Many employers offer long-term and/or short-term disability policies to their employees as part of their benefits package. Some employees, if even they know they have this coverage, think “this could come in handy some day.”
When that some day comes, they often find their claims denied by the insurance company. First, they never expected to be in a situation to file a disability claim. And second, they certainly never expected their disability claims to be denied since this was part of their benefits package.
Our disability team will review your denial letter for FREE. Then, with no obligation and NO STRINGS ATTACHED, we’ll tell you our game plan for winning your case.
What Is Long-Term and Short-Term Disability Insurance?
Disability Insurance, sometimes called long-term or short-term disability, is a benefit that some employers provide to their employees which is used to replace an employee’s income for a period of 3 to 6 months (short-term) or for longer periods (long-term). Some employers offer both short and long-term disability policies.
If you become disabled for a longer period of time, often the short-term policy will pay benefits until the long-term policy kicks in. Depending on the policy, the income replacement can range from 60% to 80% of the amount of money you made before you became disabled. If you have a disabling condition and win your disability claim, you may be entitled to receive benefits until you reach retirement age. If you lose your short-term disability claim, this obviously means that your long-term claim is in jeopardy. You need a lawyer trained to handle these complex claims to help you prepare your case.
Some long-term and short-term disability policies are governed by ERISA, the Employee Retirement Income Security Act. This law was enacted in 1974 to protect workers who have private health and pension plans. In addition to these health and pension plans, ERISA also regulates long-term and short-term disability plans. Specifically, ERISA governs how disability claims are processed, the timeline for processing a claim, and the rights of those who have been denied.
Many employers provide disability coverage to their employees. Some states require employers to provide disability coverage. Who provides the disability insurance, whether it is a private employer, governmental agency, or whether it is obtained by an individual for himself, may determine whether the policy is controlled by ERISA.
Most private companies that provide short-term or long-term disability insurance will be governed by ERISA. If a group disability plan is employer sponsored, usually that plan will be regulated by ERISA. On the other hand, a plan may not be controlled by ERISA if the employer makes no contributions to the disability insurance policy and participation is completely voluntary through payroll deductions or other means of payment. Additionally, employees of federal, state, and local governments have disability plans that are usually not covered by ERISA.
What Conditions Are Covered With Long and Short-Term Disability Policies?
Except for injuries sustained on the job or self-inflicted injuries, most conditions are covered under many disability insurance policies. Generally, disabling conditions which are commonly covered under such policies include heart disease, cancer, back injuries, as well as other severe conditions and injuries.
Frequently, disability applications which are denied may include diagnoses of pain related conditions where the level of pain can be somewhat subjective.
Many Virginia lawyers say they practice Social Security Disability law. But, most of those lawyers don’t work with long-term disability or short-term disability insurance claims. Before you hire any lawyer to handle your long-term or short-term disability claim, you should ask if he or she has been trained in handling or has handled ERISA claims before. If that attorney can’t answer yes, he or she is probably not the right lawyer for you.
That’s what makes us different. At the Ritchie Law Firm, we have a team of lawyers who have been trained to handle the complexities of long-term and short-term disability cases. Sure, we also handle Social Security Disability cases. But, ERISA long-term and short-term disability cases are a different beast. And, we know how to handle them.
If you want your long-term or short-term disability case handled by a team of lawyers trained to handle this difficult area of the law that few lawyers know the first thing about, your search is over. Whatever stage of applying for benefits you are in, whether you haven’t yet applied or you’ve been denied, we are happy to help. We can even help if you live in states other than Virginia or West Virginia by associating with counsel local to the jurisdiction where you live.
When Should You Get Legal Advice?
We are frequently asked by people who call us, “when is the right time for me to get legal help with my long-term or short-term disability claim”? The best answer is that you should definitely get legal help from a lawyer experienced with ERISA long-term and short-term disability claims BEFORE you ever file a claim. Many times people have filed their claims and gone through all of the administrative process before they contact a lawyer. THIS IS THE WRONG APPROACH!
It is very important to understand that your window for appealing your case after a denial is very short. If you fail to correctly file your appeal, you can ruin your chances of getting benefits. If you handle your case on your own and later need to hire a lawyer to file suit to appeal your claim, the court reviews the contents of the insurance company’s file. When you handle your claim yourself, you will likely not know what information and documents should be filed to properly build the court record. However, you can bet the insurance company is going to know what documents are important to build their defense against paying your claim!
What Can We Do For You?
How we can help you depends on where you are in the process. Here are a few examples of what we might be able to do for you:
- If you are thinking about applying for short-term or long-term disability benefits, you can talk to us. We will give you some advice about applying and help prepare you to talk to your doctors.
- If you’ve been denied benefits, you can send us denial letter and we will review it for you for free.
We can help with denials from both ERISA and non-ERISA (private) disability plans. Click here to give us some details about your case.
Call Us Today To Talk With Our Disability Team