Long-term Disability Lawyers Serving Nevada Residents
If you got hurt or sick due to something unrelated to your job, you might qualify for long-term disability insurance benefits through your employer. At Abell and Capitan Law, we have experience filing claims and appealing denials. We know how to protect the rights of our clients and ensure they receive the benefits they deserve. If you are in need of making an LTD claim in Nevada, Abell and Capitan Law can help.
It’s important to realize there’s a significant difference between workers’ compensation and long-term disability. If you sustain an injury at work, you can file a claim for WC benefits; however, LTD insurance doesn’t include job-related medical conditions. The payments you receive will depend on the information listed on your employer’s insurance policy.
Call (267) 419-7888 to speak with one of our long-term disability lawyers and discuss your options for recovering LTD benefits.
What is Long-term Disability Insurance?
Long-term disability replaces a portion of an injured worker’s income. It covers a disability caused by an injury or illness that occurred outside of work. If you can’t return to your job or have limited capacity to complete all required tasks, you can file a claim with your employer’s insurance company.
Policies purchased by businesses must follow regulations set by the Employee Retirement Income Security Act (ERISA). This act protects injured workers’ rights and allows them to apply for benefits when they’re unable to maintain employment because of their disability. Your employer must provide you with policy information upon your request, including coverage details, instructions for filing a claim, and conditions that qualify for benefit payments.
There are also deadlines you must follow if the insurance company denies your claim. ERISA law requires disabled individuals to file an appeal within 180 days from the denied claim date. If you miss the deadline or fail to submit adequate evidence of your disability, you’ll lose your rights to LTD coverage.
What Should I Do If I’m Disabled?
If you’re unable to work because of your injury or illness, there are crucial steps you must follow to ensure you’re eligible for long-term disability benefits.
Step 1: Inform your employer of your disabling condition immediately.
Step 2: Go to the doctor. They will evaluate your injury to determine if you have a disability. Ensure they write a physician statement stating your medical condition and how it prevents you from performing your job duties.
Step 3: Ask for a copy of your employer’s long-term disability insurance policy. Review it to determine if your injury or illness makes you eligible for benefits, and when you need to send in your application.
Step 4: Obtain an application for benefits from your employer. Complete it thoroughly and accurately. Providing incorrect details or submitting an incomplete form could cause the insurance company to deny your claim.
Step 5: Follow up with all necessary medical providers regularly. If you skip appointments or there are gaps between treatments, you won’t have sufficient medical evidence of your disability.
Step 6: Keep copies of all documentation related to your claim. You’ll need to submit it to the insurance company along with your application.
Step 7: Hire a long-term disability lawyer. We can file the claim on your behalf and provide all the necessary records to the insurance company in Nevada.
After filing your claim, the insurance company will review everything we sent them and perform their own investigation into the circumstances surrounding your condition. If they approve your application, you’ll start receiving benefits after an initial elimination period.
The elimination period is a waiting period between the date you became disabled and receiving your first payment. Every LTD insurance policy is different. Typically, it lasts between 30 days and one year. The most common is 90 days.
You’ll receive benefit payments for up to two years as long as you can’t return to your job. If you’re unable to maintain any type of employment, you might be eligible for long-term disability coverage until you turn 65 years old or the rest of your life.
What to Do if the Insurance Company Denies Your Claim
One of the biggest mistakes you could make is to give up on pursuing LTD benefits if the insurance company denies your claim. Just because you received a denial letter doesn’t mean you’ll never receive insurance coverage. You have the option to appeal the decision and provide additional evidence proving you have a disabling condition that prevents you from working. Your long-term disability lawyer will help you with this process to ensure the evidence collected is sufficient in getting the insurance company to overturn the denial.
When the insurance company decides to deny someone’s claim, they will send a letter. In the letter, there will be the reason for the denial and instructions for filing an appeal. If your employer’s policy falls under ERISA law, the deadline will be 180 days from the letter’s date.
We’ll review the letter to determine why they made their decision and begin gathering evidence to submit with our appeal letter. Sometimes things like medical records aren’t enough to convince the insurance company that you deserve benefit payments. We might have to get medical experts to review your injury or illness and provide a statement that it’s a disability.
Examples of additional evidence we’ll send to the insurance company that might not have been included in the original claim are:
- Letters from medical experts
- Results from further testing, such as X-rays or MRIs
- Copy of your job description and employment records
- Statements from a vocational expert
- Medical records missing from the initial LTD claim
- Affidavits from friends and family
After we file the appeal and submit all the evidence we found, the insurance company will have up to 45 days to review everything. Sometimes it can take longer. Most of the time they’ll request a 30-day extension to give them more time to decide. If they approve your appeal, you’ll start receiving benefits. However, if they continue to deny your request, we can file a lawsuit and take them to court.
Common Reasons for Denied Long-term Disability Claims
There are many reasons an insurance company will deny someone’s application for LTD benefits. Sometimes it’s because you made an error in the claims process; other times it’s because the insurance company messed up. There are even situations where they’ll deny the claim unfairly simply because they don’t want to pay you the benefits you deserve.
The most common reasons include:
Bad faith. Sometimes an insurer will act in bad faith by denying your claim for an invalid reason or failing to perform an adequate investigation into your disability.
Missed IME appointment. Some insurance companies will require an applicant to attend an independent medical examination (IME). This is an appointment with a doctor of their choosing that you must attend. The doctor will perform a medical evaluation and review all of your records to determine if they agree with your initial doctor that you have a disabling condition.
Disability definition. Every policy has its own definition of what constitutes a disability. Your injury or illness must fall under this definition and the circumstances that led to your medical condition.
Preexisting medical condition. Most long-term disability insurance policies list exclusions for situations and injuries or illnesses that make someone ineligible for benefits. Preexisting medical conditions are the most common. They include treatment of any physical, mental, or emotional problem before applying for insurance coverage.
Incomplete or inaccurate forms. There’s paperwork to complete and documentation to submit to the insurance company. There shouldn’t be any discrepancies or missing information.
Partial disability. Some LTD plans require the disabled individual to have a total disability. Partial disabilities where there’s an ability to return to work but at limited functioning aren’t covered.
Abell and Capitan Law has a team of dedicated long-term disability lawyers who will fight hard to protect your rights. We understand laws that govern LTD insurance and how to recover the maximum benefits available for our clients. Throughout the claims process, we’ll ensure the insurance company treats you fairly and doesn’t act in bad faith.
We know you’ve already been through a lot. When a disability prevents you from earning a living, it’s overwhelming. It creates a financial strain, and you worry about how to pay for your medical treatment and the daily cost of living. When you hire us, we’ll work diligently to get you the benefit payments you need to pay for your expenses.
At Abell and Capitan Law, we believe in providing dependable and affordable services to our clients. That’s why we offer an initial free consultation to review the circumstances surrounding your disability and determine the best legal options for you. If you choose to hire us, we’ll take your case on a contingency fee basis. That means there are no upfront fees or costs to receive legal representation. You won’t have to pay us until we recover your LTD benefits.
Call us today at (267) 419-7888 to speak with one of our long-term disability lawyers. We’ll be happy to discuss the injury or illness that keeps you from your job and how we can help you file a claim or appeal a denied claim.