If an insurance company is denying you coverage for an injury that prevents you from working, an attorney could help. Communicating with an insurance company on your own is often challenging and frustrating. However, a long-term disability lawyer understands how insurance companies make decisions and could ensure your application meets standard requirements.
A legal professional could handle all communication with insurance agents so that you can focus on your health. If an insurance company continues to deny you benefits, a skilled long-term disability lawyer could fight for your rights.
People often confuse long-term disability with workers’ compensation. Workers’ compensation is a program employers must offer their employees. It provides free medical care and a partial wage for injuries sustained in the workplace.
However, unlike workers’ compensation, long-term disability (LTD) is an optional insurance benefit employers might offer. LTD provides financial support if an employee becomes disabled for any reason, regardless of whether the condition is work-related. Independent contractors, gig workers, and freelancers can also purchase individual LTD policies. The illnesses covered, the amount an insurer will pay, and the duration of benefits vary according to the specific policy.
Unfortunately, many people do not read the terms of their policy until they need it. The requirements needed to apply for benefits often catch people by surprise. A local LTD attorney could review a policy, explain any restrictions, and guide an applicant through the process of securing benefits.
Although policies differ, employers must offer coverage plans that conform to Employee Retirement Income Security Act (ERISA) requirements. The law includes minimum requirements for employer-sponsored plans, including basic definitions for benefits eligibility.
A disability qualifies for LTD status if it will prevent a worker from doing their job for six months or more. Although a condition could be a physical injury or illness, mental and emotional illnesses may also be covered by disability benefits. Some policies exclude specific conditions from coverage, and some only provide benefits for a particular period.
To receive benefits, applicants must prove that their condition prevents them from working. In addition to requiring documentation, many plans require an applicant to have a physical examination by a doctor who works for an insurance company. A seasoned lawyer with LTD claims experience could counsel an applicant about the medical exam and, in some cases, might accompany the applicant to the appointment.
Working with a legal professional could be helpful no matter where a person is in the disability claims process. An attorney representing disabled clients is familiar with the pitfalls of insurers’ strategies and could help avoid them.
For example, insurers deny many disability claims because of inadequate medical records. However, an attorney could work with a doctor to ensure they provide proper documentation of the disabling condition, including tests or laboratory results to support their diagnosis. Similarly, insurers often demand detailed information regarding the insured’s income and finances. A legal professional could handle this tedious task.
If an insurer improperly denies a claim, a legal representative could speak with an adjuster handling the case about the reason for the denial and correct any deficiencies preventing a person from collecting benefits. If the insurer continues to deny a legitimate claim, a local attorney could develop a strategy to prove an individual’s entitlement to LTD benefits in court.
If an illness or injury keeps you from working for an extended period, LTD benefits could help you continue paying your bills and supporting your family. However, the process of proving your disability can be complicated.
Luckily, a knowledgeable long-term disability lawyer could be your advocate. Whether you want assistance with an initial application or need to appeal a claim denial, a legal team member could ensure you get the benefits you need as quickly as possible.
The Lake Law Firm
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