You rarely notice the $10 per paycheck that goes to your long-term disability (“LTD”) Insurance – until you need it. Illness and injuries can lead to you being off work for weeks, months, and maybe years. Your LTD insurance is supposed to provide you with 50% or more of your earnings, if you meet the definition of disability.
Filing a Claim
You will be asked to provide claim forms, medical information, and information about your job. Having a physician that will complete your claim forms is very important. Your doctor will need to explain to your insurance company what your restrictions and limitations are, what treatment you are having, and what your prognosis is. For many people, the claim gets paid. But sometimes a claim is denied. The good news? You get to appeal the denial. WARNING! You only have 180 days to do that. Your insurance company is counting on you to have a knee-jerk reaction and tell them to process your appeal. Why is that bad? Because you will soon learn that you usually have one chance to appeal and any information you do not put in that appeal will not be considered and you don’t get a “do-over.”
Appealing a Claim
Your LTD appeal is the most important part of the process. If your LTD benefits are provided through your employer, a federal statute known as “ERISA” (Employee Retirement Income Security Act), will apply to your claim. When the appeal is over, the file is “closed” which means you cannot put in anymore medical evidence to support your disability. And if you have to sue over your benefits, all a judge has to determine is that the insurer’s decision as reasonable.
Getting Legal Help
It’s a good idea to seek help on your claim. Make sure you look for an attorney that has experience handling ERISA disability claims.
If you need the services of an attorney that handles ERISA and LTD claims, call Schiffman Law Office, P.C. today for inquiries.