Oklahoma Long Term Disability Insurance Lawyers
Are you suffering from a disability? Is it affecting your ability to return to your job and earn an income? If so, Abell and Capitan Law might be able to help you apply for benefits through your employer’s long term disability insurance (LTD). LTD benefits replace an injured worker’s lost income if they’re unable to perform their work-related tasks due to an injury or illness.
It’s important not to mistake workers’ compensation for LTD insurance. They’re different types of benefits. Both are usually paid for by the employer; however, a workers’ compensation policy covers employees for work-related injuries, while an LTD policy covers employees for a sustained injury outside of work. Both replace a portion of wages, but long term disability only covers workers who get hurt or sick while off the clock.
Long term disability insurance is complicated and usually governed by federal laws, but it’s what we do. We know LTD insurance inside and out. If you need help pursuing benefits from your LTD insurer or appealing a denied claim, call Abell and Capitan Law at (267) 419-7888 to speak with one of our Oklahoma long term disability insurance lawyers. We’ll explain all your options at a free consultation.
The Relationship Between ERISA and Long Term Disability Insurance
LTD policies work by replacing a portion of an injured individual’s wages. If you can’t complete the tasks required in your job description, you can file an insurance claim to collect monthly payments.
If your employer pays for your long term disability plan, it falls under ERISA law. The Employee Retirement Income Security Act protects disabled workers and issues regulations that the insurance companies must follow. Under the Act, employees are allowed access to the LTD policy, including policy disclosures, available coverage, and instructions for filing claims.
Under ERISA, there are also strict deadlines you must adhere to if you want to file a claim or appeal a denied claim. You need to submit relevant evidence that proves you have a disability that prevents you from working. If you can’t prove that you have a disability with medical records or another type of evidence, you won’t receive LTD benefits from the insurance company.
Follow These Steps After an Accident Leaves You Disabled
If you end up getting hurt or sick, and the disability keeps you out of work for an extended period, you should immediately begin the process of filing a claim. It can take months for the insurance adjuster to review an application and approve it. You’ll want to begin the process as soon as possible so you can collect benefit payments before your medical treatment progresses.
To ensure eligibility, follow the steps below to pursue LTD benefits:
- Notify your employer of your qualifying illness or injury and fill out the form they provide. They will submit it to the insurance company for you, or you can submit it yourself.
- Seek treatment from a doctor and attend necessary follow-up appointments and referral treatment. Medical records are vital to proving you have a disability.
- Write an employee statement and send it to the insurer. The statement should include your personal information, employer information, and details about your injury or disease and how it affects your ability to maintain employment.
- Collect evidence, such as medical records, physician notes, imaging and lab reports, surgery records, prescriptions, and receipts.
The LTD attorneys at Abell and Capitan Law are happy to answer questions you may have about filing your application for benefits, and you may benefit from hiring an LTD lawyer at the very start of the application process, depending on your circumstances. For example, if you have a chronic medical condition or a physical and mental health impairment, we can help guide you through any road bumps you may experience during the claims process and protect your interests.
After you file your insurance claim, the insurance adjuster will perform their own investigation and review the documentation you sent them. If they approve your application, you’ll have to go through a waiting period before receiving your first benefit payment. After that, you’ll receive monthly payments for up to two years, as long as you have a disability.
If you return to work at any time, you won’t be eligible for LTD benefits anymore. However, if your doctor informs you that your disability will prevent you from working indefinitely, you can apply for benefits that last until you turn 65 years old.
Disabilities Covered by Long Term Disability
Disabilities typically covered by long term disability include the following:
- Multiple types of cancer
- Kidney disease
- Respiratory illnesses, such as asthma, cystic fibrosis, and COPD
- Loss of hearing or vision
- Mental health issues
- Cardiovascular diseases
- Immune system disorders, such as HIV/AIDS or lupus
- Digestive tract issues, such as IBD and Crohn’s Disease
- Neurological disorders, such as Parkinson’s disease and MS
- Musculoskeletal disorders, such as osteoarthritis, gout, and rheumatoid arthritis
- Skin disorders like psoriasis and eczema
- Hematological disorders
What Are My Options If My LTD Claim Is Denied?
