Nurses work stressful jobs that include the potential for contact with hazards. This combination can lead to injury or illness that may require a long-term disability claim. Those who are looking to make a long term disability claim should know the following.
#1: Know your insurance coverage.
Having at least a basic understanding of your insurance coverage is helpful. Review the policy before you start to gather information for the claim. The information needed to file the claim can vary and often includes letters from insurance companies and medical documentation to support the inability to continue working as well as financial information like proof of earnings.
Unfortunately, denials are not uncommon. The denial could be the result of a clerical error or missing paperwork. Some insurance companies have taken to hiring investigators to gather evidence to help support a denial. Whether the result of insufficient medical evidence or evidence from an investigator, those who believe they have a successful long-term disability claim and are left with a denial should not give up.
#2: Know you have options.
You can appeal a denial of benefits. It is important to keep in mind that insurance companies that provide this disability insurance are often large corporations focused on making a profit. This means there is an incentive to deny the claim. If you believe your claim is valid you can fight back and appeal the denial.
The particulars of the appeal process are generally outlined within the policy. It is important to look for deadlines and make sure to move forward before the opportunity to file the appeal expires.
#3: Be aware of the impact of ERISA.
The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that helps protect retirement funds and other benefits employers provide. Because ERISA extends beyond retirement benefits a denial of employer-provided benefits like long-term disability coverage could trigger an ERISA claim.
Navigating this system and the associated laws is not an easy process. You can seek legal counsel experienced in the specialized area of law to help better ensure protection of your right to coverage.