Nebraska Long-Term Disability Insurance Lawyers
You might be eligible for long-term disability benefits if you sustained an injury or illness from a non-work-related incident. Abell and Capitan Law is experienced, knowledgeable, and effective in filing insurance claims and appealing denied claims. We know the requirements you need to meet to receive benefits, and we know how to secure the evidence needed to help prove the extent of your disability. We’ll fight to protect your rights and recover the maximum payments available.
It’s important that you understand the difference between long-term disability insurance and workers’ compensation. Workers’ comp benefits are available to employees who get hurt or sick while performing their job duties. LTD benefits are for individuals who suffer a disability outside of work. Both provide benefit payments based on pre-accident wages; however, they each have their own eligibility requirements.
When you’re unable to continue working due to a medical condition, Abell and Capitan Law will help you get back on your feet. Call us today at (267) 419-7888, and one of our Nebraska long-term disability insurance lawyers will meet with you for a free consultation.
What Is Long-Term Disability Insurance?
Long-term disability is coverage you can receive through your employer-paid plan or an individual policy you purchase independently. It provides benefits at a percentage of your pre-disability average monthly wages. It’s meant to supplement a portion of your lost income while you’re unable to work.
If your employer pays for the LTD policy, it’s protected by the Employee Retirement Income Security Act (ERISA). This is a federal law that protects injured workers and regulates insurance companies. If you request policy information, the insurance representative should comply and provide you with a copy of the entire policy, disclosure, declaration pages, and other associated documents. They must also include instructions on filing a claim, appealing a denial, and proceeding with a lawsuit.
There are deadlines throughout the entire process that you always must follow. Whether you’re filing an initial claim or suing the insurance company for benefits, you have to check the insurance policy to ensure you’re completing everything on time. Missing a deadline could cost you the maximum available benefits. You might lose your rights altogether. That’s why you must hire a Nebraska long-term disability insurance lawyer to assist you with your case.
What Should I Do If I Become Disabled?
If an injury or illness affects your ability to perform your job, you should take immediate action to protect your rights to disability benefits.
- Notify your employer of the disabling medical condition that occurred outside of work. Complete the application they provide and return it with an employee statement. The statement should include details surrounding the incident, the type of injury or illness you suffered, medically necessary treatment, and how it affects your physical or mental capacity to perform your job.
- Seek medical treatment for your injury. Your physicians will perform an examination to determine if you have a disability and why you cannot complete your job duties. If they refer you to other providers, follow their orders, and continue treating until your doctors release you from their care.
- Hire a Nebraska long-term disability insurance lawyer. We can take over each step of the claims process, so you don’t have to worry about going through this alone.
- Ask your employer or the insurance company for a copy of the LTD policy. Read through it thoroughly to determine if you’re eligible for benefits and the deadlines you must follow.
- Request that your doctor provide a physician letter to submit to the insurance company. They should provide their expert opinion as to why your specific impairment prevents you from maintaining employment.
- Maintain copies of all medical records, invoices, prescriptions, insurance company letters, and other documents related to the claim.
After you file a claim, the insurance company will spend time reviewing everything you submitted and perform its own investigation. They’ll look through all the available evidence and decide if they agree with your request. If they approve the claim, you’ll start receiving monthly benefits once the elimination period ends.
An elimination period is a waiting period between the disability date and the first benefit payment. This timeline could last anywhere from 30 days up to one year; however, the most common elimination period is 90 days. It all depends on what’s listed on your employer’s LTD policy.
Payments may continue for as long as you have a disabling injury or illness. Some policies allow injured workers to collect disability benefits until they turn 65 years old or for the rest of their life. Others provide monthly payments until the claimant returns to their job or meets the limit listed on the insurance policy. Your Nebraska long-term disability insurance lawyer will review your coverage to determine how long your benefits could last.
Steps to Take After a Denied Insurance Claim
If the insurance company denies your claim for long-term disability, that doesn’t mean you’re out of options. You can appeal their decision and submit additional documentation that proves you have a disability and deserve benefits.
The first thing you should do is turn to your lawyer. If you haven’t sought legal representation yet, you should speak to Abell and Capitan Law about the appeals process. It’s complicated and confusing for those that are unfamiliar with it.
The denial letter should include the reason for the denied claim and instructions for filing an appeal. If the policy is employer-paid, it falls under ERISA law, meaning you’ll have 180 days from the denial letter date to pursue an administrative appeal.
Your Nebraska long-term disability insurance lawyer will review the letter and determine the best option for appealing the decision. Sometimes, medical evidence is missing from the original claim, or the physician letter doesn’t state the disabling condition. If there was something excluded, we’ll make sure to submit it during the appeal.
Additional evidence that could prove you have a disability and deserve to receive LTD benefits include:
- Results from additional MRI, X-ray, and other imaging tests
- Letters from medical experts
- Copy of your job description and employment records
- Statements from family and friends
- Affidavits from vocational experts
- Evidence missing from the initial claim
Common Reasons Insurance Companies Deny LTD Claims
Insurance companies will always look for a reason to deny someone’s insurance claim. They want to save money whenever possible and look out for their own interests. Unfortunately, you can’t trust your employer’s insurance representative during the claims process. If they deny your claim, your Nebraska long-term disability insurance lawyer can investigate to determine if there’s a valid reason or some error.
The most common causes of long-term disability denials include:
Missed IME appointment. An independent medical examination is an appointment many insurance companies require their claimant to attend. During the appointment, a physician of their choosing evaluates the injury or illness to determine if they agree with your initial doctor’s diagnosis of a disability. It’s mandatory, and if you don’t show up, that could result in a denied claim.
Insurance bad faith. The insurance company might act in bad faith by denying your claim without providing a valid reason, delaying the process unnecessarily, or failing to review all available evidence thoroughly.
Preexisting medical condition. Many LTD policies exclude coverage for preexisting injuries and illnesses. If the insurance company discovers you previously suffered from a similar condition, you might not be eligible to collect payments.
Definition of disability. Every policy includes a definition of the term “disability.” For the most part, it’s pretty much the same for every insurance company, but some might have slight variations. If your injury or illness doesn’t match your policy’s definition, you won’t be allowed to pursue LTD coverage.
Partial disability. Some insurance plans require that the claimant have a total disability to recover benefits. A partial disability is typically one that limits a person’s functional capacity but doesn’t completely prevent them from performing their job.
Inaccurate or missing information. The insurance company will provide forms that you need to complete and ask you to submit evidence of your disability. If you send incomplete medical records or documents with incorrect information, that could result in a denied claim.
Speak With A Dedicated Nebraska Long-Term Disability Insurance Lawyer
It’s overwhelming when you’re unable to earn a living. It creates a financial burden, and you wonder how you’re going to support yourself and your family. You have medical bills piling up and daily living expenses that you can’t afford. We understand the stress you’re experiencing.
At Abell and Capitan Law, we will fight hard to protect your rights and pursue the maximum benefits available. You deserve to receive payments from the insurance company for the suffering you had to endure. You can depend on us to handle each step of the claims or appeals process and help you move forward with your life.
If a non-job-related injury or illness caused you to stop working, contact Abell and Capitan Law immediately at (267) 419-7888. We’ll be happy to schedule a free consultation to discuss your case and advise you on the legal options available. Whether you’re filing an initial claim or appealing a denial, we have the experience and resources to help.