When you research disability insurance benefits, most of the information you’ll find addresses employer-sponsored disability plans. However, many people, especially self-employed individuals, purchase private or individual disability insurance as a safety net.

You might not realize that private long-term disability (LTD) insurance claims involve a different set of rules than their employer-sponsored counterparts. In this blog, the team at Bryant Legal Group answers five of our clients’ most frequent questions about individual disability insurance.

1. What’s the Difference Between Private Disability Insurance and ERISA Plans?

If you’ve been researching disability insurance claims, you’ve probably read about ERISA (Employee Retirement Income Security Act of 1974),  a federal law that governs many employee benefit programs — including LTD plans.

However, ERISA only applies to employer-sponsored benefit programs. If your company pays for your LTD insurance premiums or participation is mandatory, ERISA probably applies to your disability insurance claim.

However, if you purchased your LTD coverage individually or voluntarily, the Illinois Insurance Code and other state laws will typically apply to your claim. Importantly, the claims and appeal process under Illinois law is very different from those under the more insurance company-friendly ERISA.

While nothing compares with a personalized assessment from an experienced disability insurance lawyer, here are some common signs that you have a private disability insurance policy:

  • You are self-employed.
  • You purchased disability insurance from a broker or carrier who partners with your medical society or bar association.
  • You purchased supplemental disability coverage through an insurance broker.
  • You pay the entire premium yourself or it’s deducted from your paycheck post-tax.

If you’re unsure whether ERISA or Illinois law applies to your case, please contact Bryant Legal Group for assistance. All initial consultations are complimentary and confidential.

2. What’s the Process for Appealing a Private Disability Insurance Denial?

You may have read about how you have to exhaust your administrative remedies and complete an insurance company appeal before filing an ERISA lawsuit. Thankfully, this burdensome process isn’t mandatory in a private disability insurance claim.

While your disability insurance lawyer might decide that pursuing the insurance company’s in-house appeals process makes sense, you have the option of filing a lawsuit immediately after receiving a denial of benefits.

Once you file a private disability insurance lawsuit, Illinois’ procedural and evidentiary rules apply. That means you’ll have opportunities to negotiate with the insurance company, present new evidence and testimony, and explain why you’re eligible for LTD benefits.

RELATED ARTICLE: Common Insurer Justifications for the Denial of Private Disability Benefits

 

3. Can I Request a Jury Trial?

One of the biggest differences between ERISA and private disability insurance claims is the right to a jury trial. If your LTD plan is employer-sponsored, a judge will review your claim — not a jury. However, in a private disability insurance claim, you can request a jury trial.

Many people value the chance to present their case and legal arguments to a jury of their peers. However, you need to make a timely demand for a jury trial. Typically, your disability insurance lawyer will help you navigate these procedural requirements.

4. Can I Get Pain and Suffering Damages for the Insurance Company’s Unreasonable Denial of Benefits?

While the Illinois Insurance Code does not permit compensation for your pain and suffering, it does allow for additional statutory damages when the insurance company denies your claim in “bad faith.” Under Section 155, you can receive no more than an additional:

  • 60% of the damages the judge or jury award you at trial
  • $60,000 or the difference between the jury award and the insurance company’s settlement offer

You may also be entitled to attorney’s fees.

However, you will first have to prove that the insurance company delays were either “unreasonable” or “vexatious.” If your case involves a bona fide dispute, these statutory damages may be unavailable.

Under ERISA, you cannot file a “bad faith” claim against an insurance company.

5. How Much Time Do I Have to File an Individual Disability Insurance Lawsuit?

Under Illinois law, you typically have up to 10 years to file a private disability insurance lawsuit. However, there is a loophole to this filing deadline.

Insurance companies can insert a different limitation clause in your insurance policy. Illinois courts typically uphold these contractual filing deadlines as long as they are reasonable. For example, the courts will probably uphold a three-year filing deadline, but a 30-day limitation period is unlikely to pass judicial scrutiny.

To protect your legal claims, you should immediately review your LTD policy before you apply for LTD benefits. Note the exact deadlines imposed by your policy and follow them carefully. However, if you’re working with an experienced disability insurance lawyer, they will oversee all of your filing and procedural deadlines.

Bryant Legal Group: Get Answers to Your LTD Questions

At Bryant Legal Group, we’ve been helping disabled individuals get the benefits they deserve for decades. If you have questions about your private disability insurance policy, we would love to sit down with you to help you understand your legal options.

Please schedule your free consultation with one of Chicago’s premier long-term disability law firms by calling 312-561-3010 or completing this brief online form.

If you’re like many Illinois residents, you have employer-sponsored benefits from Lincoln Financial Group — and you may be running into red tape or other difficulties with your insurance adjuster. At Bryant Legal Group, we have extensive experience handling Lincoln Financial long-term disability (LTD) claims, and we want to share our unique insights.

