Long Term Disability
ERISA provides regulations dictating the amount of time the administrator can take to render a decision on your claim, and you will be given a relatively short amount of time after a denial in which to submit additional evidence supporting your claim and appeal the decision. Denial letters will often allow you a short window of time to communicate your appeal, and additional time to submit all supporting evidence. The sooner you involve us in the process, the greater the chances of success on any claim. Your insurer will use any and every tool at its disposal to deny your claim, and consults lawyers in the process. The only way for you the level the playing field is by consulting with an attorney yourself.
Not only rank-and-file employees claim benefits under disability insurance plans. Often even executives, partners, accountants, lawyers and doctors develop disabling conditions preventing them from being able to work. We understand the unique vocational demands and stresses applicable to the disability of executives and managers that often do not present themselves other disability benefit claims.
Claims for Benefits
We assist our clients in claiming benefits under both employer provided group disability plans and individual disability insurance policies. While we understand you may be hesitant to consult a lawyer unless and until absolutely necessary to do so, the earlier you involve an attorney, the greater your odds of ultimate success. Claimants are naturally hesitant to engage counsel unless benefits are denied and they need a lawyer. We can provide an initial consultation regarding the disability claim process, so that if your claim is denied, we can immediately begin working on your appeal rather than you losing time finding a lawyer after the denial.
Termination of Benefits Under "Any Job" Standard
We assist our clients in appealing terminations of disability benefits, which can happen for a variety of reasons. In nearly all policies, the standard of disability will change after some period of time, most commonly 24 months. Often, claimants obtain long-term disability benefits initially, and subsequently receive a notice from the administrator advising that benefits will be terminated because the claimant no longer meets the definition of disability under the plan. In these cases, the standard of disability is harder to meet and you need to arm yourself with legal counsel to combat the insurers' tactics and own lawyers. Executives and professionals often face particular difficulty, as the vocational element of the dispute becomes more complex.
Mental Health and Other 2-Year Limitations
In addition to terminations of benefits under a new definition of disability, the administrator may advise you it will terminate benefits pursuant to a mental health clause, or other benefit limitation in the policy, limiting payment to no more than 24 months, or another duration specified in the plan. Every policy is worded differently, and a plan administrator's decision on whether a mental health condition, such as depression, has caused a disability or contributed to a disability, should not be taken for granted. We recognize the unique interaction between mental health conditions and physical conditions prevalent among executives, managers, and other professionals. Other bases insurers use to limit benefits include self-reporting conditions, chronic fatigue syndrome "and related conditions," etc. As soon as you get such a notice, whether or not benefits have already been discontinued, you need to consult a lawyer to prepare for the appeal, because the sooner you involve us, the less time (if any) you will spend without receiving your monthly benefits.