Long Term Disability
Long-Term Disability Insurance Cases – You’ve paid your premiums. We’ll help you get the coverage you need.
All of our clients purchased short or long-term disability benefits or paid for them through their labor, and they did so to protect themselves in the event that an illness or injury prevents them from working for extended periods of time. Most often our client’s employer provided these benefits, but sometimes the policies were purchased individually. Either way, when dealing with long-term disability benefits, matters can get complicated. The policies that govern these types of insurance coverage can be difficult to understand. Many contain changes of definition of disability, limitations, exclusions, and traps for the unwary.
Talk to someone who has seen it all. In these cases, experience, and results matter. ERISA or State-law governed cases require an attorney who is experienced in the medicine and law. They require someone who knows how to prove a case by getting the right testing and testimony from your physicians, someone who knows how to talk to the insurance company, and someone who has litigated the case if necessary. We know the games and tricks that the biggest insurance companies use to defeat a case. We will develop your case so that it will win. Our target audience when doing appeals is not the insurance company, but a judge and jury. Only by showing an insurance company that you are willing to go all the way, will they pay your claim.
Your financial situation and quality of life may be significantly impacted if you are unable to work due to a disability. Numerous things, such as car crashes, accidents like falls, illness, or chronic medical conditions can lead to disability and the inability to work.
The reality is it can happen to anyone, at any time.
What Is Long-Term Disability Insurance?
Long-term disability insurance provides financial assistance to those who are disabled and unable to work. For an extended period, frequently until retirement age, it covers a portion of your income, typically between 50 and 60 percent. What you are buying with disability insurance, either by private purchase or through your employer, is “income protection.” Through your education, training, and experience, over the years you have achieved a certain amount of pre-disability earning potential. Long-term disability should protect your accomplishment and level of success.
An inability to work, either for a short or extended period, may result from disease, trauma, or recurring conditions. Long-term disability insurance is frequently provided to employees as a benefit, although it can also be bought independently.
It acts as a safety net for people and their families, ensuring that they will have a source of income if they become disabled and are unable to work for an extended period.
Who Needs Long-term Disability Insurance?
Anyone who relies on their income to support themselves and their family should have long-term disability insurance. Whether you work full-time, part-time, or for a big company or are self-employed, it may be a good idea to have disability insurance. The laws governing privately purchased long-term disability policies are much more protective, but most people have the opportunity to elect coverage under an employer-provided plan.
Regardless of age, gender, or line of work, anyone can become disabled at any time. The unexpected can happen, even if you lead a healthy lifestyle and make efforts to be healthy and avoid accidents or illnesses. Long-term disability insurance can offer financial security and peace of mind by guaranteeing that you and your loved ones will not go without money if you become disabled and are unable to work.
People who do not have significant savings or other income sources to rely on in the event of a disability should pay special attention to this.
Reasons Why Long-Term Disability Claims Are Denied
Many long-term disability applications are rejected for a variety of reasons. Many times, insurance companies unreasonably deny disability claims to increase their profits at the expense of their insureds. Many companies delay payment of claims to try and get you to give up. Understanding these causes will help you be ready to act and increase the likelihood that your claim will be accepted.
Lack of Medical Reports
Inadequate medical proof is one of the most frequently provided rationales for the denial of a long-term disability claim. If you want your long-term disability benefit application approved, you must submit the necessary medical evidence to back it up.
This supporting information must demonstrate that your medical condition satisfies the policy’s definition of a disability. Your claim can be rejected if the medical documentation does not document your restrictions and limitations and inability to do your job. Remember, diagnosis does not mean disability. The key question that the insurance company is evaluating is whether you can perform the material and substantial duties of your job.
Insurance companies often deny long-term disability claims because they allege that you suffer from a pre-existing condition. Most policies require you to be insured for 12 months before you can make a claim for disability benefits caused by a prior medical condition. However, insurance companies often abuse the pre-existing condition clauses in long-term disability policies and allege that a new medical condition was pre-existing to justify a denial.
Policy Definitions, Exclusions, and Limitations
Another cause for a refusal to pay a claim is that the applicant does not match the policy’s definition of a disability. Different policies have different definitions of a disability, so if you do not fit those requirements, your claim might be rejected. However, many insurance companies will inappropriately apply the definition of disability. Many companies expand the requirements to include something not contained in the policy so that they can deny the claim.
Some policies will exclude various medical conditions or limit the amount of time that you can receive benefits for a condition. For example, most policies limit benefit payment to 24 months for disabilities caused or contributed to by a mental health condition. Many disability companies will lie and state that your disability is caused by a mental health condition, when in reality your disability is caused by a brain injury, and you are simply depressed because you are in pain and cannot work. The disability company will look at the symptoms, and not the cause of the disability. They do this to increase their profits at your expense.
Failure to supply requested information on time or missing deadlines may result in denial. However, insurance companies often deny claims for spurious reasons like stating you have not provided certain information when actually, you or your doctors have already provided the information many times. Disability companies often create false deadlines to deny or delay claims. Insurance company adjusters often fail to properly request your medical records or fail to send paperwork to your doctors, and then they wrongfully blame you. Do not rely on the adjuster to get your medical records or contact your physicians. They will not try and help you. A disability adjuster’s job is to find any reason to deny your claim. You should send your complete medical record to the insurance company yourself.
What to Do If a Long-Term Disability Claim Is Denied?
If an insurance company denies your claim, you must review the denial letter’s basis for the rejection of your claim. This is the first step. The second step is to contact an experienced disability attorney like Aaron Engle to discuss your condition and the denial, review the medical evidence, and strategize the best way to appeal. We will then contact the insurance company, request your file, and execute an appeal plan that will get you the benefits that you paid for through your many years of work and premiums.
Even though the appeals process can take time, we have been very successful in getting benefits paid or positioning your case for success in Court if we must sue the insurance company. We are not afraid to sue the biggest insurance companies in the world, and we have done so hundreds of times. We know the games that disability companies play to deny claims.
Hire a Long-Term Disability Attorney in Seattle Today!
Long-term disability can be an essential financial safety net. As noted above, insurance companies reject many claims for a variety of biased and unreasonable reasons. They often hire professional claim closing physicians, who do not actually practice medicine, but whose sole job is to deny disability claims for false reasons. These physicians often ignore the medical evidence, accuse you of lying, and disrespect the opinions of your treating physician.
You must speak with an experienced long-term disability attorney. Aaron Engle Law offers legal services to those whose long-term disability claims have been rejected, ensuring that your rights under the policy are honored, and holding insurance companies accountable for their bad-faith actions.
If your long-term disability claim has been rejected, get in touch with Aaron Engle Law right away for one of our free consultations, and let’s work together to protect your financial security and force the insurance company to pay you what you are owed under the policy.
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