- Understanding Long-Term Disability
- Why You Might Want to Hire a Lawyer Before You File a Claim
- A Skilled Long-Term Disability Attorney Can Protect Your Long-Term Disability Benefits
Filing a long-term disability claim can provide financial support for you and your family when you can’t work for a long period due to a medical condition. Having long-term disability benefits is vital when paying your daily expenses, since losing your income can have devastating financial consequences.
Medical bills and work-related injuries account for 66.5% of all bankruptcy filings in the United States. Also, 1-in-4 20-year-olds today will become disabled before they reach the age of 67.
If you believe you received a wrongful denial of benefits from the disability insurance company, the appeal process can become confusing with report forms and possible hearings. An experienced long-term disability lawyer from Nessler & Associates can negotiate with the insurance company to get you the long-term disability benefits you deserve.
Understanding Long-Term Disability
Many employers offer long-term disability coverage through their insurance plans. You may also have this type of policy through an insurance company or broker. Long-term disability insurance benefits kick in upon the expiration of your short-term disability benefits, usually after 90 days. These benefits may last until you can return to work or for a specified period in your policy, such as until retirement age.
Long-Term Disability Insurance Coverage in Illinois
This type of coverage typically covers most physical and mental conditions, including substance abuse. However, your individual disability benefit plan may have some exclusions for certain conditions.
Pre-existing conditions
If you have a pre-existing condition and have received treatment for it, your plan may limit its coverage. Our experienced long-term disability attorneys can review the pre-existing condition language in your policy to determine if you qualify for a claim.
We will consider your previous medical treatment, the length of time you can receive long-term disability benefits, and when you can file your disability claim.
Mental health conditions
Long-term disability insurance policies usually cover disabilities caused by mental illness. However, the maximum benefit period may be limited unless you were under hospitalization.
Certain insurance policies may require specific treatments, such as in-patient rehabilitation, for a disability insurance claim to be payable. However, they may limit the amount of benefits you can receive for your condition.
Physical disabilities
Most physical conditions have coverage under long-term disability policies. Insurance companies usually require medical evidence to prove a debilitating illness or disability, such as imaging tests.
However, claims for fibromyalgia, chronic fatigue syndrome, and similar conditions may have a limited benefit period. Since these physical disabilities are based on self-reported symptoms, some insurance companies can exclude coverage entirely.
An experienced disability lawyer from Nessler & Associates who is familiar with these policies can assist you in learning more about the long-term disability policy definitions. They can ask for a copy of your insurance policy. Your lawyer reviews all the policy terms and processes, including the time limits for filing a claim, the exclusions for certain conditions, and the company’s definition of disability.
Why You Might Want to Hire a Lawyer Before You File a Claim
Your insurance company requires you to fill out forms to evaluate your application for benefits. These insurance company forms include:
- Your claim form
- Employer’s claim form
- Authorization form allowing medical providers, financial institutions, and government departments to release your information to the insurance carrier
- Statement from your physician
Before you file a disability claim under your long-term disability insurance policy, you can retain the legal services of an experienced disability insurance lawyer. We can help you complete your insurance claim forms. Your attorney can also help navigate the disability claim process and answer questions.
Relevant Evidence for a Disability Claim
During the application process, your lawyer can prepare your disability claim file with compelling evidence to show the depth of your disability. These critical pieces of evidence for your claim may include:
- Medical records of your MRIs, CT scans, and blood tests as proof of disability
- Evaluations from health care experts, such as rheumatologists and psychologists, to establish the existence and severity of your disability
- Additional evidence such as a personal journal demonstrating your pain and suffering from your disability
- Statements from family members, friends, and employers to prove the impact of your disability on your quality of life
Even if the insurance company denies your initial claim, the evidence can still hold up your claim during the appeal process. Your experienced attorney can review the denial letter and develop a legal strategy to help you win the benefits you are entitled to.
Appealing Bad Faith and Wrongful Denials in Long Term Disability Claims
Some insurance companies can deny or delay your claim unfairly in ways known as bad faith acts. These involve:
- Attempting to give you misleading information about the terms in your insurance policy
- Delay in paying the full amount in your claim benefits
- Denying your claim with little to no reason to prevent paying your benefits
- Requiring excessive information to prove the diagnosis of your disability
Under the Employee Retirement Income Security Act (ERISA), insurance companies must inform consumers of their disability plans’ terms and conditions. These companies must also manage disability claims from consumers appropriately.
ERISA also sets the minimum standards for all insurance providers to have a disability benefits appeal process for consumers in the event of unreasonable denials. If you have gone through the appeal review process with the insurance company, ERISA also lets you sue your insurance company in federal court for your benefits.
An experienced disability attorney can help you with the appeals process if you believe the insurance company has taken part in bad faith actions. We can advocate for your legal rights throughout the appeal process and negotiate damages, including a lump-sum settlement with the insurance company. If needed, we can represent you in court to assert your claim for disability benefits.
A Skilled Long-Term Disability Attorney Can Protect Your Long-Term Disability Benefits
If you can’t work because of a long-term illness or injury, reach out to an experienced long-term disability claims lawyer as soon as possible. The attorneys at Nessler & Associates have over 35 years of experience helping clients file their disability benefits claims when they need financial compensation the most.
In our practice, we represent only policyholders, not insurance companies, so we are committed to ensuring that the best possible outcome is achieved for your claim.
Schedule a free, initial consultation with a disability insurance attorney by calling (800) 727-8010. We can help you move quickly to gather evidence and file your application for disability benefits with your insurance company.