Keep reading to learn more about Lincoln Financial Group, its history of delaying claims, and how you can improve your chances of a successful LTD appeal.

Lincoln Financial: One of the Largest Disability Insurance Companies in the Country

Founded in 1905, Lincoln Financial Group offers a variety of insurance options to businesses and consumers — including long-term disability and life insurance coverage. In 2018, the company acquired Liberty Life Assurance Company of Boston, making it the largest provider of Fully Insured Disability policies in the country.

According to the company’s 2018 Annual Report, roughly 23% of its total revenue was from group protection policies like long-term and short-term disability plans. In 2018, Lincoln Financial earned more than $16.4 billion in total revenue.

The Company’s History of Lost and Delayed Claims

In 2015, the New York Department of Financial Services began investigating Lincoln Financial’s handling of life insurance claims. They discovered that during a merger, the company mishandled and lost at least 4,000 claims. While the company identified the problem in 2008, it failed to properly address the issue for an astounding six years.

During this time, thousands of people were left waiting for information about their claim and the benefits they deserved. Lincoln Financial Group’s backlog of pending claims skyrocketed, but they failed to fix the problems or even report them to state regulators.

Eventually, the insurance company agreed to a Consent Order in 2017, paying a $1.5 million fine to the State of New York and $50.7 million in restitution to policyholders and beneficiaries.

RELATED ARTICLE: 5 Essential Questions You Should Ask a Disability Insurance Lawyer

 

Avoid These 4 Mistakes in Your Lincoln Financial Disability Appeal

1. Always Follow Up About Your Claim

Lincoln Financial has not always been diligent about its claim processing. While you should never harass or threaten an insurance adjuster, you should carefully monitor your claim’s progression.

Under ERISA, a federal law that applies to most LTD claims, a long-term disability insurance company typically has 45 days to either approve or deny your claim. Under certain circumstances, the insurer can get up to 105 days to review a claim, but it must notify you of the delay and why it needs more time.

2. Don’t Rely on Lincoln Financial Group’s Adjusters for Your Evidence

Even if Lincoln Financial’s insurance adjusters seem polite and professional, it’s important to remember that they are company representatives. They will not advocate on your behalf or double-check your submissions.

When we review administrative records from Lincoln Financial, we commonly find huge gaps and missing medical records.  Even though you may have signed a medical release authorizing the adjuster to access your medical records, you’re better off taking a more active role in your claim. Don’t hesitate to submit your medical records and other supporting evidence.

This is particularly important in claims for employer-sponsored long-term disability benefits. Under ERISA, you have a limited time to submit evidence. Once Lincoln Financial Group issues its final decision in your claim, you can no longer supply additional information to the record.

3. Never Miss Filing Deadlines

Every LTD policy has strict filing deadlines. For example, you typically have 180 days to file a long-term disability appeal. If you miss a deadline, you could lose your right to disability insurance benefits. While Lincoln Financial Group has to notify you of these timelines, don’t expect them to send reminders.

Instead, you should carefully note these deadlines on your calendar and schedule multiple reminders beforehand. Even better, consult with a skilled and experienced disability insurance lawyer who can oversee the entire process.

4. Don’t Handle Your Complex LTD Claim on Your Own

Long-term disability claims require a highly technical analysis, and it’s easy to make mistakes. This is particularly true with Lincoln Financial disability appeals, which tend to fall under ERISA’s strict rules and procedures.

When you work with one of Bryant Legal Group’s skilled and experienced long-term disability lawyers, we will help you navigate procedural hurdles, provide medical, legal, and vocational analysis, and craft practical and results-driven strategies.

RELATED ARTICLE: Do You Know the Deadline for Filing Your ERISA Claim?

Bryant Legal Group: Guiding Clients Through Their Lincoln Financial Disability Claims

At Bryant Legal Group, we provide personalized advice and legal strategies for our clients’ Lincoln Financial disability insurance claims. We’ve earned a reputation as one of Illinois’ premier ERISA law firms, and we’d love to help find a solution to your disability insurance issues.

To request your free consultation, please call 312-561-3010 today or complete this brief online form.

Chronic pain is a frustrating and widely misunderstood condition that disables roughly 100 million Americans. A variety of circumstances can cause it — including trauma, surgery, cancer, and nerve damage. Unfortunately, this pain can persist even after the underlying condition resolves.

If you’re struggling with chronic pain, you may be eligible for long-term disability benefits — but don’t be surprised if the insurance company puts up a fight and denies your claim.

In this article, the disability insurance lawyers at Bryant Legal Group explain the essentials of a chronic pain syndrome claim.

What Causes Chronic Pain?

If you’ve suffered from consistent pain for at least three months, you might have chronic pain. Our bodies send pain responses to notify us about injuries and health issues. We have specialized nerve fibers called nociceptors that identify potential injuries. For example, when you cut yourself, your nociceptors respond to the stimulus and send messages through your spinal cord to the brain. Your brain translates these messages into feelings of physical pain.

