Long Term Disability Lawyer

Long Term Disability Lawyer

Need help securing long-term disability benefits? Edelstein Martin & Nelson is committed to helping individuals like you overcome the challenges of the claims process. Contact us today and let our experienced team maximize your chances of a successful claim or appeal.

Did you know that according to the U.S. Department of Health and Human Services, 69 percent of individuals will need long-term care services at some stage in life? This statistic highlights the importance of long-term disability insurance in protecting one’s future.

Unfortunately, obtaining long-term disability benefits is not an easy task. The claims process is deadline-driven and subject to denial, requiring careful attention to detail. A single mistake or oversight can have big consequences, affecting a person’s ability to secure the benefits they deserve.

For example, an individual’s long-term disability claim can easily be denied due to simply missing a single deadline. This innocent mistake could cost you much-needed financial support.

Furthermore, the numbers suggest that long-term care for a disabled person can be extremely expensive over the course of a person’s life, further highlighting the significance of obtaining benefits.

At Edelstein Martin & Nelson, we acknowledge your challenges in dealing with a long-term disability denial. Our experienced attorneys are here to provide you with the support and guidance needed to navigate the legal perplexities of the appeals process. Contact us toll-free at 800-887-4529 for a free consultation, and let us help you pursue the benefits that should be rightfully yours.

Typical Claimant Mistakes Leading to Denials

A single misstep on your part can derail your claim for disability. Minor oversights, inaccuracies, or inconsistencies within your claim application can arm insurance companies with ammunition to dispute or deny your claim. Unfortunately, many claimants make common mistakes that can result in their claims being rejected. Here are the errors that often lead to denial:

  • Failure to understand policy requirements: Review your policy and familiarize yourself with the specific criteria for eligibility, the definition of disability, and any applicable waiting periods.
  • Incomplete or erroneous claim forms: Ensure you provide all requested details, including dates, descriptions of your medical condition, and any relevant medical records. Accuracy and attention to detail are vital to avoid misunderstandings and potential denials.
  • Lack of supporting medical proof: Gather all relevant medical records, test results, and physician statements that support your claim for disability. Remember to include specialists’ reports and any additional evidence that substantiates the limitations caused by your disability.

Importance of Accuracy and Completeness

Insurance companies thoroughly evaluate the information provided, and any inconsistencies or omissions can result in claim denials. Here’s why accuracy and completeness matter:

  • Building a solid case: The strength of your disability insurance claim depends on the evidence you provide. Accurate and complete documentation helps create a compelling case by clearly demonstrating the extent of your disability, its impact on your ability to work, and the need for long-term disability benefits.
  • Avoiding misinterpretation: Insurance companies may interpret incomplete documentation as a lack of evidence, leaving room for doubt regarding the severity of your condition. Providing thorough and precise information reduces the likelihood of misinterpretation, and ultimately strengthens your claim.

Tips for Strengthening Your Claim

  1. Seek professional guidance: Consulting with an experienced disability insurance attorney can greatly benefit your chances of getting an approval for your claim. They can guide you through the process, help you understand policy requirements, and ensure that your claim forms and supporting documentation are accurate, complete, and persuasive.
  2. Document everything: Keep a detailed record of all medical appointments, treatments, and their impact on your daily life. This information will support your claim and provide a comprehensive overview of your disability.
  3. Be consistent and clear: Provide consistent information throughout your claim forms and supporting documentation. Any inconsistencies can raise doubts about the credibility of your claim.
  4. Submit all required documentation: Include all requested medical records, test results, and physician statements. You must include this crucial information to strengthen your claim.

If your claim with a disability insurer has been denied, don’t lose hope. Consult with a disability insurance lawyer who can review your case, identify potential errors, and help you appeal the denial. With accurate and complete documentation and professional guidance, you can improve your chances of obtaining the disability benefits you deserve.

Understanding Tactics Used by Insurance Companies to Deny Disability Claims

Imagine the following scenario: You have filed a long-term disability claim for chronic back pain because you are no longer able to work a job. You are waiting to be approved so you can start getting your disability benefits. While out with family on the one rare occasion you decide to try to push through the pain to spend time with your loved ones, you spot someone secretly recording you.

Unbeknownst to you, this person is an investigator hired by the disability insurance company. The surveillance footage they acquire could be used against you to deny your claim. While you know you are suffering from terrible and chronic pain that hinders your ability to work, you toughed it out for one hour to go out with your family. Now that the disability insurance company has spotted you out and about, their surveillance has endangered your chance of receiving rightful benefits.

Unfortunately, insurance companies often subject long-term disability claims to extensive investigations, which can compound the frustration and discouragement you may already be experiencing. Understanding the tactics employed by insurance companies can empower you to navigate this complex process with knowledge and confidence.

The Lengths Insurance Companies Go to Investigate Long-Term Disability Claims

When it comes to evaluating and investigating long-term disability filings, insurance companies leave no stone unturned. They have a vested interest in minimizing their financial liability, and therefore, they conduct thorough investigations to ensure that claims are legitimate and meet the policy requirements. These investigations can involve:

  • Surveillance by Private Investigators: Insurance companies often hire private investigators to monitor claimants’ activities. They may document your daily routines, interactions, and physical abilities through photographs or videos. It is crucial to be aware that even a single moment captured in a picture can be misinterpreted or used against you.
  • Review of Social Media: Insurance companies may also scrutinize your social media presence to gather evidence contradicting your claim for disability. Be cautious about what you share online, as innocent posts or photos can be misconstrued as evidence of your ability to perform tasks you struggle with due to your disability. You should also be aware that they may look at any of your family or friends’ social media posts as well.
  • Medical Record Requests: Insurance carriers frequently request extensive medical documentation of your disability. This may include healthcare records, diagnostic test results, physician reports, and treatment plans. They seek to validate the medical evidence supporting your claim and ensure that your condition prevents you from working. If they find conflicting information, they may deny your claim.

