Texas Disability Lawyer

When you suffer a disabling illness or injury that prevents you from working, you can turn to your employer-sponsored disability insurance for financial support. Obtaining benefits is never an easy process, however, so you want representation from a Texas disability lawyer at J. Price McNamara ERISA Insurance Claim Attorneys.

Table of Contents

• Overview of Long-Term Disability
• What Is Short-Term Disability?
• ERISA Oversees Many Disability Claims
• Common Reasons for Disability Claim
• How Our Long-Term Disability Attorneys Help
• Speak With Our Texas Disability Lawyers

Why You Should Trust Our Firm

Our ERISA insurance claim attorneys focus revolves around our Client-Centered Core Values and our Office Culture Core Values.

Our Client-Centered Core Values include:

• We focus on ERISA claims only to best help our clients
• We provide transparent representation and answer all your questions
• We educate you about your rights and guide you through the legal process fully informed
• We are always boldly honest about your rights, whether good or bad
• We not only work for an effective solution but an efficient one
• We understand the weight and stress of your situation, and we are happy to provide the support you need to lighten your load

In addition, our Office Culture Core Values are:

• We limit our caseload so we can provide our clients with the attention their case deserves
• We avoid any type of office drama, which can distract from the service we provide
• Our team always works to improve our knowledge of ERISA claims and the resources available
• We are always highly professional and upholding our firm’s reputation is a top priority

When you need a law firm you can rely on without any drama or unnecessary stress, you want J. Price McNamara ERISA Insurance Claim Attorneys.

Overview of Long-Term Disability

Long-term disability (LTD) coverage provides financial protection to individuals who cannot work for an extended period due to a qualifying disability. Unlike short-term disability, which typically covers a few months, LTD coverage provides income replacement for an extended duration, often until retirement age or until the individual can return to work.

Here’s a brief overview of long-term disability coverage. To find out how this complex insurance coverage applies to you, discuss your claim with our Texas disability attorneys.

Definition of Disability

Most LTD policies define disability in one of two ways: “own occupation” or “any occupation.”

Own occupation policies consider you disabled if you can’t perform the duties of your specific job. Any occupation policies consider you disabled if you can’t perform any job you are reasonably qualified for by training, education, or experience.

Elimination Period

LTD policies often have an elimination or waiting period, typically from 30 to 180 days. During this period, you must be disabled before the coverage kicks in. The longer the elimination period, the lower the premium.

Benefit Period

The benefit period defines how long you’ll receive disability payments. It can vary but often ranges from a few years to age 65 or even for life. The longer the benefit period, the higher the premium.

Coverage Amount

LTD policies typically replace a portion of your pre-disability income, such as 50 to 80 percent. The exact percentage varies based on the policy terms and can influence the premium.

Premiums

Premiums for LTD coverage are usually paid on an ongoing basis, either by the individual or their employer. The cost can vary based on age, health, occupation, and coverage amount.

Pre-Existing Conditions

LTD policies often have a pre-existing condition exclusion period, during which they won’t cover disabilities related to conditions you had before the policy’s effective date. This period typically lasts for the first 12 months of coverage.

Rehabilitation and Vocational Assistance

Some LTD policies offer rehabilitation and vocational assistance to help disabled individuals return to work or acquire new job skills.

Long-term disability coverage can be essential for financial security if you become disabled and cannot work for an extended period. You want a lawyer to carefully review policy terms, understand the definition of disability, and assess your specific needs to select the right coverage for your situation.

A disability attorney from J. Price McNamara ERISA Insurance Claim Attorneys can increase your chances of a successful claim.

What Is Short-Term Disability?

Short-term disability (STD) coverage provides financial support to individuals who temporarily cannot work due to a qualifying disability or illness. This coverage and claim process is similar to LTD coverage in many ways. However, unlike long-term disability coverage, STD coverage offers benefits for a shorter duration, usually ranging from a few weeks to several months.

Many people with disabling conditions begin by seeking short-term disability benefits. When they realize their disability will continue for longer than STD policies will cover, they can file a claim and try to transition to long-term disability benefits.

Fighting Your Insurance Company for Disability Benefits

The private disability insurance claims process involves providing substantial evidence to prove your disability and eligibility for benefits.

Some examples of evidence that many insurance companies require include:

• Medical records: Comprehensive medical records are the foundation of your disability claim. Gather documentation of all medical treatment related to your condition, including doctor’s notes, test results, hospitalizations, surgeries, and prescribed medications. These records should clearly detail the nature and severity of your disability.
• Physician statements: Statements from your treating physicians are crucial. They should provide detailed information about your diagnosis, symptoms, treatment plan, and prognosis. Your doctor’s opinion about your ability to perform work-related tasks and the expected duration of your disability is particularly important.
• Vocational evidence: If your disability affects your ability to perform your job, vocational evidence is essential. Vocational experts can assess how your disability impacts your capacity to perform specific job tasks and functions.
• Functional capacity evaluation (FCE): This evaluation, conducted by a healthcare professional, assesses your physical and/or cognitive abilities. FCE results help demonstrate how your disability affects your capacity to work.
• Independent medical examinations (IMEs): Insurance companies may request IMEs. Attend these examinations, but consider having a legal representative present to ensure fairness.
• Statements from friends and family: Personal statements from friends, family members, or coworkers can provide valuable insight into how your disability has affected your daily life and work performance.
• Work history: Your work history, including job descriptions and performance reviews, can help establish the demands of your occupation and how your disability prevents you from meeting them.
• Financial records: Documents showing your income, expenses, and financial status can be relevant in demonstrating the financial impact of your disability.
• Expert opinions: If necessary, we consult experts such as vocational specialists, medical professionals, or legal experts who can provide objective opinions regarding your disability and its impact on your ability to work.

