The car crash left you paralyzed from the waist down. The slip and fall accident at work has left you with neck and back injuries and you are having mobility issues. Getting out of bed in the morning is a major feat. Simply walking to the bathroom requires all the energy you can muster.
You know you are disabled, so that is all that matters, right? Not when it comes to a disability claim. Getting the insurance company to approve your claim can be a long, frustrating process. Even if you know you can not perform your job duties, your doctor may not know that. The insurance company may not know it. If there is not sufficient proof that you are disabled, your claim will be denied.
You can appeal the denial, but you will need a lawyer to help. Your claim is likely denied under ERISA law. ERISA refers to the Employee Retirement Income Security Act, which is a law that governs employee benefits. The appeal process for ERISA claim is quite complicated. In order to win your case, be prepared to contact an experienced ERISA lawyer for help.
A valid long-term disability claim has three main elements:
In order to prove these three elements, your doctor needs to certify your disability and give you specific restrictions for your job. He or she should also be ready to explain to the insurance company how these restrictions limit your ability to do your job. The insurance company will not just take your doctor’s word for it. There need to be examples of your disability.
If you tell your doctor you are in pain all the time, the doctor can not simply relay this information to the insurance company. The insurer wants more details. They want to know that the doctor performed tests and the results were consistent with someone who would be in constant pain.
It is also important to know that a disability does not automatically mean a person can not do his or her job. A person who suffers a knee injury can still do computer work. A person who injures a wrist can still perform duties as a professional soccer player. The disability has to limit one’s ability to perform his or her job duties, and this can vary depending on one’s occupation,
Disability claims can be hard to fight on your own. Do not lose out on your right to receive benefits for lost income and other damages.
Has your claim been denied? If so, make sure you get the benefits you deserve. Contact a San Antonio long-term disability lawyer from the Law Offices of J. Price McNamara. He understands how complex ERISA claims can be. To learn about your options, contact our office to schedule a free consultation.
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