You can get help with your legal needs if you have to take time away from your job with a Baton Rouge long-term disability lawyer from our team at ERISA Insurance Claim Attorneys.
Time and time again, an unreasonable insurance company denies employees expecting disability insurance benefits for a crippling injury or illness. While it is a tough fight, you can legally stand up for yourself and push back.
First, you need a Baton Rouge insurance claims lawyer who knows how to take the fight to the insurance company, even on their home turf. We get results for clients with injuries and disabilities. If you have a long-term disability claim, contact us for assistance. We have over 30 years of experience to apply to your claim.
Why Hire a Long-Term Disability Lawyer in Baton Rouge, LA?
Hiring an attorney to help with your long-term disability claim can strengthen your chances of getting the benefits you need. Our law firm knows how to stand up to big companies on behalf of our clients, leveling the playing field for disabled individuals.
Even though your company may have offered you long-term disability insurance as an employee benefit, the company with which they partnered to deliver this benefit has its own ideas and wants to protect its bottom line.
You can reach out to us for professional assistance from a Baton Rouge disability claims lawyer before filing a claim for benefits or after a denial of your claim. We can even discuss long-term disability eligibility.
When Should You Contact a Long-Term Disability Attorney?
You can reach out to us for help before you request disability benefits. We can review your application and help you avoid mistakes that could result in a long-term disability insurance denial.
We're also ready to address your legal concerns if the company denies your benefits. After a denial, we can help you file an administrative appeal, potentially overturning the denial and securing the benefits you need.
If the company denies your administrative appeal, you can contact our firm. An experienced disability attorney can help you file a lawsuit in this situation.
What does Long-Term Disability Cover?
Long-term disability insurance can provide 40 to 70 percent of your income before your illness or injury when you can show that you are disabled. The average duration of a long-term disability claim is 2.5 years, but it can pay you benefits until you qualify for Social Security if you cannot work again.
Each plan has its definition of disability that you must meet to qualify for benefits. In theory, becoming eligible for benefits should not be a complicated process.
Your doctor can document your inability to work, and the disability insurance company should pay you what you deserve since your plan is a contract. You may use a long-term disability payout calculator to understand your possible benefits.
A Complex Law Called ERISA Governs Your Plan
When your employer provides long-term disability insurance as an employee benefit, different rules apply. Employee benefits fall under ERISA (Employee Retirement Income Security Act). While lawmakers passed the law to protect employee benefits, it put procedures into place that favor insurance companies.
However, ERISA does not give insurance companies a blank check to disregard the promises they made to you in the plan documents. You can still hold them accountable in court no matter how much they fight (and they will).
Insurance companies have a wide latitude in denying claims if they can find a credible reason. You cannot sue insurance companies under state law claims for bad faith. Find out more about the laws surrounding your claim with a Baton Rouge ERISA lawyer.
What We Need to File with Your Initial Claim
We must prepare a comprehensive claim with the necessary proof to show the disability insurance company that you meet the plan's definition of disability.
We may include the following with your initial claim:
- The test results and scans that show your disability and the extent of it
- A statement from the physician who has treated you and is most familiar with your condition
- Statements from people who know you and observe you every day
- Opinions from vocational experts who know your profession and can testify that you are unable to fulfill the duties of it
Even if we come armed with all this evidence, it may not be enough to persuade the company to grant benefits. The company knows that if they grant benefits, they will need to pay hundreds of thousands of dollars, or even more, over the life of your claim.
Even though practically everyone else in this world may see the reality of your situation, the company can have millions of reasons to ignore that reality and avoid providing you with financial assistance.
Expect Challenges to Getting Fair Benefits
The insurance company is a self-interested referee, passing judgment on your claim when they are the ones who must pay out benefits. You can understand how this is a recipe for abuse. The same company that must pay you is deciding your entitlement to benefits.
The system results in many unjust and unfair decisions, where the disability insurance company denies benefits to people who are disabled. From your standpoint, you must put together the most compelling claim possible in the hopes that it will persuade the insurance company to grant benefits.
It is certainly possible to have your initial claim approved, especially when you have documentation that shows the extent of your disability. Especially when you have a sizable potential claim (for example, a permanent disability that will keep you from working again), you should work with an attorney to prepare your initial claim.
Why Insurance Companies Deny Long-Term Disability Claims
Insurance companies may deny your claim, giving one of the following reasons:
- They do not think that you meet the plan's definition of disabled.
- They hired someone to conduct surveillance on you, and they believe they have evidence that can undermine your claim
- They claim that your condition was a pre-existing one that the terms of your plan do not cover
- There is insufficient evidence to persuade them of the extent of your disability
- Their doctors disagree with the conclusions that the treating doctor who examined you initially reached
- They claim that you did not follow the requirements of the plan in applying for benefits
A claim denial is not the end of the road when you seek benefits. It can begin a long and challenging process to fight the insurance company, which you must go through to receive long-term disability benefits.
