If you have long-term disability insurance and have suffered an injury or illness, you may expect that your company will approve your claim for benefits. Unfortunately, insurance companies often try to deny claims in order to minimize their losses. If your claim is denied, it can be financially devastating. There is an appeals process that you can follow if your claim is denied so that you can try to recover the benefits that you rightfully deserve to replace a portion of your former income while you are unable to return to your job. However, this process can be lengthy and complicated. Our team at Osterhout Berger Disability Law has the experience you need when selecting a long term disability attorney to fight for your benefits.
Should I Hire an Attorney?
If your claim for long term disability benefits has been denied, you will likely need to get the help of an experienced long term disability attorney in order to recover the benefits that you should receive. We can advocate for you throughout the appeals process to help you win approval of your claim. Some of the tactics insurance companies engage in to avoid paying out long term disability claims are unfair. For example, a company may hire an investigator to surveil you and videotape you engaging in different activities. It is common for an insurance company to only show clips from the videos that portray the individual as being more physically capable than he or she is. We may be able to get copies of all of the video footage or seek to suppress it in its entirety.
It may be a good idea to secure representation before filing your benefits claim with your long term disability insurance company. Many companies request information from disability claimants at the outset of their claims that the companies may turn around later to use against them. We can advise you on what information to provide in order to better protect your interests and your claim. It is especially important for you to secure legal representation if a hearing is scheduled for your claim. We can make certain that the record contains all of the medical evidence that is needed in order to support the grounds for your claim.
Appealing a Denial
If your claim has been denied, it is important to appeal the decision. In many cases, workers’ claims are won on appeal. Most insurance companies have at least one level of appeal, and some have more. Federal law requires you to exhaust all of the appeals that you have available to you administratively before you are allowed to file a lawsuit. There are several steps that you should take in order to appeal a denial of your claim.
When your claim is denied, the company will send you a letter that outlines its reasons for doing so. Read the letter carefully to see if you have missing documents that you need to track down. The letter will outline how to file your appeal along with the associated deadlines. It is important that you do not miss any deadlines because you may then not be able to appeal your denial. We can help you to supplant the record with additional evidence and expert opinions in order to make the success of your appeal likelier.
We can work to make certain that the record of your claim is stacked with evidence that is favorable to you. If your appeal is ultimately denied in your insurance company’s internal appeals process, the federal court will not consider any additional evidence other than what is contained in the underlying record. We may locate records that have been lost to submit to the record. He or she may also have you submit to a medical exam and have your treating physician or other medical expert write expert statements giving their opinions about the functional limitations that your disabling condition cause. We may also secure additional objective evidence, including X-rays, lab tests, MRIs and others in order to help bolster your claim. Finally, if your claim is denied by the insurance company, you may then file a lawsuit in federal court.
Do’s and Don’ts
It is important for you to understand what you should and should not do for your long term disability denial appeal. When you receive your denial letter, you should request a copy of your policy and of your file from the company. The file should contain all of the medical records that the company reviewed in making its decision. It should also include surveillance video, outside doctors’ reports, internal notes and other information that the company relied on to deny your claim.
If you have been approved for social security disability or workers’ compensation, submit evidence that you are receiving benefits as evidence of your disability. You should also supplement your record and submit written reports from your treating doctor and your former employer if you are able to do so. Getting written statements from others who can state how your disability affects your daily life can also be helpful. Finally, make certain to get help from an experienced long term disability attorney.
There are several things that you should avoid doing during your appeals process. You should never send in your appeal without reviewing your policy and your file first. Make certain that the job description accurately portrays the essential tasks of your job, and don’t rely on a description that is generic. Limit communication with your insurance company via telephone. Instead, insist that everything is in writing. Don’t rely on the regular mail to submit documents and send them via certified, return-receipt mail. Don’t miss any of your deadlines because you may be permanently barred from pursuing your claim further if you do. If you have mental or physical disabilities, it is likely that you may need to get an experienced attorney’s help and should avoid representing yourself on your appeal.
While receiving an appeal of your long term disability claim can be disheartening, you may be successful on appeal. With the help of an experienced long term disability attorney like our team at Osterhout Berger Disability Law, it is possible that you may win approval during the internal appeals process without needing to file a lawsuit. If your claim is ultimately denied, then you will have the ability to file a civil complaint in federal court to try to recover the benefits you should rightfully be awarded.
Let Us Help You Get the Benefits You Deserve
Schedule a free confidential consultation about appealing your denial by calling us toll free at 1-866-438-8773. If you prefer, you can fill out our intake form, and an experienced lawyer will contact you to schedule an appointment.