Long Term Disability Lawyer in South Carolina
Long-term disability insurance benefits protect those who are prevented from working due to an injury or illness. This is an excellent benefit to have and can replace income so that people can stay in their homes and pay bills when they cannot work.
This insurance is often recommended when there is considerable disagreement regarding how the accident happened or what the medical evidence indicates. Accepting LTD insurance is a simple choice when facing the possibility of losing your income. However, for those who were harmed at work, this is not necessarily the wisest course of action. At Surasky Law Firm, we can help you with any workers’ compensation case.
Qualifying Medical Conditions
If you can’t work, long-term disability insurance should provide replacement wages. Generally, workers receive 50-80% of their typical wage, although it depends on your policy. The insurance plan should also identify qualifying medical conditions. The most common illnesses and injuries are covered and include:
Cancer: acute leukemia, lymphoma, mesothelioma, pancreatic cancer, and others
Cardiovascular diseases: hypertension, stroke, coronary heart disease
Immune system disorders: Grave’s disease, Lupus, rheumatoid arthritis, and HIV
Neurological disorders: multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, Lewy body dementia, traumatic brain injury
Mental illnesses: anxiety disorder, depression, schizophrenia, post-traumatic stress disorder
Musculoskeletal disorders: fibromyalgia, Spondylitis, osteoporosis
Genitourinary disorders: endometriosis, urinary tract infection, kidney failure
Respiratory illnesses: cystic fibrosis, emphysema, asthma:
This list is not comprehensive but simply illustrates some of the most common conditions that most policies cover. Contact Surasky Law if you suffer from a condition that is not listed above because you still might qualify.
ERISA and Long-Term Disability Benefits
Congress passed the Employee Retirement Income Security Act (ERISA) to protect workers by regulating employer-sponsored benefit plans, including long-term disability policies. The law provides protections to workers who are seeking benefits under these plans.
Among other things, the law requires that insurers provide you with information such as coverage details and filing deadlines. You also have appeal rights if an insurer denies your application.
ERISA is a complex law. Not all personal injury attorneys are prepared to protect your rights, so you should ideally meet with a law firm that has handled multiple disability claims.
Steps to Take after a Disability
Anyone suffering a disabling illness or injury should take certain steps to protect their ability to receive benefits. We have seen people lose benefits because they failed to make a phone call or submit a form in a timely manner. For example:
Notify your employer of your illness or injury as soon as possible. They should provide a form to fill out to request benefits.
Seek prompt medical attention. The main way to convince an insurer that you have a qualifying disability is to document it with medical evidence. Go to your doctor, who can schedule diagnostic tests and prescribe treatment.
Submit a complete form in a timely manner. Make sure your information is accurate and ask questions if you don’t know what information is requested.
Compile helpful evidence, including medical records and billing statements. A South Carolina long-term disability lawyer will help you identify what is needed.
Contact Surasky Law if you have questions or your claim is denied.
The insurance company will review your application and supporting evidence. They could request that you attend an independent medical examination (IME) with a doctor of their choosing. You should discuss an IME with your attorney, who will have advice on what to expect.
If approved, you typically must wait 90 days to receive benefits. This is called the elimination period, which is included in most policies. Most benefits are paid monthly for a set amount of time, typically up to two years. But some people will receive monthly benefits for life, depending on their disability.
Why Claims Are Denied
Long-term disability claims get denied all the time for a variety of reasons. Some of the most common include:
Missed deadline. There are many deadlines to meet, and if you go over one, an insurer can deny your claim.
No qualifying disability. Your illness or injury might not qualify under the policy for benefits.
Pre-existing injury. An insurer might claim your injury is pre-existing, and most insurance policies exclude them from coverage. For example, you could have sprained your knee skiing 4 years ago and now suffer a knee injury in a car accident. An insurer will claim your knee pain is the result of the earlier skiing accident.
Lack of evidence. You might not have enough evidence for the insurer to determine whether you qualify. For example, you might not have included enough medical evidence to establish your disability.
Not attending an IME. If you miss the IME, an insurer can cite this as grounds for denying your claim. Some people miss an IME because it is scheduled for an inconvenient time or at a remote location. Sometimes the travel is too burdensome.
Incomplete or inaccurate information. Your forms might be incomplete or contain conflicting information, so an insurer cannot decide whether you should receive benefits.
You may be denied for one of these or another reason. Read your determination letter from the insurer, which should spell out why they denied your claim.
We Help Those Denied Long-Term Disability Benefits
Never let an initial denial prevent you from seeking long-term disability benefits. Under ERISA, you have the right to file an administrative appeal within 180 days of the date on your denial letter. You want to meet that deadline, so talk to an attorney as soon as possible.
Most appeals require additional evidence. If the insurer does not believe you are disabled, for example, we can seek supporting medical documentation to include in your appeal. Once we submit everything, the insurance carrier takes a fresh look at your case, and they will either approve or deny benefits.
If your application is denied, your attorney might file a lawsuit in court. We can present evidence to a judge showing why you qualify under the policy. Unfortunately, you have tight deadlines to meet.
Our South Carolina Long-Term Disability Lawyer is Here to Help
These benefits are an important source of financial support to those in serious pain. Call Surasky Law Firm to discuss your case in a confidential setting.
