Long-term disability (LTD) insurance should be a safety net to protect you and your family if a medical condition leaves you unable to work. Whether your policy is a group plan provided by your employer or a private policy you took out as an individual, you have paid your premiums for years, and you should be able to depend on it when you need it. However, the sad truth is that many LTD insurance providers have no intention of paying out on these policies and will go to great lengths to deny your claim. If your long-term disability claim has been denied, an experienced LTD attorney can improve your chances of success when you file an appeal.
Disability Attorney Taking Both ERISA and Individual Claims
You may have had some difficulty locating an attorney who will represent you in a long-term disability appeal. Many Social Security disability attorneys won’t take these cases. However, the team at the Marcus Vaden Law Firm understands that you need legal help when you are struggling to get disability benefits—no matter what kind of benefits they are.
If your policy is through your employer, it is likely subject to the Employee Retirement Income Security Act (ERISA). This law was intended to protect employees by giving them access to the courts when their employer-sponsored plan is denied, but the way these cases proceed through the court system tends to favor the insurance company. If you don’t have an attorney on your side when your claim is denied, your odds of success may be greatly reduced.
When you hire us to help with your appeal, we will:
- Help you understand why your claim was denied
- Gather additional supporting evidence to strengthen your appeal
- Make sure you file your appeal within the 180-day window
- Communicate with the insurance company on your behalf
If your appeal goes to court, our firm will represent you in front of the judge—something you do not want to attempt on your own!
Why Disability Claims Are Often Denied
The first thing to understand is that the claims administrator tasked with considering your claim works for the insurance company, so he or she will be looking for any reason to deny your claim—even if your disability is clearly legitimate. Some of the most common reasons for denial include the following:
- Lack of medical evidence. To prove a claim of disability, you must be able to provide solid evidence that you are suffering from a medical condition that prevents you from being able to work. A statement from your doctor that outlines your work-related limitations will be a key piece of evidence. In addition, proof that you have sought medical help and are following your doctor’s treatment plan will be very important. If your application is missing key medical records, you will likely be denied.
- Failure to meet the standard of disability. Your policy will define what is considered “disabled” and you must be able to meet this standard. Some policies will cover you if you are unable to perform the specific duties of your current job (“own occupation”), while others have a higher standard that requires you to be unable to do any kind of work (“any occupation”). Again, the medical evidence of your limitations will be key.
- Missed deadlines. If your application is denied, most plans only give you 180 days to file an appeal. The sooner you contact an LTD attorney, the sooner he can start working on your appeal to ensure you meet the deadline.
- Evidence inconsistent with the claim of disability. LTD insurance companies have been known to engage in video surveillance of disability applicants to try to capture evidence that they are not actually disabled. The insurance company may also monitor your social media to try to catch you in a lie about your disability. If they are successful, they will use this evidence to deny your claim.
How long do I have to appeal a long-term disability claim denial?
When you suffer an ongoing medical condition and can no longer work, you will likely turn to your long-term disability (LTD) benefits for financial assistance. An LTD plan will typically pay 60% of your earnings while you’re off work.
Whether you have been promised benefits through your employer’s LTD plan or have paid the premium on your own personal plan, you expect those benefits to be readily available. However, nearly two-thirds of all initial LTD claims are denied. Because your application for LTD benefits may not be approved at first, there is important information you need to know about filing a claim, including the deadlines and timelines after a denial.
Timeframes and Deadlines for LTD Claims and Appeals
If your initial LTD claim was denied, you will typically have 180 days to appeal, but it’s important that you get a copy of your policy to verify this timeline. When you’re dealing with insurance companies that are most concerned with their own financial bottom line, six months isn’t a lot of time.
Additionally, there are other critical deadlines to be concerned with, including:
- Most LTD plans will state you must submit a Notice of Claim by a certain deadline after the onset of your disability. Generally, the plan will give you 20 or 30 days to give this notice. A Notice of Claim is a notification to the insurance carrier that you plan to submit a claim. When the carrier receives your notice, you’ll be sent claim forms.
- After you send the insurance carrier your completed forms, you will typically wait for 180 days in the Elimination Period—the time between the onset of your disability and the date you can receive benefits. During this period, you’re not eligible to collect LTD.
Trust Marcus Vaden Law
When you’re unable to work due to an ongoing illness or medical condition, dealing with an LTD insurance company that’s denied your claim can be time-consuming, frustrating, and overwhelming. Attorney Marcus Vaden can help get the money you deserve. He has successfully fought for the rights of his Arkansas clients and will help fight for yours. Call today for a free consultation.
Contact Marcus Vaden As Soon As Possible
Time is of the essence in an Arkansas long-term disability claim. The team at the Marcus Vaden Law Firm will help first-time applicants as well as people who have been denied and need to appeal.
Our experienced disability attorney will help you build a strong claim or appeal, and as a skilled litigator, will take your claim to a judge if necessary. Don’t delay in contacting our Conway, Arkansas office. We are ready to help you get the disability benefits to which you are entitled.