Long Term Disability Insurance Lawyers Serving Arkansas Residents
Abell and Capitan Law helps disabled workers like you file for long term disability insurance (LTD) so they can continue to support themselves while they’re out of work. If you sustained an injury or were diagnosed with a disease that prohibits you from performing your job in Arizona, you can apply for benefits through your employer’s LTD plan.
Employers purchase long term disability insurance so their employees can supplement their income with monthly payments if they’re unable to maintain their employment after an accident. Some states legally require employers to provide LTD insurance; however, Arkansas is not one of them. Your company might offer it as a coverage option along with other insurance benefits you receive, or you’ll have to apply through a self-insured plan.
Our long term disability insurance lawyers understand the importance of these benefits. If you lose your current source of income, you won’t be able to afford the cost of living or support your family. You also have expensive medical bills. This situation can put a severe strain on your life and create a great deal of stress. You can depend on us to help you get through it.
At Abell and Capitan Law, our lawyers focus specifically on disability insurance cases – that’s what we do. We can help you apply for LTD benefits and maximize the payment you receive, we can help you submit an appeal if your claim was denied or your benefits were terminated, and we can help you file a lawsuit if that’s what it takes to get the benefits you need.
Long term disability claims are complicated; we can help you navigate each step of the claims process to ensure the best possible outcome. Contact us at (267) 419-7888 today to schedule a free consultation.
What Is Long Term Disability Insurance?
Long term disability is an insurance policy that provides disabled individuals monthly payments at a percentage of their average wage. Plans differ from one insurer to the next, but most will pay up to 60% of the gross monthly income.
If your employer provides LTD, they pay a monthly premium towards the plan. If you get hurt or sick, you can notify them that you’re unable to work, and they will give you a form to fill out and send it to their insurance company. Some employers will pay the entire premium, while others will only pay for part of it. Whether they pay partially or fully into the policy, you’ll be able to collect benefits.
If you don’t have employer-paid LTD benefits, you can apply for an individual plan. Individual plans offer the same supplemental income as plans employers provide; however, you have to pay the entire monthly premium yourself. There are various insurers you can purchase from, and most will tailor your policy to fit your needs.
What Is ERISA?
The Employee Retirement Income Security Act (ERISA) protects the rights of disabled workers to LTD benefits. It also allows employees access to their policies. If they request policy information from their employer, the employer must provide policy disclosures, coverage information, instructions on applying for benefits, and any additional relevant information.
When you become disabled, ERISA allows you to apply through your employer’s LTD plan. Typically, you can notify your employer of your illness or injury, and they will give you a form to complete. After you complete the form, you can return it to your employer, and they will submit it to the insurance representative to begin the claims process.
When you apply for benefits, you’ll need to send the insurance company evidence that proves you have a disability and can’t work. Sufficient evidence you can submit with your claim includes the following:
- Physician letters regarding your disability and the specific physical or mental impairment it causes
- Prior records showing your disability isn’t from a preexisting medical condition
- Hospital records from the initial onset of the illness or injury
- Imaging reports, laboratory testing, physical therapy, rehab, and other documents showing consistent treatment
- Statements from family and friends who witnessed the disability’s effects on your daily life
- Copy of your job description showing the specific duties you’re unable to perform
Steps to Take After an Injury or Illness Leaves You Disabled
ERISA claims for long term disability benefits have strict deadlines you must follow. If you get diagnosed with a disease or suffer an injury, you should begin the claims process immediately. Steps to take to protect your claim include the following:
- Let your employer know about your disability and request the application for benefits. If they don’t provide it to you, you can print one online from their insurer’s website.
- Attend doctor appointments consistently. Don’t stop treatments until you recover, or your doctor releases you from their care.
- Write an employee statement that includes your personal information, details about your injury or illness, how the disability affects your job, and your employer’s information. Submit that to the insurance representative along with the application.
- Keep all documentation related to your disability, such as medical records, prescriptions, lost wage reports, and LTD policy information.
- Get a statement from your employer. Typically, your initial application for benefits will include a section for the employer to fill out.
- Get a statement from your physician that describes your disability and how it impairs your ability to complete job-related duties.
