Dallas, Texas Long-Term Disability Attorney

When an employee cannot work due to a medical condition, they may pursue benefits under a long-term disability (LTD) claim through an ERISA (Employee Retirement Income Security Act) policy.

ERISA policies, which employers may provide, offer financial support to those with long-term disabilities by replacing a portion of their income. Obtaining benefits involves meeting specific requirements established by the policy and submitting medical evidence to support this claim.

At J. Price McNamara ERISA Insurance Claim Attorney, our team can file a long-term disability claim on your behalf, negotiate with the insurance company, and fight for the full benefits you deserve.

For your free case evaluation and legal consultation with a knowledgeable Dallas, long-term disability lawyer, please contact us online today.

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Why Should We Represent You?

When you need to secure benefits under a long-term disability policy, the insurance company is never on your side.

At J. Price McNamara ERISA Insurance Claim Attorney, we know the tricks and tactics insurance companies routinely use to try and undervalue – or outright deny – long-term disability claims. We will fight for your rights and, if necessary, pursue litigation in your case.

How Much Money Can I Get for a Long-Term Disability Claim in Dallas?

In Dallas, Texas, the value of an LTD claim under an ERISA policy can vary greatly, depending on your income before the disability, the severity of your medical condition, and the specifics of your LTD plan.

Typically, long-term disability benefits under ERISA policies provide between 50 percent and 70 percent of your pre-disability income. For example, if you earned $60,000 per year before becoming disabled, and your policy pays out 60 percent, you will receive $36,000 annually in benefits.

However, determining the exact amount of compensation you can receive involves looking at your policy’s terms. Some policies have caps on how much you can receive, meaning they may limit your benefits to a maximum amount regardless of your previous income.

Additionally, benefits can be subject to reduction if you receive other sources of income, such as Social Security Disability Insurance (SSDI) or workers’ compensation.

The compensation you can receive in an ERISA long-term disability claim generally falls into two categories: monthly benefits and potential back pay. 

Monthly benefits are the ongoing payments you receive while you remain disabled under the terms of your policy. Back pay refers to any unpaid benefits from when you first became disabled until the insurer approved your claim.

If the insurer delays approving your claim, you may receive a lump sum for the benefits owed to you during that period.

It’s important to note that long-term disability benefits are typically not meant to cover 100 percent of your income. Their purpose is to provide partial income replacement to help cover living expenses.

Additionally, some ERISA policies include provisions for rehabilitative services, like vocational training, which help disabled individuals re-enter the workforce in a different capacity.

In Dallas, insurance companies may deny or attempt to reduce claims for various reasons, making ERISA claims complex.

At J. Price McNamara ERISA Insurance Claim Attorney, we can increase your chances of maximizing the benefits you deserve under your policy.

Occurrences that Can Lead to a Long-Term Disability Claim in Dallas, Texas

Several common occurrences can lead to long-term disability claims under an ERISA policy, in Dallas. These events often involve serious injuries or medical conditions that prevent individuals from performing their regular work duties for an extended period of time.

One of the most common causes of long-term disability claims is accidents, particularly those involving motor vehicles. Car accidents can result in severe injuries, such as spinal cord damage, traumatic brain injuries (TBIs), or multiple fractures, which may require lengthy recovery times or cause permanent impairments.

People injured in such accidents may never return to work – especially if they have physically demanding jobs.

Another frequent cause of long-term disability claims is chronic illnesses. Conditions like cancer, heart disease, and severe diabetes can significantly affect a person’s ability to work.

For example, cancer treatment often involves surgeries, chemotherapy, and radiation, which can lead to months of recovery or long-term physical limitations. 

Heart disease or stroke can leave a person with decreased mobility, fatigue, or other symptoms that make it impossible to continue working full-time.

In these cases, individuals may file for long-term disability benefits under their ERISA policy.

Musculoskeletal disorders, such as back injuries or arthritis, are also a leading cause of disability claims in Dallas. Jobs that require heavy lifting, repetitive motions, or extended periods of standing or sitting can lead to conditions like herniated discs, chronic pain, or degenerative joint disease.

These injuries often make it difficult for people to carry out the physical requirements of their jobs, resulting in the need for long-term disability benefits.

Mental health conditions are another significant cause of long-term disability claims. Severe depression, anxiety disorders, or post-traumatic stress disorder (PTSD) can prevent individuals from maintaining employment. Stressful work environments, traumatic events, or personal hardships can contribute to these conditions, leading to long-term disability.

In Dallas, ERISA policies are designed to help individuals who face long-term disabilities resulting from these and other serious conditions. Filing a successful claim, however, can be challenging, as insurers may dispute the severity of the disability or the individual’s ability to work.

At J. Price McNamara ERISA Insurance Claim Attorney, we will do everything possible to recover the full benefits you deserve.

How to Prove the Elements of a Long-Term Disability Claim in Dallas

To successfully prove a long-term disability claim under an ERISA policy, you must provide solid evidence showing that you cannot perform your job due to a medical condition. The insurance company will require detailed documentation to confirm that your disability meets the policy’s criteria.

