If you have suffered from an illness or injury, regardless of whether it was obtained on the job, you may be eligible for long-term insurance disability benefits through your employer’s plan, as governed by ERISA, the Employee Retirement Income Security Act.
However, because these determinations are ultimately left up to the insurance companies that also pay out the benefits, your chances of being turned down for benefits you deserve—and for which you or your employer have been paying premiums—are very high, warranting the assistance of an experienced ERISA attorney in order to ensure that your benefits have not been unfairly denied.
At the Law Offices of J. Price McNamara, we are dedicated ERISA attorneys who have committed ourselves to pursuing long-term disability claims on behalf of our clients in Decatur and throughout Alabama. We not only offer a free consultation, but answer all of your questions free, and work on a contingent fee basis, which means you do not pay us anything—we are only paid if you are first awarded your benefits.
First and foremost, it is important to understand that the terms and conditions of how and when you can receive long-term disability are in large part dictated by the actual plan to which your employer subscribes. For example, many policies dictate that you are only eligible for benefits if your disability is so severe that you cannot work in any occupation for which you are reasonably qualified, and some find ways of reducing your benefits due to external factors, such as if you qualify for or receive Social Security disability income benefits.
And aside from what the plan specifically provides for, insurance companies come up with a number of excuses to deny benefits, for example, finding that there is “not objective medical evidence on file to support disability.” Frequently, companies will send a claimant’s file to independent medical experts, who disagree with the claimants’ doctors that they cannot perform work—even without conducting a physical examination of the claimant.
Other common reasons insurance companies site to deny benefits include:
Many people do not realize that most of the time, even if the insurance company denies your benefits, this does not mean that it is right to do so. It is their prerogative not to pay out benefits. But it is within your right—under the law—to appeal any decision to deny or terminate your benefits, and it does not cost you to fight. Our attorneys work on a contingency fee basis, meaning that we only get paid if you are successfully awarded your benefits.
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