North Carolina Long Term Disability Claim Attorneys
A serious illness like cancer, chronic depression, a damaged spine, and many other medical conditions often requires a tremendous amount of time spent in therapy and recovery. If you have one of these conditions, you are likely unable to work while you recuperate. Long term disability (LTD) insurance exists for this purpose, and you may have a policy through your employer or that you bought on your own. This plan can provide benefits that will pay you a portion of your pre-disability income, but the claims process can be daunting and fraught with details that can cause your claim to be denied.
The long-term disability lawyers at Abell and Capitan Law understand all of the ins and outs of the disability claims process, and we can make sure everything is done correctly so that you can collect the benefits you need to ensure your health and your family’s well-being. We can additionally help you if your claim was terminated or denied. Even if you need help with short term disability insurance or you have an individual plan, we can help.
We’re passionate about ensuring that our disability clients receive the benefits they need and deserve. Call Abell and Capitan Law today at (267) 419-7888 to schedule a free consultation.
Why You Need A Lawyer
Long term disability claims are incredibly complex. Policies are full of legal jargon and difficult-to-interpret rules. There are important deadlines that must be followed, and documentation that must be provided, or your claim may be denied. Insurance companies don’t have a financial incentive to pay out benefits, and may use your unfamiliarity with claim requirements against you. A lawyer who specializes in disability insurance and who understands Federal and North Carolina LTD insurance rules is essential to making sure you are able to receive your benefits.
Even claims that are properly submitted sometimes get denied by the insurer. You need an attorney who will stick with you through the entire process, making appeals and even taking the case to federal court if necessary.
Why Hire Abell and Capitan Law?
The disability claim attorneys at Abell and Capitan Law focus specifically on Long Term Disability Insurance. This is an extremely specialized area of law, and requires a firm that knows all the pitfalls of a claim and exactly what steps to take to make sure your benefits aren’t denied. Insurers look for any missing detail as a reason to deny a claim. We make sure that nothing gets missed so that your benefits aren’t jeopardized.
Each LTD case is unique. Your medical treatment and financial needs are different from those of other policyholders. It is critical to your claim to make sure that all the details are accurate and that all your evidence is organized and readily available. At Abell and Capitan Law, we take pride in our ability to offer our clients individualized attention throughout their case. Your success is important to us, and we will be with you every step of the way.
What Is Long Term Disability Insurance, and Why Do I Need It?
Long Term Disability is a type of insurance policy that protects you in the event that you are unable to work while recovering from a long illness. It will pay monetary benefits that you can use to support you during this time. It is not necessary that you became ill because of your job. That would be covered by workers’ compensation. What’s important is your inability to work for an extended period.
Many people don’t carry long term disability, but it can be a crucial safety net in a very difficult time. According to the Social Security Administration, 1 in 4 of today’s 20-year-old workers will become disabled before age 67.
Oftentimes there are restrictions on how long you can receive these benefits. Many LTD insurance policies distinguish between your “own occupation” and “any occupation.” If you’re unable to perform your own occupation during your illness, an “own occupation” policy would pay you benefits while you are recovering. An “any occupation” policy is more restrictive, as it would only pay benefits if you’re unable to perform any job at all.
If you can do work that is less physically strenuous than the job you’re used to doing, the policy assumes you can do that job rather than collect benefits. Some policies switch over from “own occupation” to “any occupation” after two years. The policy may stop paying benefits in this case, or if your insurer determines that your condition has improved enough for you to go back to work.
How Do I Know Whether My Injury Qualifies?
Long Term Disability Insurance covers people with injuries that require a long period of recovery, typically one to three years or longer. Some of the conditions that would make you eligible for LTD benefits include, but are not limited to:
- Epstein-Barr Virus
- Eye and vision disorders
- Migraines and chronic headaches
- Irritable Bowel Syndrome
- Macular Degeneration
- Shoulder and back disorders
- Hearing impairment
- Crohn’s Disease
- Head and brain injuries
- Chronic Obstructive Pulmonary Disease (COPD)
- Complex Regional Pain Syndrome
- Heart Disease
- Lung Disease and Lung Cancer
- Other forms of cancer
This is only a partial list of some of the conditions for which a person may be able to receive long term disability benefits. You should discuss your own medical situation with your lawyer during your initial consultation.
What Can I Expect My Benefits To Pay?
Long term disability benefits usually amount to between 50 percent and 80 percent of your earnings before you became ill. Some policies consider commission, bonuses, and overtime as part of this figure, but others do not. There is a maximum monthly payment, which can range from between $4,000 and $25,000. The policy may have a cost-of-living adjustment built-in, which would increase your benefits from 1 percent to 3 percent per year.
What Is the Disability Claims Process Like?
The first step in making a long term disability claim is to review your policy with your lawyer. Are you insured through your employer, or do you have an individual policy? You should go over the details of your plan, and how it relates to your medical condition.
You should request an application form from your human resources department. You could also obtain an application from the insurance company. You will complete the Employee’s Statement portion of the application by providing information such as your name, Social Security number, date of birth, details related to your disability, and medical information. You will then need to obtain your Employer’s Statement, which includes information related to your job, such as date of hire, amount of your earnings, and the last date you worked.
Most importantly, you need a statement from your doctor with all the medical details relevant to your illness, such as diagnosis, symptoms, treatment dates, your physical and mental limitations, and an estimate of when they expect you to be able to return to work. You will need to provide the insurer with all your medical records related to your illness, including x-rays, MRIs, surgical reports, and exam findings.
Waiting times for approval can vary widely, but it helps to provide all the information and evidence that the insurer requests and to adhere to all of their deadlines. Insurance companies are known to sometimes be slow to respond, so be prepared for frustrating delays during this time. There is also usually a waiting period known as an “elimination period” that can range from 3 to 6 months from the onset of your illness until your benefits kick in. Short term disability benefits may be available to you during this time.
If your application is denied, you will review your denial letter with your attorney and move forward with an appeal. The letter will explain why the claim was denied and how to appeal the decision. You may need to submit additional medical documentation. Third-party documentation of your condition may also be helpful—for example, a letter written by a spouse or caregiver detailing the tasks they must perform to care for you. You must exhaust all of the insurer’s internal appeals, sometimes multiple levels of appeals, before filing a lawsuit.
Contact Abell and Capitan Law Right Away to Handle Your Long Term Disability Claim
Whether you have long term disability insurance through your job or you have your own plan, call the skilled medical disability lawyers at Abell and Capitan Law right away for help with your disability benefits application. Your primary focus should be on your health and well-being during this difficult time in your life.
You can count on our firm to remain by your side throughout this process, helping you make sense of your policy and application, and, if necessary, making appeals and taking your case to court. We will do whatever is required to make sure your needs are taken care of. This can be a lengthy process, so you should get started as soon as possible.
Call us at (267) 419-7888 today or fill out our contact form today to schedule a free no-obligation legal consultation.