The insurance company must provide you with a reason why they denied your claim. They must also provide you with the documents they relied on to reach their decision. If you are not already working with an attorney, now is the time to call one.
Your Baton Rouge long-term disability lawyer may add documents to your file and respond to the insurance company in a way that can address their concerns.
We Can Appeal to the Insurance Company
We must first go to the insurance company to contest your claim denial. As futile as this may seem, ERISA requires it. The insurance company will have the first chance to review your appeal.
You cannot expect the fox to guard the henhouse no matter how much the insurance company promises objectivity in reviewing your case. The chances are that they will deny your appeal because they do not make money by granting benefits.
However, ERISA requires you to put as much effort into the appeal. You only get one chance to build the record for the appeal. The federal district court and the insurance company will use the same record to decide whether you can get long-term disability benefits.
You can discuss your steps in this situation with a Baton Rouge disability appeals lawyer.
We Can Help You Appeal Through the Court System
If you lose your insurance company appeal, we can take steps to have a federal judge review your case. At this point, you will get an objective decision maker for the first time in your case who has no financial self-interest.
The federal judge may use one of two standards of review, depending on the language in your plan:
- A de novo review where the judge decides your benefits based on their independent review of the record and not considering what the insurance company had to say
- A review of the insurance company's decision to determine whether it was unreasonable
Either way, the federal part of the legal process can help you overcome a biased and wrong decision denying you benefits. Before you get to that point, we must work to strengthen the record after the company first lets you know that they denied your claim.
A Baton Rouge long-term disability attorney can add information they claimed was missing to have a better record. The company may even try to settle your case because it does not want to lose and make a new legal precedent.
How You Can Win an ERISA Long-Term Insurance Appeal
Federal courts can overrule the insurance company based on some of the following grounds:
- The insurance company wrongfully ignored the opinion of your treating physician in favor of their “independent” doctors, whose only relationship to the claim is that the insurance company paid them to review your file
- You did present enough documentation for the insurance company to conclude that you were disabled
- The insurance company misread the plan's definition of disability, making it more strict than it was on paper.
- The insurance company took snippets of information out of context when they claimed that surveillance found that you were not disabled.
A Baton Rouge long-term disability lawyer can explore all options to appeal your denial so you can get disability insurance benefits.
We Can Help You Win Your Appeal
Although ERISA does not make it easy for you to fight the insurance company, you can win when you find an experienced long-term disability insurance attorney in Baton Rouge, LA, to champion your case.
You can take the case further if you do not win at the federal district court level. You can proceed to the federal appeals court to review the district court judge's ruling. The appeals court can only review the district court judge's decision, and they cannot take new evidence.
Long-term disability benefits are critical for your family's financial support when you can no longer work. These claims will pay you benefits until you can work again. For some claimants, these benefits will last until when they would have retired. You can also accept your payments in a lump sum when you settle with the insurance company.
Insurance Companies May Try to Take Your Benefits Away
Even when the insurance company grants benefits, they may try to take them away at some point. Insurance companies will argue that you can do some work, notwithstanding your condition. Many plans pay for a set period when you cannot do the job that you did.
After that period, the plan's definition of disability may change to being unable to do any work at all. At this point, the insurance company often tries to tighten the screws and remove people from their roles. You can also fight this decision through an appeal.
Reasons to Pick Our Team for Your Claim
Our team at ERISA Insurance Claim Attorneys can help you apply for long-term disability, and we know how to support you during the appeal process. We have a track record of success and decades of legal experience to apply to your claim, so reach out to us today.
You never have to try to take on an insurance company without help. These companies know exactly what they are doing because they have done the same thing for as long as they have sold long-term disability insurance. We know how to beat insurance companies at their own game.
You can feel confident with an experienced disability lawyer on your side. Our lawyers and paralegals have been trauma and cognitive interview trained at the Center for Hope.
Call Us About Your Long-Term Disability Claim in Baton Rouge, LA
Never try to take on the insurance company alone. They have an army of adjusters and litigators whose interests differ from yours. Insurance companies make money by denying every claim they think they can deny. Being denied benefits when you need them most can be devastating.
Fortunately, you can rely on a Baton Rouge long-term disability lawyer to stand up for you. We have extensive experience and can explain your legal rights.
Our legal team at ERISA Insurance Claim Attorneys fights for clients who have wrongfully had their long-term disability insurance claims denied by a conflicted insurance company.
We can also work with you before you file the claim in the first place to help you build the most potent possible file. Your benefits are too important to leave anything to chance.
Baton Rouge Office
10455 Jefferson Hwy,
Suite 2B
Baton Rouge, LA 70809
Phone: 225-425-7917
Fax: (225) 201-8313
(By Appointment)
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