Demanding Extensive Medical Documentation: The Reason Behind the Requirement

Insurance providers often request substantial medical documentation to support your long-term disability claim. This requirement serves multiple purposes, including:

  • Verification of Disability: By reviewing your patient files, insurance companies aim to validate the existence and severity of your disabling condition. They seek evidence that your impairment meets the criteria defined in your insurance policy.
  • Assessment of Work Capacity: Through medical documentation, insurance companies assess your ability to perform your occupation or any alternative work. They look for any contradictory information suggesting you can still gain employment.
  • Preventing Fraudulent Claims: Insurance companies request comprehensive medical documentation to deter fraudulent claims. By conducting rigorous reviews, they aim to ensure that only individuals with legitimate disabilities receive the long-term disability benefits they deserve.

Having proper medical records to support your claim is essential. That’s why it’s beneficial to hire a skilled disability insurance lawyer. They know the ins and outs of the process, can make sure you see all the necessary specialists to document your disability, and can handle negotiations with the insurance company to get the benefits you deserve.

Evaluations by Medical Providers in Disability Insurance Claims

If you’re pursuing a disability claim, you may have encountered requests from your insurance company to meet with medical providers paid for by them. These evaluations are crucial in assessing your disabling condition and its impact on your claim.

Insurance companies often require claimants to undergo evaluations by medical providers for the following reasons:

  • Independent assessment: Insurance companies seek an independent evaluation to verify the validity and severity of your disability claim. They aim to ensure the accuracy of the information provided by your and your medical providers to minimize the risk of fraudulent or exaggerated claims.
  • Expert opinion: Independent medical examiners are experts who can provide an objective assessment, contributing valuable insights to the claims process.

The evaluations conducted by medical providers serve additional key purposes:

  • Medical assessment: The primary goal of these evaluations is to assess the nature and extent of your disabling condition. Medical providers will review your health records, conduct examinations, and may order additional tests or consultations if necessary. Their findings contribute to determining the validity and severity of your disability claim.
  • Functional capacity evaluation: Medical providers will evaluate how your condition impacts your ability to perform work-related tasks. They will assess your physical limitations, cognitive skills, and overall functional capacity. This evaluation helps insurers determine whether you meet the criteria for disability under your policy.

Potential Challenges Claimants May Face During Independent Medical Evaluations

While evaluations by medical providers are a standard part of the claims process under federal law, claimants may encounter specific challenges. It can help you to be aware of these challenges beforehand. They are as follows:

  • Subjectivity: The assessments conducted by medical providers may not always align with your personal experiences or the opinions of your treating physicians. Different providers may have varying perspectives, leading to potential evaluation discrepancies.
  • Limited time and context: Evaluations are often time-limited, which means they may not fully understand the scope of your condition. This limited perspective can impact the accuracy and comprehensiveness of their assessment.
  • Pressure to return to work: Insurance companies may use the findings from these evaluations to challenge the validity of your claim and encourage you to return to work while you are still disabled.

How an Experienced Disability Lawyer Can Help You

If you find yourself facing a long-term disability claim delay or denial, it is in your best interest to seek the assistance of a disability lawyer. Our law firm has a dedicated group of attorneys who specialize in assisting people with claims for disability. We know how important it is for you to have someone on your side, fighting for your rights.

Our experienced long term disability team is here to provide you with the guidance and support you need. Here’s how a disability lawyer can help:

  • Understanding the intricacies: Long-term disability attorneys have in-depth knowledge of disability law. They can help you understand your rights, the claim process, and the specific requirements to qualify for benefits.
  • Preparing a solid case: A disability lawyer will work closely with you to gather the necessary evidence and documentation to support your claim. They know what information is crucial and how to present it effectively.
  • Managing paperwork and deadlines: Handling the extensive paperwork involved in a disability claim can be a massive task. A lawyer can ensure that all forms are correctly completed, submitted on time, and that you meet crucial deadlines.
  • Communicating with insurance companies: Disability lawyers serve as the point of contact between you and the insurance company. They can effectively communicate your needs, address any concerns, and negotiate on your behalf.
  • Identifying potential issues: Disability lawyers have experience spotting pitfalls that could lead to claim denial. They can help you avoid common mistakes and provide accurate and complete information.
  • Preventing claim delays: By meticulously reviewing your claim and ensuring all required information is included, a disability lawyer can help avoid unnecessary delays in the evaluation process.
  • Addressing claim denials: In the unfortunate event of a claim denial, a disability lawyer can guide you through the appeals process. They will thoroughly review the denial letter, identify its reasons, and develop a strategy to challenge the decision.
  • Maximizing claim value: A disability lawyer will ensure that you pursue all available benefits and compensation to which you are entitled. They can help calculate the appropriate amount of disability benefits and negotiate for a fair settlement or ongoing payment arrangement.
  • Litigation representation: If your claim requires litigation, a disability lawyer will provide skilled representation in court. They will present your case, argue your rights, and fight for the compensation you deserve.

Don’t Let Your Disability Claim Get Denied: Trust Edelstein Martin & Nelson to Fight for Your Rights

It’s highly beneficial to consult a long-term disability attorney before filing your claim or appeal. A strong presentation of the claim is crucial, and having legal representation from the start can speed up the process and ensure you have the best possible chance of approval. Contact an Edelstein Martin & Nelson disability lawyer toll-free at 800-887-4529 or contact us online to discuss your disability case now.