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Long Term Disability Claims Attorneys for Schizophrenia

Any mental illness makes normal tasks exponentially more difficult. One of the most severe examples is schizophrenia, a serious condition that affects your feelings, thoughts and behavior. It often causes debilitating symptoms that make daily life nearly impossible.

If you have schizophrenia and can’t perform your job anymore, Capitan Law might be able to assist you with a claim for long-term disability benefits.

You should not have to suffer financially because of your diagnosis. If your employer provides long-term disability insurance, you can file a claim and collect payments that replace a portion of your lost wages.

Capitan Law will ensure the insurance company treats you fairly and provides the maximum benefits you deserve. If you want to find out how we can help with your claim, appeal, or lawsuit, call us at (267) 419-7888 and schedule a free consultation with one of our long-term disability claims attorneys.

Schizophrenia Symptoms that Could Impact Your Job

Schizophrenia is a chronic brain disorder with no known cure. It causes symptoms that make it difficult for someone to notice the difference between real and unreal experiences. Although there is no way to cure this type of mental illness, treatments could improve the symptoms and decrease recurrence.

Three are three main categories of symptoms:

  • Positive symptoms – Paranoia, hallucinations, and distorted or exaggerated behaviors and beliefs
  • Negative symptoms – Decreased ability to speak, express emotions, initiate plans, or find pleasure
  • Disorganized symptoms – Bizarre behavior, difficulty with logical thinking, abnormal movements, and confused and disorganized speech and thinking

Symptoms typically begin in early adulthood and must last for at least six months before a doctor can diagnose schizophrenia. Researchers are unsure of the specific causes of this type of illness. However, they believe genetic factors, stress, and a person’s environment could contribute to the development.

What is Long Term Disability Insurance?

Long-term disability provides workers with benefit payments when they can no longer work because of a disabling injury or illness. It replaces a percentage of their lost income so they can afford medical care, daily living expenses, and other costs. Most plans provide between 60 and 80 percent of the disabled employee’s average monthly wages before the disability occurred.

You can apply for benefits as long as your schizophrenia keeps you from maintaining employment. After you file your claim, you will have to go through an elimination period. It’s a waiting period between the date your disability started and the date you receive your first payment. Insurance companies require anywhere from 30 days to one year for the elimination period.

Monthly payments could last for as long as you have an eligible disabling condition. The duration will depend on your specific insurance plan. Some allow policyholders to collect benefits for a couple of years, while others allow lifetime coverage. When your symptoms become severe enough that you don’t have the mental capacity to perform your job, you should immediately notify your employer and request a copy of the policy to determine how long you can expect to receive payments.

What is ERISA?

The Employee Retirement Income Security Act (ERISA) is a federal law that sets standards to protect participants. If your employer pays for your long-term disability policy, it’s covered by ERISA law. It requires all insurance companies to provide essential plan information to its plan participants. If you request a copy, you should receive the entire policy, including instructions for filing a claim and appealing a denied claim.

There are strict deadlines you must follow throughout the entire claims process. If you miss one, it could ruin your eligibility for benefits. Many insurance companies require people to file their initial claim within 30 to 90 days of the diagnosed disability. You also have to make sure you notify your employer once you realize you can’t return to work.

Once the insurance company receives your application, they will have up to 45 days to make a decision. They’re allowed two 30-day extensions. If they ask you for additional information about your claim, you have 45 days to respond.

If the insurance company denies your claim, they will issue a denial letter that includes the following details:

  • Date of the denied claim
  • Reason for the denial
  • Instructions on how to appeal the decision

ERISA law allows up to 180 days from the denied claim to file an administrative appeal. The appeals process is complicated and could take several months to resolve. You should let your schizophrenia long-term disability claims attorney from Capitan Law handle it. We have the resources to thoroughly investigate your disabling mental illness and obtain the necessary evidence to prove you deserve benefits.

Common Reasons for Denied Long Term Disability Claims

Insurance companies don’t care about their policyholders. They will find any excuse to deny your claim or diminish your payments to save money. It is critical to understand why insurance companies deny claims so you don’t make any mistakes during the process.

  • Bad faith – Bad faith involves denying a claim without valid proof, delaying the process unnecessarily, or failing to review all evidence thoroughly.
  • IME results – An independent medical examination is an appointment many insurance companies require a claimant to attend. A doctor they choose will determine if they agree with your doctor’s schizophrenia diagnosis. If they conclude you don’t have schizophrenia or the symptoms don’t cause a disability, they will deny your claim.
  • Definition of disability – Insurance policies have a long list of medical conditions eligible for long-term disability benefits. There are also exclusions that limit coverage for specific illnesses or injuries. If schizophrenia isn’t considered a disability, you won’t be allowed to collect payments.
  • Inconsistent or incomplete forms – You will need to complete forms when you apply for long-term disability benefits. Unfortunately, if the information you provide is incomplete or contains information inconsistent with the medical evidence, it could result in a denial.

Schedule Your Free Consultation with Capitan Law

We opened Capitan Law in 2017 to give injured individuals a fair chance at recovering the benefits they deserve. We will focus on your legal goals to reach a favorable outcome in your case. We believe in representing people who need help filing a claim or whose claims were wrongfully denied.

When you hire us, we will use our experience, knowledge, and resources to aggressively pursue the disability coverage you need and ensure the insurance company pays.

If you or someone you know has schizophrenia and can no longer perform their work-related duties, call us at (267) 419-7888 today.

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