- Talk to a long term disability insurance lawyer who serves Arkansas clients. A skilled attorney will help ensure that you’re filing a complete, conclusive application.
- File your claim with the application, evidence, and any additional documentation you can provide.
After we help you file your claim, there will be a waiting period, which is the amount of time between your disability date and the date you first receive your benefit payments. Every policy is different, but most insurers issue a waiting period of 30, 60, or 90 days.
If the insurance company approves your application, you’ll receive monthly payments for up to two years or until you turn 65, as long as you have a disability, and it prevents you from maintaining employment in any type of industry. If you’re able to return to work, even just part-time, your LTD benefits will cease.
How You Should Handle a Denied Claim
Unfortunately, LTD claim denials are not uncommon. If the insurance adjuster denied your claim and you think their decision isn’t valid, you have the right to appeal their decision. Under ERISA law, you’ll need to file an administrative appeal within 180 days from the date on the denial letter.
Denial letters should include the reason for denied benefits, instructions on appeals, deadlines, and documentation to back up the decision.
Depending on the reason, you might need to obtain additional evidence to submit with your appeal. If the insurer states that medical records are missing or that there’s a lack of proof that you have a disability, your attorney can help you gather additional evidence such as:
- Affidavits from doctors specializing in your specific disability
- Vocational experts
- Records from additional medical care
- Affidavits from key witnesses
- Functional capacity reports
- Evidence of your job description
If the insurer continues to deny your access to benefit payments, Abell and Capitan Law will file a lawsuit. During a lawsuit, we’ll submit all of the evidence supporting your disability to a judge, and fight skillfully and exhaustively to support your case. The judge will review everything and determine if they agree with the denial or concur that you deserve LTD insurance.
Why Do Insurance Companies Deny Long Term Disability Benefits?
Inaccurate or incomplete forms
Every form you submit to the insurance company must be accurate and entirely complete. If any information is missing or you fill out incorrect information, it will likely delay the claims process.
Failure to attend an IME appointment
Some insurers require disabled workers to attend an independent medical examination by a doctor of their choosing. The doctor will perform their own medical evaluation to determine if they agree with your doctor’s assessment of the disability.
Preexisting medical condition
Every policy has exclusions, which is a list of diseases, injuries, and accidents the insurer won’t cover. If your disability is from a preexisting medical condition, the insurance company will probably deny your claim.
Disability definition on the policy
Every LTD policy includes a definition of disability. Policies can differ slightly, and if it doesn’t include your specific physical or mental disability, you won’t qualify for benefits.
Lack of medical evidence
All medical records you use as evidence should include the specific disability you have and how it interferes with your job duties. If your doctors don’t mention the injury or illness, you won’t be able to prove there’s a disability.
Insurance bad faith
The following are examples of insurers acting in bad faith:
- Intentionally delay a claim
- Offer a settlement lower than the claim is worth
- Deny a claim without reason
- Refusal to pay a valid claim
- Fail to complete an investigation
- Misrepresent policy language or benefits
Misrepresentation of disability
Some insurance companies will dig deep into their insured’s lives. They might look at your public social media posts to confirm that your disability interferes with your daily routine. If you claim you can’t work because of a leg injury, you shouldn’t post videos of yourself running or hiking. The insurance adjuster will look at something like that and deny your claim.
Choose Abell and Capitan Law to Represent You in Your LTD Claim
Applying for LTD benefits or appealing a denied claim is daunting. Both involve a complex process with strict deadlines and a lot of overwhelming paperwork. Most people don’t know how to navigate the process alone. Your long term disability insurance lawyer from Abell and Capitan Law will handle every step of the claims or appeals process on your behalf, and help you determine if a lawsuit in Arkansas may be in your best interest. You can focus on your recovery while we worry about the legal aspects of your case.
If you need legal advice or want to find out more about the services we offer, you can schedule a free initial consultation. We’ll meet with you to discuss your circumstances and let you know the best options for you to collect LTD benefits. Call us today at (267) 419-7888 if you have a disability that prevents you from working. We’ll help you secure the payments you need.