Lake Charles, Louisiana Long-Term Disability Attorney

An individual in Lake Charles, Louisiana, can recover long-term disability (LTD) benefits under an ERISA policy if they meet specific conditions. They must ordinarily be covered under their employer’s LTD plan and have a medical condition that prevents them from working. Additionally, they need to have completed the “elimination period” (usually 90 to 180 days). Strong medical evidence proving their disability is required to support their claim and receive benefits.

At J. Price McNamara ERISA Insurance Claim Attorney, our team can file a claim for benefits on your behalf and handle every step of the process for you, including filing an appeal if the insurance company denies your claim or undervalues it.

For a free case evaluation and legal consultation with a skilled Lake Charles, long-term disability attorney, please contact us online right away.

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Why Select Us?

When it comes to long-term disability claims, insurance companies are never on your side. They will do just about anything to protect their bottom line and avoid making a payout. At J. Price McNamara ERISA Insurance Claim Attorney, we understand the tactics that insurance companies routinely use, and we know how to combat those tactics effectively. You can see our most recent client testimonials online.

How Much is a Long-Term Disability Claim Worth in Lake Charles, Louisiana?

When filing a long-term disability (LTD) claim under an ERISA (Employee Retirement Income Security Act) policy in Lake Charles, compensation is available for various damages. The amount you may receive depends on several factors, including your policy terms and the specific details of your case.

Compensation:

• Monthly Disability Benefits – The most common form of compensation is a monthly benefit, typically being a percentage of your pre-disability income. Many policies pay around 60 percent of your salary, though the exact amount depends on your individual plan.
• Cost of Living Adjustments (COLA) – Some LTD policies include COLA, which adjusts your benefits annually to keep up with inflation. If your policy has this feature, you may receive increased benefits over time.
• Partial Disability Benefits – If you can return to work in a limited capacity but earn less than you did before your disability, your policy may provide partial benefits. This compensates for the gap between your current and pre-disability income.
• Retroactive Payments – If there is a delay in the approval of your LTD claim, you may be entitled to retroactive benefits. These will cover the period from when you first became disabled until your benefits were approved.

Factors That Determine Compensation:

• Pre-Disability Income – Your monthly benefit is typically calculated as a percentage of the income you earned before becoming disabled. The higher your pre-disability income, the higher your benefits.
• Policy Limits – Every policy has its own maximum monthly benefit limit. If your calculated benefit exceeds this cap, you will only receive the maximum allowed under your policy.
• Definition of Disability – Policies often have different definitions of disability. Some pay benefits if you are unable to perform your job, while others only pay if you cannot work in any job at all. Your compensation will depend on how your policy defines a disability.
• Offsets – LTD benefits may be reduced if you receive other sources of income, such as Social Security Disability Insurance (SSDI) or workers’ compensation. These offsets can lower your overall benefit amount.

Occurrences that May Lead to a Long-Term Disability Claim in Lake Charles, Louisiana

In Lake Charles, several types of injuries, illnesses, and medical conditions can lead to an LTD claim under an employer-sponsored ERISA plan. These disabilities may affect a person’s ability to work and live a normal life. Here are some of the most common reasons people file for LTD benefits.

• Musculoskeletal Disorders – Injuries to muscles, bones, and joints are a leading cause of LTD claims. Conditions like back injuries, arthritis, and spinal disorders can cause chronic pain and limit movement. These conditions often result from physical labor, accidents, or aging.
• Cardiovascular Diseases – Heart disease, hypertension, and stroke are also common causes of long-term disability. These conditions can severely affect a person’s ability to work, especially if they require physical activity or cause frequent medical issues, such as fatigue or shortness of breath.
• Mental Health Conditions – Mental illnesses like depression, anxiety, post-traumatic stress disorder (PTSD), and bipolar disorder are increasingly being recognized as serious disabilities. These conditions can affect someone’s ability to concentrate, manage stress, or maintain a regular work schedule.
• Cancer – Individuals diagnosed with cancer often need long-term treatment, which can make it difficult to work. In addition, the side effects of chemotherapy, radiation, and other treatments can be physically and mentally draining.
• Neurological Disorders – Conditions such as multiple sclerosis, epilepsy, and Parkinson’s disease can limit mobility, coordination, and cognitive function. These disorders typically worsen over time, making it difficult for someone to maintain employment.
• Chronic Illnesses – Long-term illnesses like diabetes, chronic obstructive pulmonary disease (COPD), and kidney disease can require frequent medical care and limit someone’s ability to work.

How to Successfully Prove a Lake Charles, Long-Term Disability Claim

To successfully prove the legal elements of an LTD claim under an ERISA policy in Lake Charles, you must meet certain criteria and provide strong evidence. ERISA policies – usually offered through your employer – have specific requirements for filing and winning an LTD claim.

