Long Term Disability Buyouts in DC
What if your long term disability insurance company came to you and offered a buyout - a lump sum settlement amount in exchange for giving up your future monthly benefits? You're probably thinking:
If I don't accept the buyout, how do I know that they aren't going to deny my claim down the road?
The short answer is unfortunately, you don't know.
Generally the more costly your benefits, the harder the insurance company will work to deny your claim. They are always protecting their bottom line, so a high wage-earner can expect more of a fight that a lower wage earner. Another thing you can look out for when it comes to risk of being denied is the medical condition or injury that makes you disabled.
If you have a condition that can be backed up by objective medical evidence (MRIs, scans, other definitive tests) then the long term disability insurance company may have a harder time terminating or denying your ongoing benefits. However, if your condition is more difficult to measure, but completely valid, like fibromyalgia or chronic pain, you have a higher chance of getting your claim denied because your insurance company knows you will have a more difficult time proving your disability (and yes the burden of proof is on the disabled person in these types of long term disability cases).
One thing you can do to have more control over your future is make sure you continue to see your treating physicians regularly, have a copy of all of your medical records, and index them. Your doctor should be consistently documenting that you can't work, and why you can't work. This is very important.
What You Will Need to Appeal A Denied Claim
If your claim is ever denied you will need all of this information (and a lot more) to draft and file the appeal of your claim. If the insurance company denies your appeal and you need to file a lawsuit, your appeal, everything you put in it and the insurance company claim file will make up the administrative record - which is what the federal judge will analyze in deciding your case. No jury, no witnesses, no trial, just the administrative record. Compiling the right evidence to go into the appeal to your insurance company is the critical step in this process. Get it wrong, leave something out or just complete the insurance company form to appeal and you will lose.
An experienced ERISA disability insurance attorney will be able to use those medical records and other medical, vocational and factual evidence he or she has incorporated into your appeal. Usually there are only 180 days to appeal a denied claim, so you should have your medical records all sorted out now just in case - you will probably be using those records with other medical specialists and experts to support your appeal.
You always want to have as much evidence as you can generate, both to put yourself in the best position if the insurance company reviews your claim and terminates your long term disability benefits and to use as leverage to negotiate a higher buyout or settlement.
Generally speaking, you don't know whether the insurance company will deny your claim in the future - they might. But, if you accept an insufficient buyout, you could be leaving tens of thousands of dollars on the table, or more.
Many times, if you have been approved for long term disability and are receiving benefits, a buyout doesn't make financial sense, strictly speaking. But everyone is different and what matters is that you make the best decision for yourself and your family. There are a lot of things you should consider but the answer is always to do what is best for you and your family.
You need to get the best information you can before you make an important decision like this
If I Work with Donahoe Kearney to Handle My ERISA Long Term Disability Insurance Case, What Does That Get Me?
It depends on where you are in the case. If you are thinking about filing for long term disability, on claim (receiving long term disability benefits) and you receive a buyout offer, or you're concerned because of what you've heard about long term disability claim denials, and want to put yourself in the best position to avoid having the claim denied or be ready if it is denied, you can come in (or Zoom in, of course) for a Long Term Disability Insurance Claim Consultation.
We can put you in the best possible position if you claim is denied in the future.
Or, let's say your claim is denied. You most likely need a lawyer in order to move forward. Send us your denial letter and we will review it for free, and give you our opinion as to what your next steps might be. In most cases you only have 180 days to appeal a denied claim, so you want to send us your denial letter right away. You can fax it in, email it to our Director of Client Services Brooke Birkey at [email protected] You can take a picture of it and text it to us at 202-670-1875.
However you can get it to us most easily and quickly, send it over.
We have a process for filing your appeal - from obtaining your claim file to working with you to compile all of the evidence we can to show you are disabled under the policy and entitled to benefits. You will transfer all of the confusing, difficult, time consuming tasks of proving your case with the right evidence, to us.
Your job will be to work at getting better and getting the medical treatment you need. We know from having clients who have serious medical conditions and long term medical treatment how overwhelming it can be to simply manage your own medical treatment. If your claim has been denied, let us do the heavy lifting.
Call us today at 202-393-3320 to get started.