Denying ERISA long term disability claims in D.C.
Before you were seriously injured or developed a medical illness and could no longer do your job, if you're like most people, you didn't worry too much about what would happen if you suddenly couldn't work because of injury or illness. The reality is, none of us think it will happen to us (but 1 in 4 Americans will become disabled over their work life).
That's normal. Nobody thinks it will happen to them.
Plus, with long term disability insurance your company provides, most people believe they will be protected in case the worst case scenario happens.
And if you're like most people, if the disability insurance company denied your legitimate claim for benefits and you can't work, you were probably shocked when you got the news (and upset and irritated), but really caught off guard by getting denied, because let's face it, you live you life a certain way, honestly, with integrity. And you've worked hard to get to where you are now. So when something like this comes along, it's a total shock.
First you're dealing with the injuries, hospitals, doctors, surgeries, rehab, therapy and every thing else. Now you're dealing with stress and anxiety over finances (that you thought were at least covered by disability insurance)
Here is the #1 thing you need to know about insurance companies – they exist for one reason only - to make a profit for their shareholders. So even if you are right and your doctor agrees with you, most of the time, you can't just write them a letter showing that in order to get your disability benefits going.
They also love their forms and they will send these to you or your doctor periodically. But remember, those disability insurance company forms are often intended to be used in denying disability claims. These forms ask for all kinds of information from you, which is later used against you when the insurance company denies your claim.
And insurance company employees are trained to find ways to deny disability claims.
Also, the insurance company may offer an appeal process (they have to do this under ERISA) and they sometimes make it sound simple and fair, but it's not fair and unbiased. When you think about it, the insurance company is the one who has to pay your disability benefits if they lose the appeal, and they are in charge of the appeal process, and are the ones who decides who wins!
Another built in incentive to deny your disability claim.
Federal judges and law professors have written a lot about the unfairness of ERISA, and how it seems like the insurance company holds all the cards. That's generally true, but don't give up! With a good system, and the right medical and legal guidance in place, your appeal can formidable.
So call us today at (202) 393 - 3320 to discuss your ERISA long term disability claim.