• Coverage Under an ERISA Policy – The first step in proving your LTD claim is showing that you are covered under your employer’s ERISA policy. You must have been employed with a company that offers long-term disability insurance and must be a participant in the plan. This involves showing that you paid into the policy through payroll deductions or that the employer provided the coverage as part of your benefits package.
• Medical Condition and Disability – Next, you must prove that your medical condition qualifies as a disability under the policy’s terms. This condition must also prevent you from working. Some policies consider you disabled if you cannot perform your current job, while others require you to show that you cannot do any work at all. To prove this element, you will need medical evidence such as doctor’s reports, diagnostic tests (including X-rays and MRIs), treatment records, and other documents that clearly outline your condition and its effect on your ability to work.
• Elimination Period – Most LTD policies have an “elimination period,” meaning a waiting period (usually 90 to 180 days) before benefits can be paid. During this period, you may need to rely on short-term disability benefits or other forms of income. You must prove that your disability has lasted through the elimination period and that you are still unable to work.
• Medical Evidence and Ongoing Documentation – The key to winning an LTD claim is providing clear and convincing medical evidence. This includes up-to-date medical records, test results, and statements from your healthcare providers. You must also comply with any requests from the insurance company for additional documentation or medical exams to prove that your condition persists.

Successfully proving these elements will help to ensure that your LTD claim under an ERISA policy is approved.

Fighting the Insurance Company in a Lake Charles, Louisiana Long-Term Disability Claim

If you’re filing an LTD claim under an ERISA policy in Lake Charles, you may be battling the insurance company to get the benefits you deserve. Insurance companies often deny claims or delay payments, but having the right legal representation can make a big difference. At J. Price McNamara ERISA Insurance Claim Attorney, here’s how we can fight the insurance company for you:

• Reviewing Your ERISA Policy – The first step is to carefully review the terms of your ERISA policy. Every policy has specific rules about what qualifies as a disability and how benefits are calculated. We will ensure that you meet all of the requirements and identify any loopholes or clauses the insurance company may try to use against you.
• Gathering Strong Medical Evidence – One of the most important parts of winning a long-term disability claim is having strong medical evidence. Insurance companies often deny claims because they believe there isn’t enough proof that you’re unable to work. We will work with your doctors to gather comprehensive medical records, test results, and detailed reports that clearly explain your condition and why you cannot work. This evidence is vital to proving your disability.
• Handling Communication with the Insurance Company – Insurance companies sometimes use tricky tactics to confuse or pressure you. They may ask for repeated documentation, schedule numerous medical exams, or try to catch you saying something that hurts your claim. We will handle all communication with the insurance company, so you don’t have to worry about saying the wrong thing or being tricked into a lower payout.
• Filing Appeals if Your Claim Is Denied – If your claim is denied, don’t give up. ERISA policies require you to go through an internal appeal process before filing a lawsuit. We will handle your appeal by gathering more evidence, addressing the reasons for the denial, and strengthening your case. We’ll ensure all deadlines are met and your appeal is filed properly.
• Taking Legal Action if Necessary – If your claim is still denied after the appeals process, we can take the fight to court. We will file a lawsuit on your behalf, using all of the evidence and legal strategies necessary to win your case.

By handling every aspect of your claim, we can fight the insurance company to get the LTD benefits you deserve in Lake Charles.

Successfully Litigating a Long-Term Disability Claim in Lake Charles, Louisiana  

When you litigate an LTD claim in Lake Charles, under an ERISA policy, the case typically moves to federal court. The process involves several key steps, each important to pursuing and maximizing your benefits.

• Filing the Complaint – The first step in litigation is filing a formal complaint in federal court. This document outlines the facts of your case, including the details of your disability, the terms of your ERISA policy, and how the insurance company wrongfully denied your claim. The complaint also includes legal arguments explaining why you are entitled to benefits under the policy. Once filed, the court officially opens the case.
• Serving the Insurance Company – After the complaint is filed, it must be “served” on the insurance company. This means the company must receive a copy of the complaint and be formally notified that they are being sued. The insurance company then has a limited period of time to respond to the complaint – usually by filing an answer that either admits or denies the allegations.
• Discovery Process – Once the case is underway, the parties enter the discovery phase. Discovery is a period where both sides gather evidence to support their claims. In an ERISA case, this typically involves exchanging documents related to your medical condition, the insurance policy, and the insurer’s reasons for denying the claim. ERISA cases are often decided based on the “administrative record,” which includes all of the information the insurance company used to make its decision. 
• Summary Judgment – Most LTD cases under ERISA are resolved through summary judgment rather than a full trial. During this phase, both parties submit briefs to the judge, arguing why they believe they should win the case based on the evidence in the administrative record. The judge reviews these arguments and issues a decision. If the judge rules in your favor, the insurance company will be ordered to pay your benefits. If the judge rules against you, your claim is denied.

Talk with an Experienced Lake Charles, Louisiana Long-Term Disability Attorney Right Away 

The experienced team at J. Price McNamara ERISA Insurance Claim Attorney can aggressively advocate for you during your LTD claim and pursue the fair benefits you deserve. For a free case evaluation and legal consultation with a knowledgeable Lake Charles, long-term disability lawyer, please contact us online or call us at (225) 201-8311 today.

Don't face the challenges of a long-term disability alone. Reach out to a seasoned Lake Charles, long-term disability attorney today and get the legal support you need. With their experience by your side, you can focus on your well-being. Don't wait - contact a Louisiana ERISA Lawyer right away to ensure your rights are protected and your future is secure.