Although the Employee Retirement Income Security Act (ERISA) was designed to protect employees who are unable to work due to illness or injury, filing a claim can be an extremely onerous process, especially because your claim is reviewed by your employer’s insurance company, which has every interest in denying the claim. One oversight—or mistake—can place your benefits in jeopardy and introduce a significant amount of unjust delay.
This is why an attorney who specializes in long-term disability/ERISA litigation can be extremely helpful. ERISA attorneys not only know the ins and outs of the application process but are well-versed in dealing with appeals that end in success.
As soon as you are unable to work, contacting a long-term disability attorney will help you proceed strategically through every step of the claims process. One of the most important aspects of your application, for example, is to include all of the relevant evidence upfront because you cannot introduce new evidence when you file a lawsuit. In other words, your attorney will “stack the record,” and include all of the relevant medical evidence and other information that is needed to make your application (and, if necessary, appeal) as successful as possible.
No one is more familiar with how insurance companies work in this area than the attorneys at The Law Offices of J. Price McNamara. Having previously worked for insurance companies, we know the intricate ins and outs of how to get the job done for our clients, and we handle cases on a contingency fee basis, so we only get paid if/when you get paid.
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.
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 cite to deny benefits include:
Under a contingency fee basis, you do not pay your attorney a cent unless you win your case and receive your benefits. Contact us today with any questions you have. We answer all questions FREE OF CHARGE.
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