Here are some key steps to improve your chances of winning a long-term disability claim.

• First, gather thorough medical evidence. This includes reports from your doctors, medical records, lab results, and any other documentation that explains your condition. It’s important that your healthcare provider clearly outlines how your illness or injury limits your ability to work. For example, if you have a back injury, your doctor should describe how the pain and mobility issues prevent you from lifting objects or sitting for long periods, as required by your job.price
• Second, you need to be aware of your ERISA policy’s definition of a disability. Each policy has its own language about what qualifies as a disability. Some policies require that you cannot perform any job, while others only require that you cannot do your specific job. Understanding this definition is vital to proving that your condition meets the standards laid out in the policy.
• Next, consistent medical treatment is important. Insurance companies may deny claims if they see gaps in your treatment, so attending all of your medical appointments and following your doctor’s recommended treatment plan is essential. This shows the insurer that you tried to recover but cannot work due to your condition.
• You should also consider vocational evidence. Some claims require vocational assessments, which determine whether you can perform the tasks necessary for your job or any other job in the market. These assessments can help prove your claim by showing that your disability prevents you from working in any capacity.
• Lastly, hiring our experienced Dallas, long-term disability lawyer can be highly beneficial. ERISA laws are complex, and insurance companies often deny claims or try to reduce benefits. At J. Price McNamara ERISA Insurance Claim Attorney, we can gather the necessary evidence, meet deadlines, and challenge any unfair denials from the insurance company.

Fighting the Insurance Company in a Dallas, Texas Long-Term Disability Claim

Insurance companies often try to deny or limit claims to avoid paying out benefits for an LTD claim.

However, at J. Price McNamara ERISA Insurance Claim Attorney, we can navigate the system for you and pursue the fair compensation you deserve.

• First, we gather strong evidence to support your claim. Insurance companies require detailed proof of your long-term disability, and they may deny your claim if the evidence is unclear or incomplete. We work closely with your doctors to collect medical records, test results, and professional opinions that clearly show how your condition affects your ability to work. We also ensure that the documentation meets the specific requirements outlined in your policy.
• Second, we handle all communications with the insurance company. Insurers often use tactics to pressure claimants into accepting far less than they deserve, including repeated requests for more information or offering lower settlements. By taking over communication, we can protect you from these tactics and ensure your rights are respected throughout the process.
• We also meet all of the deadlines in your case. ERISA claims have strict deadlines for submitting paperwork, appeals, and other documents. Missing a deadline can lead to a denial of your claim. We ensure everything is filed on time, giving your case the best possible chance of success.
• We can file an appeal on your behalf if the insurer denies your claim. ERISA laws require you to undergo an appeals process before taking the insurance company to court. We review the denial letter to understand why the claim was rejected and gather any additional evidence necessary to strengthen your claim. During the appeal, we can argue on your behalf to get the insurance company to reverse its decision.
• Finally, if necessary, we can take your case to federal court. If the insurance company refuses to pay your benefits after the appeal, we can file a lawsuit in federal court, which decides ERISA cases. Throughout this process, we will fight for your right to receive the long-term disability benefits you deserve under your ERISA policy.

Successfully Litigating a Long-Term Disability Claim in Dallas 

When an insurance company denies your claim or appeal, you may need to file a lawsuit in federal court to seek the benefits you deserve. 

Here’s what typically happens during litigation in an ERISA case.

• The first step is filing the lawsuit. ERISA claims are handled in federal court – not state court – which means we must follow specific federal rules and procedures. At J. Price McNamara ERISA Insurance Claim Attorney, we will prepare and submit a formal complaint to the court, outlining why the insurance company’s denial of your long-term disability benefits was wrongful and why you are entitled to receive those benefits.
• Once you file suit, the insurance company can respond. They will file an answer to the complaint, usually defending their denial of the claim by citing medical evidence or policy terms that support their decision. At this stage, the insurance company may also try to dismiss the case, but we’ll argue against such a motion if it happens.
• Next is the discovery process, though in ERISA cases, discovery is often limited. This means that both sides exchange the necessary documents and information that will be used in the case. Typically, the insurance company will provide the administrative record, which contains all the medical records, policy documents, and other evidence used to deny your claim.
• After discovery, the case often moves to summary judgment. Unlike many other legal cases, ERISA lawsuits don’t usually go to trial with witnesses or a jury. Instead, both sides submit briefs to the judge, summarizing the evidence and making legal arguments. The judge will review the administrative record and decide whether the insurance company acted unfairly or incorrectly in denying your claim.
• If the judge rules in your favor, you may receive the long-term disability benefits owed to you under your policy. However, if the judge sides with the insurance company, it may deny your claim. 

Talk With an Experienced Dallas, Texas Long-Term Disability Lawyer Today

When pursuing a long-term disability claim under an ERISA policy in Dallas, the team at J. Price McNamara ERISA Insurance Claim Attorney can handle every step of the process for you and aggressively fight for the benefits you deserve.

For a free case evaluation and legal consultation with a skilled ERISA lawyer in Texas, please contact us at (713) 300-0462.