When you become disabled and are unable to continue working as rigorously as you had before your injury – or unable to work at all – you may be able to file a claim to seek short-term or long-term disability benefits if your employer offers its employees a long-term disability plan. Many employers offer long-term and short-term disability benefits to provide disabled employees with the income they need to continue supporting themselves and their families.
Although you may have the right to receive these benefits, it is not uncommon for a disability insurance provider to look for reasons to deny a claimant the compensation he or she seeks. This is because replacing a disabled individual’s income can be quite expensive. When you are disabled and in pursuit of long-term disability benefits, work with an experienced long-term disability benefits lawyer who can be your advocate and help you pursue the benefits you deserve.
In the United States, most private sector long-term disability insurance plans are governed by the Employee Retirement Income Security Act of 1974 (ERISA).
Under ERISA, your employer must provide you with comprehensive information about your policy, how to file a claim for benefits, and how to appeal the insurance provider’s decision if your claim is denied. When you file a claim, the provider must make a decision about it within 45 days. This can be extended for up to an additional 60 days in some circumstances.
ERISA does not regulate how a long-term disability insurance provider defines “disabled.” Some have a more specific definition of the term than others, and some exclude certain conditions from their policies or limit the duration for which benefits may be able for certain conditions.
You also have the right to have a lawyer represent your case and work with you to pursue your long-term disability benefits. Your long-term disability insurance provider may hire an investigator to watch you at doctor appointments and even outside your home. He or she may even utilize video surveillance in an attempt to “catch” you moving in ways that you claim you are unable to move because of the disability. Your lawyer can help you handle interactions with an investigator, with the insurance provider and if necessary, with the court.
If your ERISA long-term disability claim is denied, you have the right to appeal it. Under ERISA, the deadline for filing your internal appeal can never be less than 180 days. If this does not result in a favorable ruling and you still feel your claim should have been approved, you may bring a civil action against the insurer or the disability plan pursuant to Section 502(a) of ERISA. 29 U.S.C. § 1132(a).
When you are disabled and unable to work, it is in your best interest to pursue long-term disability benefits with the aid of an experienced long-term disability lawyer. Contact The Garner Firm, Ltd. today to set up your legal consultation with us.
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