New Mexico Long-Term Disability Insurance Lawyers
Did you suffer a disabling injury or illness? Does it prevent you from returning to work? If so, Abell and Capitan Law might be able to assist you with your application for long-term disability benefits, or we can help you fight for your benefits if your application was denied. You’ll need payments to replace your lost wages so you can afford your medical treatment and daily living expenses. We’ll work to ensure you receive the maximum benefits available so you can support yourself and your family.
There’s a major difference between workers’ compensation and LTD insurance. You might think workers’ comp benefits will cover your disabling condition; however, it only provides payments when the injury or illness occurs while performing job-related duties. Conversely, long-term disability provides coverage for employees who get sick or hurt outside of work. We understand state laws and the legal process necessary to recover the long-term disability benefits you deserve.
To find out more about us or our legal services, call Abell and Capitan Law at (267) 419-7888. One of our New Mexico long-term disability insurance lawyers will be happy to meet with you for a free consultation to discuss your case.
How ERISA Laws Effect Long-Term Disability Insurance
Long-term disability policies supplement injured workers’ lost income when they can no longer complete their job duties. Payments range from 50% to 80% of average monthly wages before the disabling condition occurred. The exact amount depends on the specific insurance policy. Each policy contains variations as far as eligibility requirements, payment amounts, and other information.
ERISA laws protect disabled workers who receive benefits from an employer-paid LTD plan. The Employee Retirement Income Security Act requires insurance companies to provide their policyholders with information related to coverage.
The federal law also regulates the claims process. There are strict deadlines you must follow to file a request for long-term disability benefits. You must submit specific evidence that proves you have a disability and can no longer perform your job. There’s also a procedure for appealing a denied insurance claim and documentation you have to provide to show you have a disabling condition.
What You Should Do If You’re Diagnosed With a Disability
If you end up with a disability, there are steps you should take immediately. You’ll need to hire an experienced New Mexico long-term disability insurance lawyer to assist you with the process. At Abell and Capitan Law, our team knows ERISA law and the evidence insurance companies look for when determining a claimant’s eligibility for benefits. It’s crucial that you begin building your case as soon as the injury or illness occurs. The sooner you start, the sooner you’ll receive benefit payments.
- Inform your employer of the disability and ask for an application to begin the claims process. There should be a section for you, your employer, and your doctor to complete. Your employer should submit it to their insurance representative on your behalf once everything is filled out.
- Request a copy of the insurance policy from your employer or the insurance company. It contains information you’ll need, such as filing deadlines and qualifying medical conditions.
- Seek medical treatment from a qualified doctor. Medical records are crucial evidence in an LTD claim. Ensure that your doctor states the specific injury or illness you have, how it happened, and why it prevents you from earning a living. They should also write a letter to submit to the insurance company.
- Write an employee statement that discusses your disability to include with the application.
- Maintain all records associated with the case, such as imaging reports, physical therapy records, insurance company letters, and other documents.
Once you file your claim, the insurance company will investigate and determine if you deserve long-term disability benefits. If they approve your request, you’ll begin receiving monthly payments after an initial elimination period. This is a specific amount of time you must wait before benefits begin. Most policies issue a 90-day elimination period, but some can be as short as 30 days or as long as one year.
Coverage can last up to two years as long as you continue to have a disability that prevents you from maintaining adequate employment. In some situations, you could be eligible to receive payments until your turn 65 years old or for the rest of your life. If at any time you no longer have a disabling condition and can return to work, payments will cease immediately.
How to Handle a Denied Long-Term Disability Claim
One of the most common mistakes injured workers make during the LTD process is giving up after receiving a denial letter. They usually assume they have no other options. Most people don’t understand their rights under ERISA law and how to handle a denied claim. You’re entitled to file an appeal and prove that you deserve payments.
Most insurance policies require that you file an administrative appeal within 180 days (p.4) from the date on the denial letter. Confirm with your insurance company the exact deadline. If it passes, you’ll lose your right to appeal their decision.
