You deserve comprehensive compensation benefits in the wake of a workplace accident. While workers’ compensation can cover some of your expenses, your injuries may require more immediate support. Fortunately, our Houston short-term disability lawyers can help you file an ERISA claim asking for support.
ERISA Insurance Claim Attorneys bring a unique perspective to your fight for compensation. Our Houston insurance claims lawyer have been through the ERISA disability claims process and have a unique understanding of your situation. We’re ready to put over 30 years of experience to work for you and your family.
Don’t let an insurance company get away with slowing down your recovery or denying your request for support. Let Price McNamara take your case today.
What Is Disability Insurance?
Disability insurance is a type of insurance policy that employers offer to employees. Disability claimants can rely on disability insurance to cover a portion of their income after a serious accident or illness.
One of the benefits of disability insurance is that an insurance company pays the employee’s benefits directly to them, and there are little to no limitations on how the employee spends the money.
Some policies can cover at least 70% of an employee’s income for an extended period, ranging from three months to the employee’s retirement age.
For a free legal consultation with a short-term disability lawyer serving Houston, call (225) 201-8311
Short-Term and Long-Term Disability Insurance
Employees may be offered short-term disability insurance, long-term disability insurance, or both when beginning a new position. These policies vary in coverage and benefit period.
Short-term coverage provides support for anywhere from a few weeks to 12 months or potentially even longer. Comparatively, long-term coverage provides lengthier support, often until an individual can return to work or reaches Social Security retirement age.
These insurance plans can cover up to 70% of a person’s employee benefits, with greater variation found in long-term plans.
Houston Short-Term Disability Lawyer Near Me (225) 201-8311
When Do Short-Term Disability Benefits Begin?
The benefits from your employer’s insurance policy likely won’t kick in immediately. Both types of disability insurance have an elimination period. Your injury needs to impact your health for a minimum of 14 days, in most cases, to qualify you for support.
However, the amount of time it takes a policy to take effect will vary on your employer’s specific coverage. You may start receiving benefits within seven days. You may alternatively have to wait up to 30.
If you need help breaking down your right to file a claim for disability benefits and that claim’s subsequent timeline, our law firm can walk you through what to expect from the claim process. We can also speak to insurance adjusters on your behalf to ensure that they take your losses seriously.
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Qualifications for Short-Term Disability Benefits
Insurance companies like to stretch the definition of disability to deny the average person the financial support they need to recover from serious accidents. Most providers will require you to pursue a medical examination, during which a medical professional must declare you unable to perform your work duties.
If you receive such a diagnosis, you can continue with your disability claim. You can specifically cite conditions that require specialized treatments, including surgery and rehabilitation, as the cause behind your claim.
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Exclusions to Short-Term Disability Benefits
Even though people can cover most non-work-related medical conditions through short-term disability benefits, there are exclusions. Some common exclusions for short-term disability benefits include:
- Injuries caused by pre-existing conditions
- Self-inflicted injuries
- Injuries from acts of war or conflict
- Hazardous activities
- Work-related conditions
Workers’ compensation insurance can help you secure the settlement you need for work-related injuries. Unfortunately, if you file for workers’ compensation, you cannot file for short or long-term disability benefits.
If you think you’re facing wrongful exclusions when trying to undergo the claims process after a serious injury, don’t panic. You can work with our legal professionals to gather the additional evidence you need to make your needs known to applicable parties.
What’s more, our team can go to bat for you during the appeals process, at which point we can challenge insurers’ definitions of disabilities and pre-existing conditions to advocate for your right to fair compensation.
Reasons for Short-Term Disability Insurance Claim Denials
Our Houston, TX, short-term disability attorneys recognize that some of the common reasons for short-term disability insurance denials involve:
Not Covering a Condition
The conditions that are covered in each short-term disability insurance plan vary. Some conditions are covered through the insurance policy, while others are not. It also does not help that the technical jargon in the insurance policy makes it difficult for you to understand what types of conditions are covered.
