Bross & Frankel is a law firm focused on obtaining disability benefits for clients in New Jersey, Pennsylvania and throughout the country. Our experienced long term disability lawyers have represented thousands of clients in more than twenty years of practice. We advocate for people who have individual disability policies, as well as those with group disability policies offered through their employers.
The attorneys at Bross & Frankel can help you receive your full long-term disability benefits by providing a wide range of services, including:
- Disability Claim Review
- Application Assistance
- Appeals for Denied/Terminated Private Insurance LTD Benefits
- Appeals for Denied/Terminated ERISA Benefits
What Is Long-Term Disability Insurance?
Long-term disability (LTD) insurance is a specialized type of insurance policy that protects you in the event that you are unable to work due to a disability. While workers’ compensation benefits will typically protect you if you are hurt or become ill on the job, a long term disability policy offers you benefits if you suffer from an illness or injury that is unrelated to work. In other words, it is income protection insurance.
LTD insurance can often be purchased through your employer’s group plan or may be purchased individually. In most (but not all) cases, if you have coverage through a group plan, then the policy is governed by a federal law known as the Employee Retirement Income Security Act of 1974, or ERISA. This law sets out specific standards that must be followed, including requiring insurance companies to provide certain information to policyholders and to set up an appeals process.
Under ERISA, policyholders can file a lawsuit in federal court for wrongful denial of a claim or another reason, such as improper termination of benefits. Policies that are not subject by ERISA are governed by state law. If a lawsuit is filed regarding these LTD policies, it will be heard in state court.
Whether your policy is governed by ERISA or by state law, it will provide a percentage of your monthly income — typically 50 to 60% — if you are unable to work due to an illness or injury. In addition, many policies will offer rehabilitation services and/or incentives to help you return to work sooner. These benefits are available after a waiting period, which is usually when you have been out of work for 6 months.
Long-term disability insurance is an important part of any overall financial plan. However, many insurance companies make it difficult to be approved for LTD benefits. Bad-faith delays, denials of disability insurance claims, and early termination of coverage are all-too-common.
Hiring an experienced long-term disability attorney early in the process can help you obtain the highest possible level of disability benefits. A disability insurance lawyer can examine your LTD policy and explain its terms, conditions, and limitations, enabling you to make a strategic decision about how and when to apply for benefits. With an advocate to guide you through the process, you are less likely to have the process delayed — or to have your claim denied outright.
How Insurance Companies Deny Valid Disability Insurance Claims
If you have a long-term disability policy, you may think that you will automatically receive benefits if you can’t work due to a disability. But just like other types of insurance, it often isn’t that simple. Long-term disability insurance companies look for reasons to deny or delay claims because their main business isn’t to pay out on claims — but to make money.
Insurers use a variety of reasons to deny legitimate LTD claims. An insurance company may deny your application on the basis that you have not proven that you are disabled, even if you have submitted mountains of medical records to back up your claim. Alternatively, the insurer may use its own independent medical professional’s opinion to make a determination that you are not truly disabled, or that you are still able to work.
In some cases, an insurance company may argue that you have a pre-existing condition that is excluded from coverage. A skilled long term disability lawyer can cut through the legalese and demonstrate that your condition isn’t subject to an exclusion. Depending on the type of policy that you have, this may mean following a strict appeals process before ultimately filing a lawsuit in federal court.
There are other ways that insurance carriers may deny your legitimate long-term disability claim. Many ERISA plans also have two different definitions of disability you may have to meet in order to continue receiving LTD benefits. Doing so can be complicated — particularly if you are unfamiliar with the system and the process.
When you work with a seasoned disability benefits attorney from the start of your case, it puts you at a distinct advantage. Many denials are based on specific policy terms. Having a lawyer examine your LTD policy and base your application on the terms and conditions of your policy can help to avoid any delays — and possible denial of benefits.
One of our clients experienced how smoothly the process can be when you work with a long term disability lawyer from the start:
Excellent legal help! Did amazing work on my disability case. Compared to the normal wait, I was approved extremely quick and did not need to testify in front of a judge (something I was terrified of). Highly recommend their services!
While each case is unique and results are not guaranteed, having an attorney to advocate for you can help you achieve a better outcome.
Appealing Denied LTD Benefits
If your application for LTD benefits is denied, the next step will depend on the type of policy that you have. Because the law governing disability insurance policies is complex, it is important to consult with a disability benefits attorney as soon as possible if you receive a denial letter.
ERISA benefits have strict deadlines that, when missed, can seriously limit or forever prevent a disabled worker from getting disability benefits. Many ERISA policies will only allow a single appeal with a limit of 180 days from the date of the initial denial to submit that appeal, and any additional evidence you may have to support your claim. If the LTD insurer again denies the claim, your only remaining recourse would be to file a federal lawsuit to try to obtain your benefits.
Bross & Frankel’s ERISA disability attorneys have the experience and knowledge necessary to address the insurer’s reasons for denying your claim. We’ll get to work to give your appeal the best chance of success.
If you have been denied long term-disability or your benefits have been terminated, or if you have questions about applying for benefits, contact our disability benefits attorneys today.
We Take on Insurance Companies of All Sizes
Our long-term disability lawyers have helped Pennsylvania and New Jersey residents with their claims and appeals of denied benefits from insurance companies both large and small. We have advocated for clients with a range of insurance plans and insurance companies, including:
- The Hartford
- Liberty Mutual
- Sun Life
- Lincoln Financial
- Dozens of other private and ERISA disability insurance companies
Having an attorney who is familiar with long-term disability claims and the private disability insurance companies that deny them is vital to the success of your case. This is a difficult and specialized area of the law. Our firm only takes cases that we think we can win, and in most cases, we only earn a fee if we do.
When talking to a disability insurance attorney — even if it isn’t us — make sure that you feel comfortable that he or she knows how to fight LTD denials and win. Any lawyer that you talk to should also be realistic about the difficult hurdles the insurance companies and the law have put in front of people. The attorney-client relationship is an important one and should be built on trust, starting with honesty about the process.
Nobody wants to have to use disability insurance, but you want it to be there for you when you need it. When a claim is denied or terminated, that’s why we get to work when you can’t ®️.Contact us or call us today at 856-795-8880 for a free consultation and case evaluation.