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Nashville Long Term Disability Lawyer

Nashville Long Term Disability Lawyer

Nashville, TN is quickly becoming a boomtown in the region, with thousands of new jobs being added in recent years. Downtown Nashville is seeing a steep increase in the number of high-tech and well-paying jobs. Many employers use competitive and generous benefits packages to recruit highly skilled workers. One common part of many employer benefit plans is a long term disability (LTD) plan.

Sadly, a lot of people do not really understand how these plans operate until they need to use them. Many people are denied their benefits when they need them most This can be especially devastating for single-income families that depend on every paycheck to meet their financial responsibilities.

If you have been denied LTD benefits in Nashville, TN, call the Law Offices of J. Price McNamara today to get aggressive legal representation. Our firm will carefully evaluate your LTD benefits denial to see whether the denial was justified or not. People are often surprised to realize just how common unfair and improper denials really are.

Why are LTD Benefits Denied?

There are typically two broad categories of denials that people can receive. These are either “technical” or “substantive” denials. Regardless of why your LTD benefits have been denied, time is of the essence. Your plan contract will likely dictate how long you have to file an appeal. If you fail to meet contract terms, you could forever lose your right to benefits. When you and your family are out of work and depending on your insurance policy to kick in, you can not afford to let too much time go by. Give the Law Offices of J. Price McNamara a call right away for a completely free case evaluation.  

What Does the Law Say About LTD Benefits?

Although not all long term disability plans are governed by federal law, the fact is that most are. If you work for a large employer, a school district, a union, or a government agency, chances are you are covered by a law known as the Employee Retirement Income Security Act of 1974 (ERISA). This complex federal legislation includes a wide range of protections for employees.

Ways that ERISA Protects Employee Benefits

An LTD disability plan is designed to provide you a regular paycheck while you are out of work due to a long-term disabling condition, such as an injury or health problem. Some employers choose to self-administer their benefit plans by pooling premiums and managing the plan funds. Other employers use a third-party administrator (TPA) to handle the routine functions of the plan benefits. In both situations, whoever is in charge of the funds must act in a fiduciary capacity to prudently administer, invest, and pay out plan assets in a way that is in the interests of plan participants. This protects employees from seeing their investments and benefits misapplied and eroded.

LTD Benefit Denials

LTD insurance carriers often use technical denials to quickly and efficiently refuse payments to people, even when there is merit to the claim and the participating employee has dutifully paid premiums year after year. Common technical denials may include:

  • Failure to file a claim within the required period of time after learning of a disabling condition or disease
  • Failure to include the correct type of medical report with your claim
  • Treatment for a related pre-existing condition within 90 days (or other periods of time set forth in the policy) prior to the plan taking effect
  • Failure to use the proper forms
  • Failure to submit medical bills and records with appropriate ICD-9 codes and other diagnostic information

While technical denials are by far the most common, there are also more substantive denials, which may be based on a lack of adequate medical evidence. This does not mean your claim is without merit; it simply means the evidence submitted is not being considered the way it should. In many cases, doctors lack experience writing reports for LTD insurance plans, or the medical evidence does not clearly address your inability to work in your profession.

How a Nashville Long Term Disability Attorney can Help

At the Law Offices of J. Price McNamara, we understand just how important a long term disability plan can be, so we work fast to secure the benefits you deserve. Call us today to schedule a private consultation free of charge.

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