Texas Long Term Disability Insurance Claim Lawyers

Long disability insurance benefits are available to individuals unable to work for a significant amount of time due to an injury or illness. If you need assistance with a long term disability insurance claim in Texas, contact Abell and Capitan Law for help right away. Our firm focusses solely on helping individuals get the disability benefits they are entitled to.

If you can’t work due to a disabling condition, you shouldn’t have to worry about how you’ll support yourself and your loved ones. Your disability insurance policy is supposed to replace a portion of the wages you’ll lose while you’re unable to work, which can be crucial to your financial stability during this challenging time. Unfortunately, getting the benefits you’re entitled to isn’t always as simple or straightforward as it should be. The process can be frustrating for many eligible applicants since insurance companies will often use complicated conditions to delay or deny paying you what you’re owed.

Insurance companies make billions of dollars off of the premiums you’ve paid, and they will do everything in their power to keep as much money in their pockets as possible. Fortunately, with an experienced insurance disability lawyer on your side, you can even the playing field. Your lawyer can assist with your application to make sure all information is complete and accurate and can help you appeal if your claim is denied for any reason.

If you need assistance getting disability benefits in Texas, turn to the team at Abell and Capitan Law for help. It’s our goal to ensure your rights are protected, and the insurance company treats you fairly. Call us at (267) 419-7888 or reach out to us online to schedule a free, no-obligation consultation to discuss your case with us today.

What Is Disability Insurance?

Disability insurance and workers’ compensation are two different types of benefits. Most people confuse the two and believe they’re interchangeable. However, workers’ comp pays benefits to an employee for their job-related injury. In contrast, disability insurance pays benefits to an individual unable to work because of a non-job related injury. Additionally, an employer provides worker’s compensation while disability insurance could come from multiple available sources. There are three categories of disability an individual could file for payment. Those categories are the following:

  • Short-Term Disability: Benefits for an injured person unable to work for less than a year.
  • Long-Term Disability: Benefits for an injured person unable to work for more than a year.
  • Individual Disability: Benefits purchased by an individual who isn’t covered by their employer or is supplementing their current coverage.

When it comes to coverage for disability, there are multiple avenues you could take. Some employers pay for their employees’ benefits while others don’t. There’s no Texas law requiring employers to offer disability insurance to their employees. Below are options for individuals seeking disability insurance coverage:

  • Employer Paid: Many employers provide disability to their employees and pay the entire premium or just a portion of it.
  • Employee Paid: If your employer doesn’t fund your disability insurance, but offers it as an option for purchase, you can pay for your coverage through their insurance broker.
  • Member Coverage: If you’re a member of a professional association, disability insurance is available at a group rate.
  • Individual Plan: Coverage is purchased through an insurance broker or directly from an insurance company.

Many states require employers to provide disability insurance to their employees. However, Texas is not one of those states. That doesn’t mean your employer won’t offer it to you. Throughout Texas, some companies pay for their employees’ disability benefits or offer it as additional coverage. If your employer doesn’t provide it, or the coverage isn’t high enough, you should supplement with an individual plan. Choosing an individual plan allows you to customize your coverage and decide what areas of the policy are necessary for your lifestyle.

What Are Some Disabling Conditions?

Some disabling conditions include the following, which is not an exhaustive list:

  • Stroke
  • Herniated disk
  • Heart disease
  • Lung disease or lung cancer
  • Parkinson’s disease
  • Post Traumatic Stress Disorder (PTSD)
  • Irritable Bowel Syndrome (IBS)
  • Kidney disease
  • Spinal Stenosis
  • Chronic fatigue
  • Rheumatoid Arthritis
  • Type 1 Diabetes
  • Multiple Sclerosis
  • Lupus
  • Osteoarthritis
  • Depression
  • Anxiety
  • Leukemia
  • HIV/AIDS
  • Fibromyalgia
  • Epilepsy
  • Blindness or vision loss
  • Deafness or hearing loss
  • Carpal Tunnel Syndrome

What Are the Steps in a Disability Insurance Claim?

The Texas long term disability insurance claim attorneys from Abell and Capitan Law know the statutes and deadlines in Texas, so your claim gets filed on time and approved. The first step to filing any claim is reviewing your insurance policy. Every policyholder is entitled to specific benefits and a maximum amount of coverage. After the initial application gets submitted to the insurance company, we’ll provide documentation to the adjuster assigned to the claim, so they’re able to decide if you’re eligible to receive payments. We’ll help you through the time-consuming process of filling out claimant forms, undergoing medical examinations, organizing your medical records, and preparing for any required interviews.

Once we complete the application process, there is a waiting period. During this time, you must continue with regularly scheduled appointments to treat your injury or illness. You should also collect your medical records and any vital documentation the insurance company might request. If your claim is approved, you will receive a fixed monthly payment based on your salary and the severity of your injury or illness.

What Happens if My Claim Gets Denied?

If your claim gets denied, that’s not the end of your case. We would file an appeal to get the decision reversed. Unfortunately, disability insurance claims get denied frequently due to a lack of appropriate evidence or undiagnosed condition. Multiple factors contribute to denials. The most common reasons include:

  • Lack of Medical Evidence: Undergoing treatment isn’t enough for your claim to get approved. Your physician must state in your records that your injury or illness has directly affected your ability to perform at or return to work.
  • Upcoming Medical Procedure: Any future surgery could negatively impact your claim. Insurance companies will require proof that your surgery didn’t result in any complications requiring disability before moving forward with your original application.
  • Undiagnosed Condition: Symptoms with no known origin could result in unforeseen treatments in the future. If your physician is unsure of the cause of your condition, it could develop into something more severe. Your insurer won’t approve your claim until you submit additional documentation of your medical state or proof you recovered.
  • Ineligible Medical Condition: Disability insurance benefits don’t cover specific illnesses diagnosed before the claim. If you sustained an injury as a direct result of your disease, you might also get denied any benefits.

If you applied for disability benefits through your employer, it likely falls under the ERISA statute. ERISA, Employee Retirement Income Security Act, is a federal law enacted to protect employee benefits. Depending on the type of claim you file, ERISA could benefit or harm you. Texas disability insurance claim attorneys from Abell and Capitan Law know the ins and outs of ERISA claims and how to effectively appeal denials under this law. They will review the denial letter from the insurance company and request any necessary documentation that shows the reasoning for your claim getting denied. They will use that information to obtain crucial evidence, such as medical records not previously submitted or non-medical documentation showing the negative impact of your disability, to start the appeals process. If our appeal isn’t successful, we’ll file a lawsuit against the insurance company and fight them in court.

Contact a Texas Long Term Disability Insurance Lawyer

If you’ve become disabled and cannot work, call a Texas long term disability insurance attorney atAbell and Capitan Law today. Our skilled lawyers will be ready to help you get the disability benefits you deserve.

We’ll be ready to discuss the benefits you’re owed and how we can help you get them during a free consultation. There’s no risk or obligation to speak with us about your situation, so call us today at (267) 419-7888 or reach out to us online.

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