Numerous legal issues must be considered in long-term disability claims. These include policy interpretation, circumstances in which a claim can be legitimately denied, and legal remedies when claims are improperly denied.
Individuals who are applying for benefits, who are on claim, or who have had their claim denied are frequently unaware of their legal rights. Michael Jordan is a long-term disability lawyer who offers free legal advice in the following situations:
1) When the claim is denied: Many claims are denied during the application process. Other times, the insurance company will pay for a period of time before deciding to stop paying. Insurance companies frequently deny claims for reasons that are not legally correct. If your claim has been denied for any reason, you should seek legal counsel as soon as possible and before filing an appeal. Get more information on long-term disability appeals.
2) If you believe your claim will be denied: When an insurance company is laying the groundwork for a denial, it is sometimes obvious. For example, if you become aware of any kind of surveillance or investigation into your daily activities. Contact an LTD lawyer if you suspect the insurance company is setting you up for failure.
3) Definition change is approaching: Most group policies and some individual policies include a definition change after two years, though this could be longer or shorter. In general, the disability test shifts from “own occupation” to “any occupation.” Many insurance companies fail to recognize that “any occupation” does not mean any job in the literal sense, but rather an alternative occupation that takes into account your ongoing restrictions and limitations, as well as your training, education, and experience.
4) Work hardening programs: If your insurance company requires you to participate in a work hardening program but your doctor objects, you should seek legal counsel. Failure to participate may result in the claim being denied. In these circumstances, you must exercise extreme caution to avoid having your claim denied.
5) Independent medical examinations: Almost certainly, the policy will include a provision that allows the insurer to send you to an independent medical examination, or IME. However, if you believe the IME is not fair in the circumstances, or if you have any other concerns, seek legal counsel from an LTD lawyer.
6) Prior to attempting a return to work: The majority of people with a long-term disability claim want to return to work. After all, since LTD only pays a percentage of pre-disability earnings, there is a financial incentive to do so. However, because you are no longer disabled, the insurance company may misinterpret your willingness to try. Before attempting to return to work, seek legal counsel.
Of course, there are times when you should consult with a long-term disability lawyer. Whatever your issue, our LTD attorneys would be happy to provide you with prompt, no-obligation legal advice.