Long Term Disability Benefits Denied
As long term disability lawyers, we know you have relied on Hartford or another insurance company to provide benefits while you can't work due to an injury or medical condition. We see two types of cases when they deny or end your long term disability benefits, and you will get a letter from your insurance company when that happens.
Here are two common situations involving long term disability benefits being denied, and what to do about it.
Your Insurance Company Denied Your Initial Application For Long Term Disability Benefits.
You've applied for long term disability benefits by completing all of the paperwork you received from your insurance company or your HR department at your job (usually you start the disability benefit process, whether you're applying for long term or short term disability benefits, by getting the disability insurance information and application from your company's HR or benefits office).
Most of the time, you will receive a packet from your company's long term disability insurance company with a number of forms to fill out.
It Is Critical To Get A Copy Of Your Long Term Disability Insurance Policy
This will include all of the terms, conditions and definitions you need to apply for disability benefits. You want to make sure that you understand all of the policy provisions.
Plus, your carrier will usually send you several pages of forms for you to fill out, asking for information such as:
- Work History
- Health History
- Job Description
- List of health care providers
- How the injury or medical condition occurred or when you were diagnosed
They will include an Authorization for the Release of Your Medical Information. This will give the insurance company the right to obtain your medical records and information to verify your medical condition or injury and the fact that you are disabled because of it.
Access to all of your medical information will also give them an opportunity to look for medical reasons to deny your claim as well.
Talking to Your Doctors About Your Long Term Disability Case
Once you have the long term disability insurance policy, you can see exactly how your policy defines disability and what conditions are covered, and for how long. Now it's time to educate your doctors.
If your doctors are like most practicing physicians, they are way too busy to study the definitions of your long term disability insurance policy - most doctors have a definition of disability in their head already, or at least think they "know" how to answer a questionnaire or write a medical report or letter that helps their patients get disability benefits.
The reality is, they don't.
Many doctors will unwittingly hurt your case for long term disability by using the wrong definition, or adding on medical conditions that are secondary but may limit your ability to get disability benefits. It's hard work convincing them, even though they mean well.
Understanding exactly how to speak to your doctor about your case can have a steep learning curve. That's why we talk to physicians, specialists and expert consultants on our cases so you don't have to.
Beware This Common Initial Denial of Long Term Disability Benefits
Understanding how to speak to your doctor goes hand in hand with managing your medical records properly. Many claimants get stuck here because they aren't expecting the insurance company to require they prove their case with their own medical records.
Here's how it works. You send in your application, sign everything and are completely honest in completing the information (always, always be 100% honest). You give the insurance company a list of doctors and they write away for your medical records.
You think you're done.
Your long term disability insurance company cannot get your complete information, they will write to you asking for more time to do so (almost all long term disability cases are covered by ERISA, a federal law, that has deadlines and regulations for just about everything regarding these claims).
It is your responsibility to get the right rmedical records for your long term disabiltiy claim - not your doctor's, not the insurance company's (even if they volunteer to take care of this for you).
Because if you can't get those medical records within the time limit, they can deny your claim for long term disability benefits. It's a simple denial really and many people don't realize what they need to do about it, and when.
Most long term disability claimants need an experienced long term disability lawyer to help them through this step. There's just too much at stake and it's too easy for the insurance company to deny your claim to handle it on your own.
What To Do When Your Long Term Disability Claim Is Denied
First of all, under ERISA (the federal law that governs most long term disability insurance claims) the insurance company will send you a letter that reviews the evidence they had, what they reviewed, the long term disability insurance policy definitions, terms and conditions that they say apply to your specific situation, and how and what you need to do to appeal and when you need to appeal.
Under ERISA policies, you have 180 days to submit your appeal of the denial letter. There have been extensions due to COVID, but depending on your medical condition or injury and the extent of your disability, your job duties and several other factors, that is not a long time to prepare, draft and file an appeal.
You will need to analyze the insurance policy terms, conditions and definitions, research federal law, work with your doctors and outside medical specialists, coordinate and draft statements from co-workers and others, arrange for specialized testing and evaluations, and a number of other things.
Our Long Term Disability Lawyers Will Analyze The Letter Denying Your Benefits At No Charge to You.
The review and analysis of your denial letter is complimentary, with no obligation, and will outline some of the steps you need to take to generate the strongest and most persuasive appeal you can.
Once you have this valuable resource, you can use it as a roadmap to handle your own appeal and the fight with the insurance company (which may end up in federal court, since ERISA is a federal law) or you can have our experienced long term disability lawyers do all of the work, keeping you informed every step of the way.
Contact Our Experienced Long Term Disability Lawyers Today To Get Started
Most people are terrified of losing income after an injury keeps them out of work. We provide financial stability and medical treatment while you can’t work so you can pay your bills and recover.
We make it easy to get started. To send us a letter you received from your long term disability insurance company, just email it to [email protected] with the subject line: Denial Letter, or fax it to us at (202) 393 - 3324.
Either way, you'll get valuable information that can help you with your long term disability benefits right now!
You've never been through this process before and you want to stand up to the insurance company. Let our legal team be your guide.
But don't wait to contact us - we can't take every case and we want to be able to give you the information you need to make the best decision for you and yor family as soon as we can. Just call us at (202) 393 - 3320 or chat with one of our agents right now.