Because of the potential for an illness or injury to disable a worker, many New Orleans residents pay for long term disability coverage either through their employer or through a private plan. Unfortunately, while many employees pay for this insurance with the hopes that they will be covered in the event of an accident, some injured workers who file a claim meet resistance.
If you were injured on the job and are seeking aid, you might wish to contact an experienced New Orleans long term disability insurance lawyer. A dedicated ERISA attorney could help you through each step of the application or appeals process and work tirelessly to get you the benefits you need.
Eligibility for filing and receiving a claim approval might vary, depending on if a worker has a plan governed by the Employee Retirement Income Security Act (ERISA) or one they purchased on their own. If a claim for long term disability insurance is through an employer, it is likely covered under ERISA. However, long term disability plans usually have strict requirements for claim approval.
Reviewing the summary plan description to find out if a disability meets the outlined definition of disability should be the first step in filing a claim for both ERISA and non-ERISA plans. By working with a meticulous lawyer, an injured worker in New Orleans could determine if they qualify for long term disability insurance.
Most long term disability policies exclude any conditions that were present within a certain period—usually 90 or 180 days—before the coverage began. This is because these injuries or illnesses would be considered pre-existing conditions. Unfortunately, if the need for coverage arises due to a pre-existing condition, the claimant is not usually eligible for benefits.
While approval for a long term disability insurance claim is never guaranteed, there are steps a claimant could take to help increase their chances for success. For example, it might be imperative that the claimant has a statement from their physician affirming the severity of the condition in question, as well as any supplemental medical records needed to back up their claim.
An experienced long term disability insurance attorney in New Orleans could help with obtaining and properly implementing these records into a claim. Additionally, a claimant should always follow their doctor’s advice regarding treatment and care for their condition, both for their own health and to prove that the disability is ongoing.
Claimants who receive a denial on their first attempt have the right to an appeal. Once a claimant receives the denial letter, they should closely examine the denial reason and note the deadline for filing an appeal.
Under 29 CFR § 2560.503-1, denied claimants have 60 days to file an appeal. Adhering to the deadlines for filing and appealing a claim could be crucial to its success. While there might be exceptions, missing this deadline usually voids the validity of a claim.
When filing an appeal, it could be essential to add any medical records or information that may be pertinent to the case at that time. Once the file is closed, the claimant can no longer add any prudent evidence. A New Orleans long term disability insurance lawyer could work to ensure that the file includes the right information.
Whether you have already started the application process for a disability insurance claim, need assistance with an appeal, or simply want to find out if your illness or injury is appropriate grounds for long-term benefits, a New Orleans long term disability insurance lawyer may be able to help.
A determined attorney familiar with the claims process should know the tactics used by insurance companies to wrongfully deny claims and could help you combat them effectively. For more information about how seasoned legal aid might be able to help you, call today.
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