Long-term disability insurance benefits are a type of insurance that many employers offer to their employees. If you have a plan of long-term disability insurance through someone for whom you work, it is likely that the Employee Retirement Income Security Act of 1974, a federal statute which is also known as ERISA, controls your disability benefits plan.
Insurance companies are big businesses, and they will look for any reason to deny a long-term disability benefits application. The insurance company may be skeptical that you are truly suffering from a permanent or long-term injury. The insurance company may also believe that despite your illness or injury, you are still able to work in some capacity, even though it might be a light-duty capacity.
If you are in the process of pursuing benefits for a long-term disability, or if it becomes necessary for you to appeal a claim denial, a San Francisco long-term disability insurance lawyer at Roberts Disability Law, P.C., can help.
Long-term disability insurance benefits are in place to compensate individuals when they suffer from an injury or illness that is long-term and which prevents them from working.
When a person is successful in pursuing a claim for long-term disability benefits, he or she will receive a specified amount of money. An experienced San Francisco long-term disability insurance attorney can assist you with the steps for filing a claim and pursuing the benefits you deserve.
The first step to pursuing and recovering long-term disability benefits is to file a claim with your insurance company. Along with the claim, you must submit medical documentation which shows that you are unable to work, specifically as a result of the injury or illness from which you suffer. This medical documentation must be provided by a qualified healthcare professional who must state his or her opinion to a reasonable degree of medical certainty.
Once you file your claim, the insurance company will review all of the claim documents, as well as any medical documents from your healthcare provider, and make a decision. If the insurance company denies your claim, it will send you a denial letter. You should review the denial letter and make sure that you understand everything in it. You then have the option of filing an administrative appeal with the insurance company and submitting additional supporting medical documentation.
Depending upon your insurance company, you may have one or two administrative appeal opportunities. If you have exhausted the administrative appeals process and are still not successful in obtaining disability benefits, you have the option of federal court litigation. If you decide to file a complaint against your insurance company in federal court, you will go through the litigation process, and the case may settle. If not, you will have a hearing in front of a federal judge – not a jury. The judge will decide the issue of your entitlement to long-term disability benefits.
Given the many complexities associated with federal court litigation, it is essential that you have a San Francisco long-term disability insurance attorney on your side, if you decide to go that route.
The legal team at Roberts Disability Law, P.C., is ready to assist you right away. To schedule a free case evaluation and legal consultation with a San Francisco long-term disability insurance attorney, please contact us online today.
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