An experienced Texas disability attorney from J. Price McNamara ERISA Insurance Claim Attorneys can collect the necessary evidence and protect your rights. We can also navigate appeals if the insurance company already denied your claim.

You must submit thorough, well-documented evidence for a successful private disability claim. Your attorney will follow the requirements outlined in your insurance policy and work closely with medical professionals and other experts to build a compelling case that demonstrates your disability and your eligibility for benefits.

ERISA Oversees Many Disability Claims

The claim process can be further complicated by the Employee Retirement Income Security Act (ERISA), which governs employer-sponsored LTD plans. These laws can affect the timeline, standards of review, and legal remedies available to claimants.

To effectively fight your insurance company for LTD benefits, seek legal representation from an attorney experienced in ERISA disability claims. We can navigate the process, gather the necessary documentation, and protect your rights to disability benefits.

With the right legal representation, determination, and support, you can improve your chances of securing the benefits you deserve.

Common Reasons for Disability Claim Denials and What to Do

Even with the right evidence and legal support, you can receive a claim denial. Moreover, if you filed your initial claim without legal support, your insurance company will almost certainly deny your claim. Consult our Texas disability attorneys immediately if you receive a denial letter.

Understanding the common reasons for denials and how to address them can improve your chances of a successful claim.

Here are some common reasons for disability claim denials and steps you can take:

• Lack of sufficient medical evidence – Insurance companies often deny claims when insufficient medical evidence supports the disability.
• Failure to meet the definition of disability – Insurance policies typically define disability in specific terms, such as “unable to perform the duties of your occupation.” Insurers will deny claims that don’t meet this definition. Your attorney will carefully review your policy’s definition of disability to understand the criteria and work with your healthcare providers to document how your condition affects your ability to perform your job.
• Pre-existing conditions – Some policies have pre-existing condition exclusions, meaning they won’t cover disabilities related to conditions you had before the policy’s effective date. Always seek legal representation to argue against an unjust pre-existing condition denial.
• Administrative errors – Sometimes, claim denials occur due to administrative errors or missing documentation. When a disability lawyer files your claim, they will double-check all submitted paperwork for accuracy and keep records of all insurance company communications.
• Incomplete or untimely claims – Submitting an incomplete or late claim can lead to a denial. An attorney will ensure you meet all deadlines and provide all requested information. Always seek help from an attorney at the start of the claim process to avoid errors.
• Lack of vocational documentation – For some policies, you must provide vocational documentation showing how your disability affects your ability to perform specific job tasks. Your lawyer can guide you on how to work with your healthcare providers to obtain comprehensive vocational assessments that highlight the limitations and restrictions that prevent you from working.
• Independent medical examinations (IMEs) – Insurance companies may request IMEs, which can be biased in their favor. You may need to attend IMEs as necessary, but consider having a legal representative prepare you for it. In the meantime, continue receiving treatment from your regular healthcare providers.

Our Texas disability attorneys can address a denied claim. Consult J. Price McNamara ERISA Insurance Claim Attorneys, and we can review your policy, guide you through the appeals process, and advocate for your rights.

If your disability claim gets denied, don’t give up. Many claimants successfully appeal denials with the right legal strategy and documentation. Seeking legal guidance can secure the benefits you deserve.

How Our Long-Term Disability Attorneys Help Throughout the Disability Benefit Claims Process

Working with a long-term disability attorney throughout the disability benefit claims process offers several significant advantages. Our attorneys focus on this complex area of law and understand the nuances, ensuring you follow the right legal procedures.

We have experience dealing with ERISA disability insurance companies and understand their tactics. We can level the playing field and avoid common pitfalls that may lead to claim denials.

We can assess the strength of your claim from the outset, helping you determine whether to pursue a claim. Our legal team also knows what evidence you need to support your claim, from medical records to vocational assessments. We can prepare and file a comprehensive case for the best chance of obtaining benefits. If the insurer denies your claim, our disability attorneys can guide you through the appeals, increasing your chances of a successful outcome.

Speak With Our Texas Disability Lawyers Directly

Whether you are filing an initial disability claim or have received a denial, you want J. Price McNamara ERISA Insurance Claim Attorneys on your side. Working with our long-term disability attorneys streamlines the claims process, increases the likelihood of a successful outcome, and relieves much of the burden and stress associated with navigating the complex world of disability benefits.

Consult our team for free today by calling our Texas disability attorneys at (713) 300-0462.