Long-Term Disability Lawyers Beaumont
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What is the Purpose of Long-Term Disability Insurance?
A serious injury or medical condition can change the way we live our lives. It can affect our energy levels, cause us great pain, and derail our daily lives. One way our daily lives might be changed is having to take time off from work. While your regular schedule and ability to do your job might be halted, your bills and regular expenses will continue as usual. Long-term disability insurance serves as an income replacement to help protect you from financial trouble while you focus on your recovery.
You can often access long-term disability insurance through your employer’s group insurance plan, or you can purchase it privately through an insurance broker. If the former is applicable, your employer is likely covering the cost of the premium. There are some cases where that cost may be shared between the employer and the employee. Be sure to familiarize yourself with your insurance company’s policy to see the different ways it may affect you. The wording in these policies may be confusing. Consider reaching out to our Beaumont long-term disability lawyers to arrange a free initial consultation.
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Are There Different Types of Disability Insurance?
You may experience an injury or medical ailment that forces you to stop work but not indefinitely. Perhaps you’re fully recovered or at least healthy enough to return to work at the end of a 3-month period. In situations like this, short-term disability insurance is usually most applicable. You may find, however, that while short-term seemed best at first, your recovery is not going as expected. Your condition could unpredictably worsen and force you to miss work for a period beyond what was covered under the short-term disability plan. This is when long-term disability insurance is the better option. It’s not unusual to start off with short-term disability benefits and move over to long-term. If you have questions regarding these issues, you may want to call our Beaumont long-term disability lawyers to schedule a free initial consultation.
How Do I Know if I Qualify for Long-Term Disability Benefits?
Any injury or medical condition that prevents you from working should be covered under most long-term disability insurance policies. You should consult your own specific policy to see if your issue is covered. The types of issues that are potentially covered don’t stop at physical issues though. Mental health issues are also often covered. The symptoms may not be as visible, but they can still be just as debilitating.
Some conditions that are typically covered by policies are:
- Multiple sclerosis
- Cancer
- Migraines
- Back pain
- Musculoskeletal injuries
- Arthritis
- Paralysis
- Heart disease
- Fibromyalgia
- Herniated discs
- Bipolar mood disorder
- Depression
- Anxiety
- Panic attacks
- Post-traumatic stress disorder (PTSD)
- Lupus
- Lyme disease
- Crohn’s disease
- Neurological disorders
- Psychological disorders
- And more
Don’t worry if you’re not seeing your issue listed here. This is not an exhaustive list and there are other diagnoses that may still be covered by your policy. Familiarizing yourself with your company’s policy will help you gain a better understanding of where you stand. It’s especially important to do this before you begin the application process.
What Steps Should I Take to Apply for Long-Term Disability Benefits?
There are some basic steps in the application process that are common across most long-term disability policies. While some of these steps will be outlined here, you should still consult your own policy. You’ll need to obtain a copy of the initial application form for your benefits. Your human resources representative at work should be able to help with this or you can reach out directly to your insurance company. It may also be available on the company’s website.
You will likely need to provide demographic information, banking information, occupational information, and information on your ailment such as your symptoms and how they prevent you from working. Record any deadlines in the application process and make sure to stay ahead of them. It will likely be necessary to provide medical documentation regarding your condition. Medical evidence is usually an essential element of any long-term disability claim. This will involve visiting your doctor(s) who will need to fill out a section of the application on your behalf. Your insurance company may also request that you be examined by a doctor of their choosing.
There may be a phone interview or an in-person assessment. You may have heard about some steps in this process from a family member, friend, or coworker who also had to apply for long-term disability benefits. Insurance companies usually approach each case differently, paying mind to the unique circumstances at hand. Don’t be worried if your experience is different from what you expected. It’s important to be patient and fully participate with your insurance company. The sooner the assessment process is complete, the sooner the insurer can reach a decision. Navigating a long-term disability benefits application can be overwhelming and confusing. Consider contacting our Beaumont long-term disability lawyers to arrange a free initial consultation.
What Should I Do if My Long-Term Disability Claim is Denied?
