benefits that you are entitled to under the terms of your policy. They will evaluate your policy, analyze your medical evidence and other supporting documentation, and suggest additional ways to bolster your claim before filing. If the insurance company tries to delay or deny a claim, they will push back to protect your rights. If necessary, your lawyer will appeal a denial or termination, up to and including filing a lawsuit in state or federal court.
Most long-term disability attorneys work on a contingency fee basis, although some work through a flat fee or hourly agreement. With a contingency fee arrangement, you won’t pay any money upfront. Instead, you will only pay a fee – a percentage of your settlement or total award – if your claim is approved.
The decision to hire a lawyer can be a difficult one to make, particularly if you believe that you have a strong claim for LTD benefits. During a free claim review, your attorney will listen to your story and provide an honest opinion about your options for moving forward. If you decide to hire a disability law firm, they will work hard to help you get the money that you are entitled to under the terms of your policy.
Can I File an Appeal If My LTD Claim Was Denied?
Too often, applications for long-term disability benefits are denied – even when the applicant qualifies as disabled under the policy. Fortunately, it is possible to appeal a denial with the help of an LTD lawyer.
The appeals process will depend on the type of insurance policy that you have. If it was purchased through your employer’s group plan, then it will likely be governed by ERISA. You will usually have 180 days from the date of the initial denial to file an appeal along with any additional evidence to support your claim. If the insurance company denies your claim at this stage, your only remaining option is to file a lawsuit in federal court.
If you purchased your own LTD policy through a broker, then the appeals process will be governed by the terms of the policy. An experienced long-term disability attorney can review this contract and advise you of your appeal rights. If the insurer denies an internal appeal, then you can file a lawsuit in state court to try to obtain your benefits.
Appealing an LTD denial can be challenging, particularly if you aren’t familiar with the technical rules that apply to these matters. At Bross & Frankel, we will work with you to help you understand your rights and your options for pursuing an appeal. If you decide to appeal, we will fight to get you the benefits that you deserve.
Considering an LTD Claim? We Can Help.
We buy long-term disability insurance to protect ourselves in the event that something goes wrong – like getting into an accident or developing a chronic condition. Too often, however, insurance companies balk at providing us the coverage that we sought when we purchased the policy. Our law firm will take on the insurance company for you to help you get long-term disability benefits.
Based in Cherry Hill, Bross & Frankel represents people with disabilities throughout New Jersey and Pennsylvania as they seek disability benefits. We have significant experience handling long-term disability claims and aggressively advocate for our client’s rights in each case. To learn more or to schedule a free claim review with a New Jersey long-term disability attorney, give us a call at 866-864-3130 or fill out our online contact form.