Fight Back Against Your Long-Term Disability (LTD) Claim Denial
If you’re suffering from a disability that impacts your ability to work, you may be entitled to long-term disability benefits through your employer. Unfortunately, getting those benefits is not always easy or straightforward. If your insurer wrongfully denied or terminated your disability benefits, you have the right to challenge that decision, provided you take action within the appropriate window of time.
At the ERISA Law Center in Fresno, we can advise you on your options if you feel that you’ve experienced a wrongful denial or termination of long-term disability benefits. For more than 35 years, our lawyers have helped clients nationwide appeal disability decisions. We are intimately familiar with the intricacies of the Employee Retirement Income Security Act (ERISA), which governs disability benefits in the private sector and grants employees important rights. Our ERISA attorneys know how to position your case for an appeal to help you achieve the best outcome available.
Fighting Against Big Insurance Companies
Taking on large insurance companies requires skill, determination and a deep understanding of the law. We have successfully fought against some of the biggest names in the industry, including giants like Cigna and Unum. Our experience in dealing with these companies equips us to anticipate their moves and develop robust legal strategies. To learn more about who we take on, visit our Who We Fight page.
You Do Not Have To Take No For An Answer
Insurers commonly deny or terminate disability claims and appeals. They hope that this will discourage you from further action so that they do not have to pay you. There are a variety of reasons an insurer might deny your claim, including:
- Failure to meet the policy’s definition of disabled
- An excluded or preexisting condition
- Missing medical records
- Lack of medical documentation of ongoing treatment for the condition
- A finding by the insurance company’s doctors that you should be able to continue working
- Evidence of you engaging in activities your disability should prevent you from
Each of these reasons involves complex variables that may or may not apply to you. Addressing them requires a comprehensive understanding of long-term disability rules and regulations. We have successfully helped hundreds of clients challenge their insurers’ denials and reinstate their benefits.
What To Know About The Appeals Process
If your insurer denies your long-term disability claim, it’s important to act fast. Hiring an experienced attorney can improve your chances of successfully appealing your claim denial. Every denial letter is unique, often with varying timelines ranging from 45 to 180 days for filing an appeal. We can help you meet all necessary deadlines and requirements. Remember, we need more than a two-week notice to prepare your case effectively. While we prefer to assist clients right at the appeal stage, we also handle cases where an initial appeal has been denied. For more detailed information on this process, visit our appeals page.
5 Tactics Used By Insurance Companies To Deny Claims
When facing a long-term disability (LTD) claim denial, it’s important to recognize the tactics insurance companies may use to avoid paying you benefits. Those strategies can include:
- Questioning the legitimacy of your disability: Insurance companies may dispute the validity of your disability by requesting multiple medical examinations or seeking opinions from their chosen medical professionals. They may argue that your condition does not meet the policy’s definition of disability.
- Demanding excessive documentation: Another common tactic is to request an overwhelming amount of documentation, hoping you’ll miss something critical. They might ask for exhaustive medical records, employment history and even personal information that seems unrelated to your claim.
- Misinterpreting policy terms: Insurers might interpret policy language in a way that benefits them, rather than you. They could argue that your condition is excluded under specific policy provisions or that you haven’t fulfilled all policy requirements.
- Delaying the claims process: By prolonging the claims process, insurance companies may try to frustrate you in hopes that you will eventually give up. They might repeatedly request additional information or “lose” documents to delay a decision.
- Surveillance and investigation: Insurers sometimes conduct surveillance on claimants, using private investigators to observe daily activities. They may use this information to argue that your disability isn’t as severe as you claim it is.
Understanding these tactics is the first step in effectively countering them. At the ERISA Law Center, our attorneys are well-versed in identifying and challenging these strategies to protect your rights and make sure insurers fairly evaluate your claim. If your long-term disability claim gets denied, call us at 866-360-0983 to discuss how you can fight back.
Why Hire An Attorney For Denied LTD Benefits?
We can ensure that you don’t miss any crucial steps during your appeal process. We know how complex these matters can be, and jeopardizing everything over a small oversight is not worth the risk. For example, once you complete the appeal process, you cannot add to or alter the administrative record.
We also know the time frame to successfully file an appeal. Whatever circumstances surrounding your denied long-term disability claim, we have the knowledge and experience to guide you toward the best possible resolution for your case.
Contact our experienced long-term disability lawyers at 559-549-6490 or by filling out our contact form for a consultation to see how we can help.
What Kinds Of Disabilities Can Qualify For Benefits?
Countless other conditions can be a cause for long-term disability benefits if it interferes with your ability to work. The specifics depend on the terms of your employer’s insurance policy.
Common disabilities that might render you eligible include:
- Depression, which can take a toll on all areas of your life, especially when treatments aren’t effective
- Bipolar disorder (sometimes called manic depression), which often makes it difficult to hold down a job
- Post-traumatic stress disorder (PTSD), which can lead to debilitating anxiety
- Chronic fatigue syndrome, a condition that makes it extremely difficult to work when you can’t get good rest
- Cancer, including breast cancer, colon cancer and other types, all of which can make it hard to work when you’re battling for your life
- Epilepsy, especially when it’s not responsive to medication and puts you at risk of seizures at any time
- Multiple sclerosis, a devastating disease that attacks the nervous system
- Irritable bowel syndrome (IBS), a common condition that can be disabling in its severe forms
- Complex regional pain syndrome, a rare condition causing chronic pain
- Mental health
Countless other conditions can serve as grounds for disability benefits. With decades of experience, our lawyers have seen it all. We know how to gather the appropriate medical evidence to build strong LTD cases for any type of condition that impairs your ability to work.
Pursuing A Lawsuit For Wrongful LTD Denials Or Terminations
Your insurance company is supposed to help you in your time of need. But when it denies or terminates your LTD benefits, it can leave you feeling angry. You have every right to feel this way.
Depending on your situation, you may have grounds to sue your insurer for wrongful denial or termination of your LTD benefits. However, if you’re a private sector employee, your case will likely fall under ERISA, which means you must meet certain conditions before you can sue. Our long-term disability lawyers can help you through the process with personalized attention to your needs.
Defend Your Benefits With A Strong Litigator
Denials are commonplace, since most insurance companies expect you to give up without a fight. Some insurers deny or terminate your benefits in the hopes that you do not pursue legal action so they can avoid paying you. Other insurers expect a lawsuit and will fight aggressively to keep you from the benefits you deserve.
In either case, having an experienced litigation attorney working for you will help protect the benefits you deserve. When the security of your future is on the line, you cannot leave anything to chance. If an insurance company wrongly denied or terminated the benefits of you or a loved one, get the help you need. With over three decades of experience, we have successfully taken on dozens of insurance agencies. When we fight for you, we strive to win the reinstatement of your benefits or to provide you with a fair settlement.
Do Not Take On Your Insurance Company On Your Own
If you need help protecting your disability benefits, don’t leave things to chance. If you or a loved one has had their insurer deny or terminate their long-term disability (LTD) benefits, work with an experienced ERISA attorney who can help.
Contact our Fresno office today by calling 866-360-0983, 559-549-6490. By being available 24/7 by phone, we are never out of reach. Our lawyers handle long-term disability cases throughout the 9th Circuit, including not just California but also Oregon, Washington, Arizona, Hawaii and Nevada.
You can also complete our online contact form to schedule a confidential case review with one of our intake specialists.