Failing to Provide Sufficient Medical Evidence
It is often easy for insurance companies to deny these types of claims because the injuries are temporary. If the insurance company does not believe that the evidence presented is credible, they will deny your claim.
Questioning the Nature of Injuries or Disabilities
The insurance company can also deny your claim if the adjusters believe that your actions contradict the nature of your injury. Insurance adjusters often turn to an employee’s social media platforms and even resort to following employees around to find evidence that can question their injuries.
Inaccurate or Mistaken Information
Insurance companies can deny your claim if it contains any inaccurate information regarding the material facts on your original application.
What to Do After a Denial
When the insurance company has denied your short-term disability insurance claim, it is crucial to understand that you have the legal right to appeal that decision. Your legal rights are protected by the federal law known as the Employee Retirement Income Security Act of 1974, or ERISA.
This federal law allows you to file an appeal for your short-term disability benefits by following several procedures. One of the procedures includes filing an appeal with the insurance company within 180 days of receiving your denial letter. Once you exhaust all of your appeal options, you may file a lawsuit against the insurance company.
How a Houston Short-Term Disability Insurance Attorney Can Help
When you receive your denial letter from the insurance company, you may feel overwhelmed. You may find yourself in a position where you know you want to file an appeal but also want to give yourself the best opportunity to have your claim approved.
When you or a loved one find yourselves in this position, your best option is to contact a Houston, TX, short-term disability insurance lawyer at ERISA Insurance Claim Attorneys. Our lawyers can help with your short-term disability claim appeal in several ways.
We Create Strategies for Your Appeal
One of the ways that our short-term disability insurance attorneys can help with your case is to design the best strategy for your appeal process. Our attorneys can help create a winning strategy by reviewing your denial letter and determining why the insurance company denied your claim. Insurance adjusters are required to provide a detailed explanation for your denial.
We Can Review Your Disability Insurance Policy
Another way that our short-term disability insurance lawyers can help is by reviewing the terms of your policy. Because ERISA appeals require serious attention to detail, one simple mistake can cause you to lose your short-term disability benefits.
An experienced short-term disability insurance lawyer can carefully review all of your documents and ensure that you meet deadlines for your appeal. We can also clarify any confusing language in your policy and strengthen your appeal.
We Offer Practical Legal Advice
The short deadline to prepare the appeal can intimidate claimants. An experienced lawyer can help offer practical legal advice and assist you in presenting the best case for your appeal.
Your legal representative can file paperwork on your behalf, gather and analyze the best evidence for your case, and keep in communication with the insurance company on your behalf.
We Order the Right Records to Send to an Insurance Provider
Another benefit of having a short-term disability insurance lawyer on your side is having someone who can order the proper records on your behalf. When submitting documents for your appeal, the information on each document will be the only information the judge will consider in the ultimate decision.
Because the documentation plays such a crucial role in your appeal, it will be in your best interest to have an experienced attorney submit the best documentation on your behalf.
Short-term disability insurance lawyers are skilled in offering the proper evidence that presents the best case for their clients, including medical records from medical professionals and letters that explain your limitations and ability to work in detail.
We Understand ERISA Requirements
Having a short-term disability insurance lawyer familiar with the ERISA requirements can help strengthen your chances of receiving your desired outcome. An experienced attorney can ensure that your short-term disability appeal process is handled best during every step of the process.
One challenge ERISA requirements bring to a short-term disability benefits appeal is that the requirements tend to favor insurance companies. A short-term disability insurance lawyer with experience with ERISA requirements knows how to present your case in a manner that favors you over the insurance companies.
Get Assistance From an ERISA Houston Short-Term Disability Insurance Lawyer Today
You have legal options when it comes time to recover from an injury or serious illness. ERISA Insurance Claim Attorneys can offer you legal representation that accounts for your concerns and makes the claims process more accessible.
We have personal experience advocating for family members filing these claims–we can prepare you for what’s to come and offer the representation you need to feel heard.
You can schedule a case consultation with an experienced short-term disability insurance lawyer in Houston right now to learn more about our available legal services.
Call or text (225) 201-8311 or complete a Free Case Evaluation form
