Michigan Long Term Disability Insurance Claim Attorneys
Did you suffer an injury outside of work or were you diagnosed with an illness that will prevent you from working for an extended period of time? If you purchased an individual disability policy or your employer provides long term disability coverage, you can file a claim for benefits. Abell and Capitan Law can handle all stages of the disability claims process, and fight for maximum compensation.
Insurance companies look for reasons to deny a policyholder’s claim or delay providing payments for as long as possible. Our Michigan disability insurance claim attorneys can review your policy and determine what you’re entitled to receive.
Many people find it overwhelming to deal with the deadlines and guidelines set by Michigan laws. Filling out all the required forms is time-consuming and any missed detail could cost you significant benefits. With an experienced attorney by your side, you’ll feel confident knowing nothing will fall through the cracks.
We understand this is a difficult time in your life. Abell and Capitan Law will stand by your side throughout the entire claim process to ensure you receive the full benefits you deserve. Contact us for a free consultation at (267) 419-7888.
What Is Long Term Disability Insurance?
A lot of people don’t understand the difference between workers’ compensation benefits and disability benefits. Workers’ comp is coverage provided by your employer for a job-related injury or illness. Long term disability benefits pay workers if they’ve been injured or become ill outside of work and will be unable to return to work for a significant period of time, if ever.
You can only seek workers’ compensation benefits from your employer. Long term disability insurance, however, could come from various sources. The different plans you could pursue benefits from include:
- Employer Paid: Your employer provides coverage to their employees by paying the entire premium or just a portion of it, so you can file a claim if you can’t return to work.
- Employee Paid: If your employee doesn’t pay for your disability insurance, but offers it along with your benefits package, you could choose the coverage by paying a monthly premium.
- Member Coverage: You can pay for a policy at a group rate if you’re a member of a professional association.
- Individual Plan: If you’re not eligible for coverage through your employer or a professional association, you can apply directly through an insurance company.
Specific laws dictate the availability of disability benefits for injured workers. However, Michigan law doesn’t require employers to provide such insurance. If your employer doesn’t offer coverage or the policy limit isn’t high enough, you could supplement it with an individual plan. Many people prefer an individual plan because it’s customizable based on the types of benefits you would like if you’re unable to work.
ERISA: What it is and How it Affects Disability Benefits
ERISA, Employee Retirement Income Security Act, is a federal law that protects employee benefits. Whether it’s self-funded or an insured plan, you can file an ERISA claim through your employer’s policy. Benefits paid for through a professional organization or governmental plan don’t fall under ERISA law.
It’s essential to submit documents that support your ERISA claim promptly. It’s often difficult to add additional documentation down the road if you choose to file a lawsuit. During the claims process, you must provide the following documents:
- Copy of your disability policy and a summary of the coverage descriptions
- Medical records from all providers proving you have a disability
- Job description from your employer listing the physical and/or mental requirements of your job that you can’t fulfill
When it comes to long-term disability claims, insurance companies can’t request objective evidence for a subjective problem. When reviewing your application, insurers must consider any mental health issues, pain, and the side effects of a medication you’re taking. They can’t deny access to benefits based on the subjective symptoms of your disability. Understanding special issues to include in your claim could ensure you receive the benefits you need. Special issues include the following:
- Cognitive impairment
- Medication side effects
- Eligibility for Medicare benefits
- Pain and fatigue
- Mental illness
- Continued to work with a disability
The Process of Filing a Disability Claim
Your attorney from Abell and Capitan Law will begin the process of filing your claim immediately. The first step we’ll take is to obtain a copy of your disability insurance policy and review it. We’ll determine if there’s coverage for your specific injury or illness.
After submitting the initial application, the insurance company will require the completion of forms and submission of documentation to decide if you deserve benefits. We have experience assisting our clients with the process of accurately filling out forms, undergoing necessary medical examinations, requesting copies of your medical records, and preparing for any interviews required by the insurer.
After we file the claim and submit all evidence, it’s the insurance representative’s job to review everything and make an initial decision to approve or deny the claim. Depending on the coverage listed on your policy and extent of your injury or illness, you could potentially receive payments equivalent to your monthly income.
There’s a waiting period during which the insurance company reviews everything we send to them. During that time, you should continue consistent treatment of your injury or illness. It’s also a good idea to keep all records, bank statements, and other documentation that proves your disability. If the insurance company approves your claim, you’ll start receiving payments based on your income.
The Insurance Company Denied My Claim. Now What?
It’s your right to appeal the insurance carrier’s denial if you believe you deserve disability benefits. Abell and Capitan Law is experienced in appealing claims and providing the necessary evidence to get them reopened.
When an insurer denies a disability benefits claim, they must provide a denial letter along with documentation for their reasoning. The letter should also include information for appeals if that’s what you choose to do.
Unfortunately, it’s not uncommon for injured individuals to receive a denial. Various factors result in a denied claim, including:
- Lack of Medical Evidence: It’s not sufficient to just seek medical treatment. Your doctor must state in your medical records that your illness or injury prevented you from performing your job-related duties or returning to work altogether.
- Upcoming Medical Procedure: If you already scheduled an upcoming surgery, it could affect your claim. Insurance companies typically require proof that complications didn’t arise after your surgery before moving forward with your application.
- Undiagnosed Condition: A condition or symptoms with an unknown origin could result in unplanned treatments in the future. If your physician doesn’t know what caused your situation, it could develop into something severe down the road. The insurance company won’t approve your claim until you provide the status of your medical problem or you recover from it.
- Ineligible Medical Condition: Disability insurance benefits don’t cover specific illnesses if you received a diagnosis previously. Your claim could also get denied if you sustained an injury as a direct result of your disease.
Speak with an Experienced Attorney
Don’t try to handle your claim alone. It’s a complicated procedure with strict deadlines and confusing guidelines. Abell and Capitan Law aims to make this difficult situation as easy as possible for our clients. It’s stressful enough dealing with an injury that keeps you from working. Applying for disability benefits on top of everything else is overwhelming.
We know you don’t want your case to drag out unnecessarily. Neither do we. We work efficiently, so you don’t have to wait long to receive the benefits you need. Experience matters and our attorneys know how to push claims forward and fight with insurance companies.
When you hire us, we will regularly communicate with you regarding the status of your claim, so you know what to expect next. We’re available 24/7 through our live chat feature to answer your questions or schedule an appointment. We believe in providing our clients with one-on-one attention and making your needs a priority.
Need Help with Your Disability Benefits? Contact Abell and Capitan Law for a Free Consultation
Whether you haven’t filed your claim yet or received a denial letter, we’re prepared to help you. It’s our job to ensure you receive the disability benefits you deserve.
We offer a free consultation, so there’s no risk or obligation to speak with us about your unfortunate situation. We’ll review the details of your case and determine if we can move forward with it.
All of our attorneys take disability insurance cases on a contingency fee basis. That means we don’t get paid unless you get paid. We don’t require upfront fees or costs. If we’re unable to secure your benefits, you won’t have to pay us anything.
Abell and Capitan Law is prepared to take on your disability claim if your injury or illness prevented you from returning to work. Call us at (267) 419-7888 today, and we’ll schedule your free consultation.