A sizable minority of people will suffer from an injury or illness that prevents them from returning to their jobs at some point in their lives. As much as 25 percent of workers who are currently in their 20s will be disabled and unable to work at least once in their careers. Long-term disability insurance can provide the financial safety net that you need if you become disabled in Pennsylvania. If you have long-term disability insurance, there are some important things that you should know when you file your claim or if your claim is denied.
Appealing a Denial
Insurance companies sometimes deny valid claims in order to reduce their losses. If you receive a notice of denial, you should read the letter closely. It should list the reasons for the decision and the appeals process. There will be a listed deadline for appealing the denial, and it is vital that you do not miss it or your ability to pursue the claim later will be barred. You will need to complete the company’s internal appeals process before you can file a lawsuit against it in federal court.
Do’s and Don’ts
It is important for you to make certain to do certain things during your appeal and to avoid doing others. You should never file your appeal without first reviewing the letter that you received as well as your claim file. You should request a copy of your file because it will contain all of the documents and evidence that the company relied on to deny your claim. Use the contents of your file to focus your appeal. Do observe the deadlines and never miss them. Do not try to represent yourself if you have suffered a mental or physical limitation that could harm your claim, and do consider hiring an experienced Pennsylvania long-term disability attorney for help.
Getting the Benefits You Deserve
Make sure to supplement the record with favorable evidence. This may include such things as letters from your doctors opining about your disability and how it limits your functionality. You may also want to get letters from friends, family members and your former employer that also describe the functional limitations your disabling condition has caused. If you are receiving benefits through workers’ compensation or Social Security Disability, submit evidence of your approval for those benefits as it strongly shows that you should win on appeal. Make certain to track down any missing documents and submit them. You should insist on communicating in writing with your insurance company and avoid communicating with the representatives orally as much as possible. Finally, consider hiring experts to offer their opinions about your condition and the limitations that you have because of it.
Working with an Attorney
Getting help from an experienced Pennsylvania long-term disability lawyer early in your claims process is best. It might be smart for you to get help before you file your claim initially. An attorney may advise you about the information that you provide to the company for your claim so that you do not say or submit something that could be used against you as a reason for denying it. If your claim is denied, a lawyer may help to supplement the record and advocate for you through the internal appeals process. If the company ultimately upholds the denial, your lawyer may then file a lawsuit on your behalf and seek legal remedies through the court process.
Additional Service Areas
While we work with residents across Pennsylvania, and handle cases nationwide, we have particular experience with certain PA cities.