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Long-Term Disability Claims Attorneys for Dementia

When you’re planning for your future following a dementia diagnosis, you may be able to turn to long-term disability insurance benefits to cover the cost of daily living, so you can focus on your health. The long-term disability attorneys at Capitan Law can help you apply for benefits or appeal a denied claim and fight for the maximum coverage you deserve.

Dementia is a debilitating condition that can impact an individual’s mental capacity and ability to perform daily tasks. It can disrupt the brain’s normal functioning, causing memory loss, difficulty with speech, and disorientation. According to the World Health Organization, approximately 50 million people have dementia, and another 10 million develop it each year.

At first, your symptoms might not impact your life substantially. You may still be able to care for yourself and your family and continue to work. However, as symptoms worsen, the mental impairment could limit your ability to complete daily tasks and earn a living.

At Capitan Law, we dedicate ourselves to helping our clients receive long-term disability benefits that cover medical treatment, daily living costs, and other necessary expenses. We’ll work hard to protect your future.

To find out more, call (267) 419-7888 to schedule your free consultation with one of our dementia long-term disability claims attorneys.

Applying for Long-Term Disability Benefits

Long-term disability is a form of insurance coverage that replaces a person’s lost income when they cannot return to their job. It’s useful for paying for daily living expenses, medications, and medical treatment. The amount you receive will depend on what’s listed on your policy, but most will provide between 50% and 80% of your average monthly wages before you developed dementia.

Follow the steps below to help ensure you receive the full benefits you need:

Step 1 – If your employer provides long-term disability insurance, you should notify them when your doctor diagnoses you with dementia and determines you can’t complete your work-related duties. They will give you an application for benefits that you must complete promptly and accurately. Missing information could result in a delayed claims process.

Step 2 – Write an employee statement to include with the application. You should mention your diagnosis, the symptoms you experience, and the tasks you perform at your job that you can no longer complete because of the disability.

Step 3 – Return the application and employee statement to your employer. They will also include an employer statement to provide to the insurance company. It’s crucial that they mention the exact date you stopped working and how your disability impacts your daily duties. They might also include a copy of your job description for the insurance company to review.

Step 4 – Obtain a physician statement from your doctor that diagnosed you with dementia. They must explicitly state that you have dementia and can’t work.

Step 5 – Follow the treatment plan your doctor prescribed. If they recommend prescription medications, take them. If they refer you for cognitive therapy or other forms of treatment, you should attend those appointments regularly.

Step 6 – Hire a dementia long-term disability claims attorney from Capitan Law. We will help you with every step of the process, so you don’t have to handle a complicated claims application on your own.

After you apply for benefits, the insurance company will have up to 45 days to review everything. They can request two 30-day extensions if they need additional time to make a decision. If they approve your claim, you will have to go through an elimination period. This is a specific timeframe between the date of your disability and the first date your benefits begin. It can last anywhere from 30 days up to one year. However, most policies require a 90-day elimination period.

Why Did the Insurance Company Deny My Claim?

Unfortunately, insurance claims get denied frequently because insurance companies don’t want to pay the benefits claimants deserve. They will look for any excuse to issue a denial or provide minimal benefit payments. When that happens, Capitan Law can help.

The most common reasons for denied long-term disability claims include:

  • Disability definition – Every policy includes its own definition of a disability. If dementia does not fall under your insurance company’s definition, you would not be eligible for benefits.
  • Inadequate medical evidence – You must provide evidence of your disability and ongoing treatment. If there are missing treatment dates or medical records that don’t mention your diagnosis and symptoms, the insurance company won’t be able to approve your application for benefits because there’s no proof that you’re no longer able to work.
  • Inaccurate information – Insurance companies require specific details in any claim they handle. If there are discrepancies between your statement and your doctor’s statement, they may not be able to verify that you have dementia or can’t return to your job due to the diagnosis.
  • Procedural errors – You must follow every deadline throughout your claim. If the insurance policy requires that you begin the application process within 30 days of your disability, you must adhere to that. If the insurance company asks you for additional evidence, you must submit it promptly according to specific laws and regulations.

Employer-paid long term disability plans follow ERISA regulations. The Employee Retirement Income Security Act sets standards for insurance companies and protects policyholders. Under this law, you have 180 days from the date of the denied claim to file an administrative appeal. Capitan Law will review your denial letter to determine the insurance company’s reasoning and the best option for appealing their decision.

Some of the additional evidence we might need to provide includes:

  • Functional capacity reports and a copy of your job description
  • Affidavits from medical experts
  • ER, hospital, physical therapy, and other medical records missing from the original claim
  • Laboratory and imaging reports
  • Physician statements
  • Statements from friends and family about the effect of dementia on your daily life

If the insurance company denies your appeal, we can move forward with filing a lawsuit.

Contact Capitan Law for Help With Your Long-Term Disability Claim

Our dementia long-term disability claims attorneys will assist you with the process of recovering the benefits you deserve. When you can’t maintain adequate employment, it puts a strain on your life mentally, emotionally, and financially. We know the importance of receiving monthly payments to pay for your medical bills, household expenses, and other associated costs. You can depend on our legal team to fight vigorously and effectively for the full benefits you need.

If you or someone you love was diagnosed with dementia and need to file a long-term disability claim or appeal a denied claim, don’t hesitate to call Capitan Law at (267) 419-7888 today.

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