Long Term Disability Insurance Claims

New York Long Term Disability Insurance

Whether you purchase a private policy or are covered under ERISA by a group policy offered by your employer or another group, Long Term Disability insurance policies share certain features that make it dangerous for you to go through the process alone no matter how obvious your disability appears. At Hermann Law Group, PLLC, we have the experience to handle your case and the success record to prove that we are the best at what we do. New York long term disability lawyer Gabe Hermann has been in the business for years. Moreover, he will be able to back that up with his track record.

How to Apply for Long Term Disability Insurance

If you have a medical condition or were injured and have become unable to work, you may need to file for long term disability (LTD) insurance. Many people have a long term disability insurance plan through their employer; however, some people purchase benefits individually. In either case, take the following steps to apply for benefits:

Request an application

Your human resources (HR) department or the insurance company may be able to provide you with the necessary documents to submit an initial application for long term disability insurance benefits. You should be able to contact a claims administrator at your HR department or through the insurance company to request necessary forms.

Many long term disability insurance claim forms are available online. You may be able to Google your insurance company name and the forms you are looking for. However, you should always confirm with your claims administrator to make sure you have accessed the correct forms.

Submit an Employee Statement

One of the first sections you will have to complete on your long term disability insurance application is an employee statement. This includes information about you, your condition, and your past work. Your LTD insurance company needs this information in order to verify who you are and the company you work for.

The employee statement will include information such as your:

• Name, phone number, and address
• Social security number and date of birth
• Employer name and occupation
• Work history and education information
• Injury or sickness information
• Dates of disability, including last date worked
• Reason for disability
• Medical providers and contact information
• Prescribed medication
• Other forms of income

You should complete all of this information in detail, including additional sheets, if necessary. If you fail to include all information requested, it could delay your application or result in a denial from the long term disability insurance company.

Complete a Medical Release Authorization Form

The insurance company will want access to your medical information. You should complete a signed authorization form for each medical provider that you have seen about your illness or injury that resulted in disability. If you fail to provide a medical release of information form for every provider, the long term disability insurance company may deny your claim or delay making a decision.

Get a Statement From Your Employer

A portion of your long term disability insurance application form will include a statement from your employer. You may have to submit this form to your employer and request their completion. They will have a limited amount of time to complete this information and return it to the long term disability insurance company.

Your employer will provide information, such as:

• Effective dates of your long term disability insurance coverage
• Earnings
• Last date worked
• Job title
• Physical and mental requirements of your job
• Whether they can alter your job description for your limitations

Get a Statement From Your Doctor

One of the most important sections of your long term disability insurance form will be completed by your primary care doctor. Your doctor will provide information about your:

• Diagnosis
• Symptoms
• Ability to complete work duties
• Expected duration of your illness or injury
• Physical limitations and mental impairments
• Treatment types
• Other doctors

You may have to pay your doctor for completing long term disability insurance forms for you. However, most doctors are familiar with these types of paperwork and can complete it within a reasonable amount of time.

Submit Any Additional Information to Support Your Claim

Your long term disability insurance application should include all information necessary to obtain approval of your claim. You may need to submit multiple doctors’ statements and additional information about your conditions. If you were approved for short term disability insurance prior to this LTD application, then you may have information from that claim to submit. Work with your long term disability insurance claim lawyer to make sure you submit all of the information necessary to support your claim.

Why Your LTD Company May Deny Your Claim

Carriers often deny a long term disability insurance claim initially because they either:

• don’t hear from your doctors, or
• pick out one thing your doctor said and use it against you.

In a group policy, you may jeopardize your ability to appeal successfully if you fail to adhere to strict time limits or if you do not carefully follow all of the filing procedures. The definitions of “disabled” are also complex and varied. It is therefore extremely important that you ask your doctors the right questions from the start. That way, the insurance carrier will not misinterpret their answers. It can be a daunting process, but a New York long term disability lawyer has the skill and knowledge necessary to see you through it.

Be Aware of Insurance Carrier Tactics

Carriers use interviews and even surveillance to question your disability. In addition, they may want you to undergo an evaluation to determine what your physical abilities and limitations are. The attorneys at Hermann Law Group, PLLC have the experience and knowledge to successfully fight some of almost all of these efforts to deny you benefits.

Even if you have been receiving payments for several years, your carrier may review your claim at any time. As a result, the Administration may challenge your benefits at any point. In many policies, after two years the definition of disability changes, making it harder to continue receiving disability even if your condition has not improved at all!

Whether you have a group or a private policy, the key is not to give up and to have an experienced law firm help you fight for the benefits that you have paid for, and are now entitled to. Our New York long term disability lawyer can help you through this process as well, as well as ensure that you obtain what you are entitled to.

How to Appeal an LTD Claim Denial

If your long term disability insurance claim is denied, you have a right to appeal. You likely have a limited amount of time, usually 60 days, to apply after your denial. Take the following steps to appeal your claim denial:

Read the Denial Letter and Ask Questions

When you are denied, the insurance company will send you a letter explaining your denial. You may need additional medical documentation or information from your employer. The denial letter will give you information about why you were denied and also how to appeal.

Request Appeal Forms

You may have to submit specific appeal forms to your insurance company. Those forms can be obtained from your employer, claims administrator, or online. It’s important to submit the specific forms necessary so that your LTD company does not refuse your appeal up front.

Submit Your Appeal

You may need to submit your appeal to a new office within your long term disability insurance company. Find out who should receive your forms and submit all necessary information within the specified amount of time. Federal law requires your LTD company to give you at least 60 days to submit an appeal.

Continue to Seek Medical Treatment

Throughout your initial application and appeal, it’s important that you continue to see your doctor regularly. Your medical condition may require frequent medical monitoring, or you may simply need to follow up with your doctor periodically. It’s therefore vital to your claim to continue regular medical care to support your claim.

At Hermann Law Group, PLLC, a Long Term Disability Lawyer Will:

• Consult with you prior to filing your long term disability insurance claim, and provide advice, including review of your policies or Summary Plan Descriptions, and review of your medical records and job descriptions, even if you are still working or have not filed your claim.
• Prepare your initial application and file it, as well as provide the insurance company with medical and vocational reports to support your claim.
• Advise you about the interplay between all your possible benefit sources, so you can collect your maximum benefits.
• Refer you to medical and vocational experts when necessary.
• Deal with the insurance company if they want you to go to their doctors, undergo a Functional Capacity Evaluation, or do a personal interview with them.
• File ERISA appeals and litigate those claims when necessary.
• Consult with you to prevent termination of the benefits you are already receiving.
• Appeal suspension or reduction of your benefits.

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Call a Long Term Disability Insurance Lawyer Today

If you are unable to work due to a medical condition or injury that is lasting a significant period of time, then you should file a long term disability insurance claim. If you’ve already been denied, time is of the essence. An attorney can help you with the legal process, which is often so complex that people are denied multiple times. Call Hermann Law Group, PLLC, PLLC today to learn more about long term disability insurance.