Most injured workers think they don’t have options if they receive a denial letter. That’s not necessarily the end of the road for you. If the insurance company denied your claim, you might be able to file an appeal. Under ERISA law, you can file an administrative appeal within 180 days from the date on the denial letter. The appeal gets submitted with the insurer you sent your original application to.
This would be a great time to hire an Oklahoma long term disability insurance lawyer from Abell and Capitan Law. We know the steps we need to take to ensure the denial gets taken care of promptly and accurately. When you hire us, we’ll review the denial letter and documents you received from the insurance company.
Denial letters are supposed to state the denial reason and instructions on how to appeal the decision. We’ll thoroughly investigate your circumstances and gather all the information we’ll need to submit the appeal. If anything was missing from the original claim, we’ll include that with our evidence.
Some crucial evidence we can use to prove your disability prevents you from working includes:
- Opinions from medical, vocational, and disability experts
- Copy of your job description
- Additional medical appointments or testing
- Doctor letters
- Affidavits from those who witnessed the negative impact your disability had on your job and life
- Medical records excluded from the original claim
After you file the administrative appeal, the insurance carrier will have 45 days to look over everything you submitted and decide if they will overturn the denial. If they approve your appeal, your monthly payments will begin. If they continue to deny the benefits you deserve, we can file a lawsuit. During a lawsuit, we can provide the judge with everything the insurance company had, and explain why you should receive disability insurance.
Denied LTD Claims Are Common
Many LTD claims get denied initially. Sometimes the reason is valid; other times, the insurance company is acting in bad faith. To ensure the insurance company approves your claim, you should know the most common reasons for LTD benefit denials.
- You missed a scheduled IME appointment that your insurer required.
- You submitted documents that were incomplete or incorrect.
- You have a partial disability instead of a total disability.
- The insurance carrier acted in bad faith by unnecessarily delaying your claim or denying it for an undisclosed reason.
- Your injury or illness is preexisting, which excludes you from LTD eligibility.
- The insurance company’s doctor doesn’t agree with the diagnosis your doctor gave you.
- Your medical issue doesn’t qualify as a disability under your policy’s definition.
Why Hiring an Oklahoma Long Term Disability Insurance Lawyer Is Necessary
When you hire Abell and Capitan Law, we’ll handle every step of the process on your behalf. You won’t have to pursue the claim alone or fight against an intimidating insurance company. We’ll do everything for you so you can focus on what’s important: recovering.
The LTD claims process can be confusing and overwhelming. If you never handled an insurance claim before, you won’t understand how to review the policy, what evidence you need to collect, and how to obey ERISA rules and statutes.
Our experience, knowledge, and resources will allow us to follow every deadline, submit completed forms, find the right doctors to treat you, and ensure the insurance company pays you the maximum benefits available.
If we need to take your case to court, our Oklahoma long term disability insurance lawyers are ready to do so. We’ll fight to maintain your rights and prove your disability qualifies for LTD coverage. You can feel confident knowing your case is in capable hands.
Please know we are here to help you with any questions you have about the LTD claims process. Following are answers to questions we commonly receive about long term disability insurance.
Do I really need to file for LTD benefits?
If you lose your only source of income and still have expenses to pay for, you need LTD benefits. Your monthly payments won’t equal your normal wages; however, they will offer some assistance in paying your rent/mortgage, utilities, and food.
When should I file a claim for long term disability insurance?
File your claim immediately after you get hurt or sick and know you can’t return to work. Sometimes the claims process could take a while, so filing early on will save you trouble down the road.
How is long term disability calculated?
Monthly benefits depend on your average monthly wages. Typically, policies provide payment up to 60% of your gross monthly salary.
What is a waiting period?
The waiting period is the period you have to wait before you receive benefit payments. It starts on the date of your disability. LTD policies differ from one insurer to the next, but waiting periods usually last 30, 60, or 90 days.
We Can Help You With Your LTD Benefits
If you need help applying for long term disability insurance or appealing a denied claim, contact Abell and Capitan Law. Our Oklahoma long term disability insurance lawyers only work on LTD claims, and we’ve helped numerous clients just like you. We have years of experience getting clients the benefits they deserve from their LTD insurance companies.
We’ll uphold your rights and ensure that you receive fair treatment from your insurer. You can depend on us to work hard and recover the money owed to you for your disability. To schedule your free consultation, call us at (267) 419-7888.