When you file, you’ll have to provide the insurance company with evidence that you have a disability and can’t perform your job-related duties. Relevant evidence you could submit includes:
- Reports from vocational experts
- Medical expert affidavits
- Witness statements from friends and family who saw the impact of the disability on your life
- Additional medical testing and records
- Copy of your job description and performance evaluations
- Letters from your medical providers
- Documentation missing from the original claim
Typically, insurance companies have 45 days to review the appeal and determine if you deserve disability benefits. If they approve it, you’ll begin receiving payments for long-term disability insurance. If they deny your request, you might have to file a lawsuit. A federal judge may be involved at that point and will review all of the information to decide whether they agree with the insurance company’s decision.
Common Reasons for Denied Long-Term Disability Claims
There are various reasons insurance companies deny claims. Some are valid; others aren’t. The best way to ensure you submit an application that gets approved is to understand why insurance companies typically deny LTD claims.
- The injury or illness doesn’t fall under the policy’s disability definition.
- You failed to attend an IME, a mandatory appointment with a doctor chosen by the insurance company to evaluate your disabling condition.
- There’s a partial disability instead of a total disability.
- The disability is from a preexisting condition that’s excluded from coverage.
- The insurance company acted in bad faith by denying the claim for an invalid reason or unnecessarily delaying the process.
- The insurance company’s physician disagrees with your doctor’s diagnosis of the disability.
- The application is incomplete or contains inaccurate details.
- There are missing medical records.
Why You Need a New Mexico Long-Term Disability Insurance Lawyer
If you’re unfamiliar with LTD claims and appeals, you will have a hard time navigating the complex proceedings. Our New Mexico long-term disability insurance lawyers will file the claim or appeal and take care of every aspect of the process on your behalf. We’ll ensure we don’t miss a deadline and submit all the necessary documentation to the insurance company.
When you hire us, we’ll thoroughly investigate the incident that led to your disability and collect evidence. We’ll work hard to prove that you have a condition that prevents you from returning to your job. Evidence may include:
- Eyewitness statements
- Accident scene evidence
- Medical records
- Video surveillance
- Employer statement
- Physician letters
You won’t have to worry about communicating with the insurance company. They can be intimidating to applicants. We’ll handle all communication on your behalf. Your only job will be to show up to your doctor’s appointments and try to heal from your injuries.
Abell and Capitan Law never backs down from a fight. If the insurance company denies your claim, we can file an appeal. If they continue to deny your rights to benefits, we have the resources to file a lawsuit. We have extensive experience and knowledge litigating cases and battling it out in court. You can depend on us to work hard until you receive the benefits you deserve.
How Much Does It Cost to Hire A Lawyer?
Most people who choose not to hire a lawyer because they think it will save them money. They don’t want to pay legal fees. Unfortunately, when someone files a claim for disability benefits, they usually end up with much less money than they deserve if they don’t have legal representation. Insurance companies take advantage of those individuals by intimidating them into settling for a low payment amount or by delaying the process.
At Abell and Capitan Law, we know you’re already struggling financially. We don’t want to add to your burden. That’s why we take cases on contingency. That means you won’t have to pay us up front to represent you in your case. We don’t collect any legal fees unless we can recover benefits for our clients. If we lose your case, you won’t owe us anything.
Let Abell and Capitan Law Help You Fight for Your Rights
Our team of New Mexico long-term disability insurance lawyers is ready to take your call and discuss your legal options. We offer a free initial consultation to all prospective clients. There’s no risk in meeting with us to determine the best method for pursuing LTD benefits from your employer’s insurance company or from your own policy. We’ll provide advice and guidance during this challenging time in your life.
If you have a disability and can no longer work, call Abell and Capitan Law at (267) 419-7888. We’ll help you file your insurance claim or appeal a denied claim and fight for the maximum benefits you deserve.