Georgia Long Term Disability Claim Lawyers
If you have a long term disability that has left you unable to work for a significant amount of time, your long term disability benefits are vital to you and your family. If you have long term disability (LTD) insurance, you could be entitled to payments for a portion of your earnings. You want to make sure that you and your family are receiving the maximum benefits, and that your claim is not wrongly denied.
The Georgia long term disability insurance attorneys at Abell and Capitan Law are here to answer all your questions, and we can help you make a claim. We can also help you if your claim is denied, or suddenly terminated.
You have enough to deal with to maintain your health during your disability—we know this is a stressful time for you and those you care about. Let Abell and Capitan Law help you so that you can focus on what’s important right now: your own health and your family’s well-being. Call (267) 419-7888 today for a free consultation.
Why You Need A Lawyer
When making a long term disability insurance claim, it is essential to have an attorney experienced in federal and Georgia disability insurance law to help guide you through the process. The disability claims process can be incredibly complex, and policies are often full of legal jargon and exceptions that make it difficult for anyone but an expert to interpret.
A good lawyer can explain all the details to you, as well as make sure all the paperwork is properly filed on time and that any evidence is organized and available when needed. Mistakes in your application and missed deadlines can easily lead to a denial of benefits. You need a lawyer who will stick with you through the entire process, and through appeals and a lawsuit if necessary.
Why Should You Hire Us?
The long term disability claim attorneys at Abell and Capitan Law are committed to helping those who with disabling conditions get the money they’re entitled to, and we are knowledgeable about Georgia insurance law. We can make sure your claim is filed properly, and that you aren’t denied your essential benefits by an insurance company looking to protect its bottom line. If your claim is denied, we can appeal, or even take them to court to ensure your rights are protected.
Disability insurance is what we do—this is an area of law unto itself, and most firms do not have the expertise or the specialized knowledge that we do to ensure our clients are able to recover all the benefits they are owed. Each case is unique, and we take pride in being able to bring individualized attention to your specific needs as we go through this journey together. When you hire Abell and Capitan Law, you’re gaining a staunch ally and advocate that you can rely on during this trying time.
Disability Insurance Explained
If you become unable to work because of a serious disability or illness such as cancer, partial or full paralysis, Parkinson’s disease, stroke, epilepsy, or a number of other disorders, and you have Long Term Disability (LTD) insurance, you can receive benefits as a portion of your full pay that will support you and your family during your illness.
The policy may be part of a group plan purchased by your employer, or you may have bought supplemental coverage, or have your own plan. If you have an employer-related plan, there may be requirements such as length of employment, full-time status, and electing into coverage in order to later receive benefits.
In order for your claim to be approved, you must receive regular medical treatment, and your doctor must provide an evaluation of your ability to perform the essential functions of your job.
LTD plans often distinguish between your “own occupation” and “any occupation,” in determining your inability to perform your job. If your disability prevents you from performing your own occupation, an “own occupation” policy will pay benefits while you are disabled. In an “any occupation” policy, you would only receive benefits if your disability prevents you from performing tasks related to any occupation for which you are qualified.
The policy might switch from “own occupation” to “any occupation” after 24 months, meaning you would no longer receive benefits if you’re able to perform another occupation or your insurer determines that your condition has improved enough to allow you to go back to work.
You may find some notable exclusions and limitations in your LTD policy, including:
- A 24-month limit on benefits for mental conditions,
- Exclusions for pre-existing conditions for which you’ve been treated in the past 90 days,
- A waiting period, also known as an “elimination period,” usually 3-6 months during which you aren’t eligible for benefits even though your illness prevents you from working,
- A reduction in your benefits by the amount of your Social Security Disability Insurance (SSDI) benefits, and/or
- An age limit of 65, or a limit to the number of years you are allowed to collect benefits.
Your benefits may also be subject to taxation, depending on whether the premiums are paid with before-tax dollars or after-tax dollars.
Some conditions that may qualify you for long term disability benefits include:
- Rheumatoid Arthritis
- Type 1 Diabetes
- Multiple Sclerosis
- Blindness or vision loss
- Deafness or hearing loss
- Carpal Tunnel Syndrome
- Herniated disk
- Heart disease
- Lung disease or lung cancer
- Parkinson’s disease
- Post Traumatic Stress Disorder (PTSD)
- Irritable Bowel Syndrome (IBS)
- Kidney disease
- Spinal Stenosis
- Chronic fatigue
This is only a partial list of illnesses that may qualify. You may have one or a combination of conditions that qualifies you for benefits. Speak with your lawyer to determine whether your own disability makes you eligible.
Frequently Asked Questions
What is ERISA, and what does it mean for my benefits?
ERISA is the Employee Retirement Income Security Act of 1974. It is the federal law that governs group health insurance plans. Your insurance policy may be subject to ERISA if it was purchased by your employer. If you have an individual plan, it probably falls under Georgia insurance law.
ERISA requires you to follow specific procedures in applying for benefits and in making appeals. It allows LTD insurance companies to decide whether you’re approved. If your claim is denied, ERISA allows you to bring a lawsuit in federal court. If there are errors or inconsistencies in your application for benefits, it is very difficult to win a case like this. This is why it’s so important to have a lawyer in your corner to make sure that all the details are in order from the beginning.
How much will my policy pay?
Typically, LTD plans will pay out between 50% and 80% of your pre-disability earnings, up to a maximum monthly payment, which can range between $4,000 and $25,000. Most plans will use the amount you were earning right before you became disabled, but some will factor in other forms of pay such as bonuses, overtime, and commission. Your policy may have a cost-of-living adjustment built-in or as an optional rider, which would increase your benefits from 1 percent to 3 percent each year.
SSDI benefits will reduce the amount you get from your policy. Continuing to work in a reduced capacity while on long term disability may also reduce your benefits, unless your policy allows you to work in another occupation.
What do I do if my claim is denied?
If your claim is denied, don’t give up! You can appeal, or even bring a lawsuit if that doesn’t work. Your insurance company will have an internal appeals process, which you must follow before taking the case to court. During this appeals process, you and your attorney will submit medical records and statements from your doctors to prove that you should receive benefits. Ample evidence is often key in an appeal. Your social activities may be subjected to scrutiny by the insurance company to be sure that your injury is as serious as you claim.
Call Abell and Capitan Law For Your Long Term Disability Claim
If you or a loved one is battling a serious long-term illness, you are managing a lengthy, draining ordeal during which you have to be concerned with doctors, medication, and painful treatments. Struggling with an insurance company is the last thing you should be worried about. The experienced disability insurance lawyers at Abell and Capitan Law have helped many clients in Georgia going through the exact same situation as you.
We know all the ins and outs of the long term disability claims process, and we can lead you through it step by step. If your claim is denied, as sometimes occurs, our top-notch legal staff will be right by your side, even if it’s necessary to take the insurer to court. We don’t earn a fee unless you win your case. Call us at (267) 419-7888 or fill out our contact form today for a free consultation.