Many people received short-term and long-term disability insurance as a work benefit that their employer provides. It is also possible to purchase your own short-term or long-term disability insurance. These insurances provide a stream of income, usually a percentage of your normal monthly salary, should you become ill or disabled.
Claims can be complex and frustrating and the insurance company may delay or deny your benefits. Every contract is different and there are strict deadlines to meet, so having a lawyer can be beneficial. Quatrini Law Group has helped clients throughout Fayette County to safeguard their benefits.
How Long-Term Disability Claims Work
If you become ill or disabled and will be unable to work for an extended period of time, having long-term disability insurance, whether an employer-sponsored plan or a private policy, can be very helpful. As far as what you will receive, the terms of these contracts can vary drastically from policy to policy in terms of duration of benefits, definition of disability, deductible sources of income and rehabilitation incentives. An attorney can help you understand what you may expect.
Common Long-Term Disability Claim Issues
Long-term disability benefits are typically paid for two years if you cannot perform your specific occupation. After two years, individuals must show they are unable to perform any type of gainful employment. When you are too ill to work and have Long-Term Disability insurance, you would think getting your benefits would be simple. Unfortunately, we see many people who need to fight to get their benefits for a wide variety of reasons.
Denied Long-Term Disability Claims
It is not unusual for the insurance company to deny a long-term disability claim. They may say there is not enough evidence of your disability or that you had a pre-existing condition. There may be missing paperwork or medical records. Insurance companies may also use surveillance to make sure you are truly injured.
Benefits Depend on the Definition of Disabled
Your policy may include a definition of what constitutes “disabled.” Many employer-sponsored plans have a hidden trap in the policy: you are covered under your “own occupation” for years and then switched to “any occupation” – a higher standard. Suddenly, you don’t meet the standard and are cut off. Our attorneys can help you understand your contract language and what evidence you may need to provide to secure your benefits.
ERISA Appeals
You have appeal rights under ERISA, but ERISA is a complex area of the law that many lawyers are unfamiliar with. There are strict deadlines and rules about what evidence is permitted. Our Altoona lawyers practice a lot of ERISA law. We help clients understand their policy language, which is crucial as you begin your ERISA appeal.
What to Do If Your Long-Term Disability Claim Is Denied
Understanding ERISA and Disability Insurance Law
If your long-term disability Insurance is through your employer, then it is governed by ERISA or the Employee Retirement Income Security Act of 1974. There are mandatory appeals processes, deadlines, and regulations that must be met or you risk losing your benefits. You must go through the administrative appeal process before you can go to court and the appeal process if your only chance to submit new evidence. It’s vital to your case to get it right and well worth having someone who understands ERISA law on your side.
Types of Disability Insurance Cases We Handle
Long-term disability income policies give a monthly benefit (usually 60 percent of your wages) to individuals who are unable to perform their job. We handle cases where the insurance company denies or cuts benefits before our clients have recovered. If the disability or illness is permanent, we can help clients apply for Social Security Disability benefits.
Short-Term Disability Litigation
Our Uniontown attorneys can help you take action when your employer or the insurance company improperly deny your short-term disability benefits.
Long-Term Disability Insurance Litigation
If you are having issues claiming or keeping your long-term disability benefits, Quatrini Law Group has lawyers with experience in ERISA legislation. The insurance companies have a team of lawyers on their side – shouldn’t you?
Disability Income Policy Disputes
When the insurance company disputes your claim for long-term disability benefits, an attorney can be invaluable for countering their arguments and gathering facts and documentation that prove you should still receive benefits.
Bad Faith Insurance Claims
If you have been denied contractual disability benefits which were not endorsed by an employer, you may have a cause of action against the insurance company for bad faith based on their conduct in intentionally and wrongfully denying your benefit.
Why Clients in Uniontown Choose Quatrini Law Group for Long-Term Disability Claims
Our clients choose our Uniontown office because they want a local lawyer who will put them first. At Quatrini Law Group, you will meet your attorney face to face. Your attorney and legal team will get to know you, your circumstances and your case. We are not a national firm doing a huge volume business. We are a Pennsylvania firm that values community and personal interaction.
Meet Our Long-Term Disability Attorneys
Brian P. Bronson | (724) 552-2708
James A. Miller | (724) 552-2434
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FAQs About Long-Term Disability Claims in Uniontown
I was getting LTD for two years and suddenly, I was denied. What happened?
Many long-term disability policies have language that changes at the two year mark. Now, instead of being unable to perform your “own occupation” to receive benefits, you must prove you cannot perform “any occupation” to continue to receive benefits. We have helped many people to appeal this trap.
What is the deadline if I am denied LTD?
ERISA gives approximately 180 days to file an administrative appeal. After that window closes, the record is sealed. No new evidence, no federal lawsuit. That is why it is vital that you consult with a skilled ERISA lawyer as soon as possible.
My employer and my doctor agree I am too ill to work but I still got denied. Why?
Ultimately, the decision of your benefits is up to the insurance company, not your employer. Depending on a statement from your employer or having your doctor fill out the insurance company forms may not be enough. A long-term disability lawyer can review your policy and suggest what evidence you need to make sure the insurance company approves your claim.
Speak With a Long-Term Disability Lawyer in Uniontown
Every case and every policy have different terms, so it is in your best interest to obtain a copy of your policy and have it reviewed by the Quatrini Law Group if you think you have been wrongfully denied benefits. Call us at 888-534-6016 or contact us online.