After waiting up to 8 weeks for your insurance provider to reach a decision regarding your claim, you may receive a denial. It’s important to understand the reason for your denial before you go any further. There are several reasons why a claim might be denied. Some common reasons are:
- Your insurance company has found evidence that contradicts your claim
- Your insurer does not agree with your doctors
- You have not followed your recommended treatment plan
- Your insurer believes you’re able to work in a different job
- Your insurance provider does not believe a diagnosis exists for your disability
- You are excluded from collecting LTD benefits due to a pre-existing condition
- Your application for long-term disability was too late
- Your insurer thinks that you are not “totally disabled”
- You have violated a condition of your policy
This is not an exhaustive list and there may be other reasons for a denial. Any one of the above-mentioned reasons could be the result of a wrongful denial. You will likely wish to dispute your claim, especially if you’ve been left with no other options for income replacement. Remember that your insurance company most likely has substantial experience in dealing with claims like yours while this may be your first experience with long-term disability.
It is to your advantage to have someone in your corner who is experienced with claims similar to yours and knowledgeable about the maneuvers used by insurance companies in these actions. Our legal team may be able to help you recover compensation that you’re entitled to such as damages resulting from your claim’s denial.
Reach Out to Our Beaumont Long-Term Disability Lawyers for a Free Initial Consultation. Let us help.
The decision to hire a lawyer is incredibly personal and should not be taken lightly. If you are eligible to dispute your claim, our legal team may be able to take on your case. You shouldn’t have to deal with fighting a denial of your benefits alone while also recovering from your condition. Dial our Beaumont long-term disability lawyers today for a free initial consultation.
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Commonly Asked long-term disability Questions
Here are our most asked questions on long-term disability claims.
What is long-term disability?
Long-term disability claims arise when you have disability insurance, either through your work or privately, that denies your claim after you have become disabled.
Is there a time limit on when I can sue for long-term disability?
Yes. The Insurance Act, RSA 2000, sets a two-year limitation period that commences two years after the claims arise.
How much is my long-term disability case worth?
Long-term disability cases are several heads of damage that are assessed independently. First, there is the arrears or the past benefits that have not been paid. Next, there are potential future benefits. Finally, if a denial was made in bad faith, there may be extracontractual damages that can include aggravated damages or even punitive damages against the insurance company.
What types of compensation can I claim in a long-term disability case?
You can claim contractual damages for past benefits that should have been paid. In a settlement discussion, you can claim for future benefits that will be paid, but in a trial, you cannot make this claim. Finally, if the denial was in bad faith, you can make an extracontractual claim for aggravated damages and/or punitive damages.
What are the common causes of disability?
The most common causes of disability are related to chronic pain and psychiatric disorders like anxiety or depression. However, there are many causes of disability, including:
- Chronic pain;
- Depression;
- Anxiety;
- Brain injury;
- Stroke;
- Heart attack;
- Cancer;
- Injury;
- COVID;
- Stroke;
- Orthopaedic injury;
- Paralysis;
- And more.
What are my options if my long-term disability claim is denied?
The insurance company will provide you with options to appeal their decision. Keep in mind these appeal processes are usually created by the insurance company and adjudicated by the insurance company. And they do not stop the limitation period from running. Our lawyers will file a lawsuit instead and put the claim into the impartial realm of the court system.
What information is needed to support a long-term disability claim?
Copies of your policy, the denial letter, and your medical records are generally needed to support your long-term disability claim. Our lawyers can work with you to determine what documents exist and how to collect them to make sure nothing is missing.
When should a long-term disability lawyer be contacted?
If you have been denied long-term disability benefits, it is time to contact a lawyer to discuss next steps. Our consultations are always free, and there is no obligation to sign up.
Can a mental illness be considered a long-term disability?
Yes. Mental illness is increasingly being recognized as a real and problematic cause of disability for a substantial percentage of the population. In addition, these ailments are often invisible. Because of that, insurance companies will suggest that you have not met your burden to prove your mental illness exists and is disabling to deny your claim.
How is the Canada Pension Plan Disability different than a long-term disability?
The long-term disability claims we handle are from private long-term disability companies. Canada Pension Plan Disability is a statutory pension plan run by the Federal Government that you may or may not qualify for depending on your contributions to CPP and your injuries.
How is short-term disability different than long-term disability?
Short-term disability is similar to long-term disability but has a shorter waiting period to kick in and a shorter duration. Sometimes, the insurer or entity that pays short-term disability is different than the insurer that pays long-term disability. Since it is a different benefit, there is often some difference in the compensation formula between the two.
Do pre-existing conditions impact long-term disability claims?
Sometimes yes. Long-term disability contracts are often set up to have an exclusion for pre-existing conditions. These exclusion clauses typically only apply if you become disabled within the first year of coverage on most group policies. However, it is very important to read the specific language of your insurance policy if you have become disabled from a long-standing or pre-existing ailment.
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