However, pain sometimes continues even after your wounds have healed and your condition resolves. Doctors believe this type of chronic pain occurs when your nerves are damaged or become overactive, causing them to send false pain messages to the brain.

Physicians define chronic pain as pain that lasts for at least 12 weeks, and it can occur in any part of your body. Common forms of chronic pain include:

  • Arthritic pain related to degenerative joint disease
  • Back pain due to degenerative disc disease and other conditions
  • Cancer-related pain
  • Headache and migraine
  • Nerve pain due to neuropathy and other issues
  • Postsurgical pain
  • Post-traumatic pain, such as after a catastrophic car accident
  • Psychogenic pain linked to mental trauma or psychological conditions

Sometimes, there is a clear cause for your chronic pain; other times, it is multifactorial or idiopathic (without an identifiable cause).

Your doctors’ treatment recommendations will depend on the severity of your pain, your other diagnoses, and how well you respond to conservative treatment. They may prescribe medications and order physical therapy, mental health treatment, nerve block procedures, acupuncture, and even surgery.

Many pain management medications and treatment options carry significant side effects, which can limit your ability to work. Even worse, some people develop intractable pain that is resistant to treatment and medications.

Why Do Disability Insurance Companies Struggle With Chronic Pain Issues?

When you file a long-term disability claim for chronic pain, you may encounter significant skepticism. Disability insurance companies tend to approve cases where there is a clear diagnosis that is substantiated by diagnostic studies like MRIs, CT scans, and nerve conduction studies. However, almost every pain-related claim involves a level of subjectivity, and your pain might persist even after your underlying conditions have stabilized or resolved.

For these reasons, insurance adjusters regularly deny chronic pain — alleging that there is insufficient evidence, that your symptoms are inconsistent with objective data, or that you do not meet the policy’s definition of disability.

RELATED ARTICLE: Why Substance Use and Addiction Can Complicate Your Disability Claim

 

3 Ways You Can Strengthen Your Chronic Pain Disability Claim

To combat the challenges associated with a chronic pain syndrome claim, you’ll need a well-prepared application for benefits, compelling evidence, and an aggressive legal strategy.

1. Seek Treatment With the Right Doctors and Specialists

When you’re dealing with a complicated diagnosis like chronic pain, it’s best to treat with respected pain management specialists and other highly trained practitioners. Both insurance adjusters and judges give more weight to medical opinions from doctors who specialize in chronic pain than to primary care providers and general practitioners.

For example, if you’re dealing with chronic back pain, your medical team may include orthopedic doctors, neurosurgeons, neurologists, and certified pain management specialists.

2. Don’t Overuse Your Pain Medications

Your credibility is essential in a chronic pain disability claim, since tests and scans may not explain all of your symptoms. If you have a pattern of overusing your medications, going to the emergency department for early refills, or exaggerating your symptoms to get additional medications, you’re more likely to run into problems in your LTD claim.

Furthermore, some long-term disability plans exclude or limit claims that are related to substance use.

Consult With a Disability Insurance Lawyer

When chronic pain is your primary disabling condition, you’ll need to have a well-built claim for long-term disability benefits. Depending on your unique circumstances, this may include statements and opinions from your physicians, evaluations by vocational experts, and a comprehensive review of your medical records.

When you’re dealing with chronic pain, it can be difficult to handle all of these tasks on your own — especially if your pain levels and medications impact your ability to concentrate or finish tasks. Rather than struggling through the process alone, consider hiring a qualified disability insurance lawyer.

Bryant Legal Group: We Fight for People With Chronic Pain

Are you juggling chronic pain and a long-term disability claim? At Bryant Legal Group, we assist individuals in Chicago and throughout the country with their complex disability claims. We have extensive experience handling matters involving chronic and intractable pain and are ready to put that experience to work for you.

If you would like a complimentary consultation, please call us at 312-561-3010 or complete this brief online form.

During a long-term disability (LTD) claim, you may worry that private investigators are watching your every move, but it might surprise you that most of this surveillance occurs online. Today, disability insurance companies like UNUM, MetLife, and Aetna use social media and online monitoring to deny and terminate disability claims — even when the person has a valid claim.

In this article, we will discuss how the insurance company may try to use your online data against you and what you can do to combat these tactics.

Modern Surveillance Starts Online

Historically, surveillance involved a private investigator setting up cameras or following an LTD claimant. Sometimes, an insurance company employee would ask to visit the claimant at home for an interview, during which they would assess the person’s living situation and demeanor and look for evidence that could be used against them.

Today, an estimated 60-70% of disability insurance companies use online surveillance. They typically target social media accounts — such as Facebook, Instagram, Twitter, and LinkedIn to identify credibility gaps in a claimant’s narrative. They may even use archiving software like Wayback Machine to search past versions of your profiles and scan your friends’ and loved ones’ posts for information about you.

Because online surveillance is much less expensive than hiring a personal investigator to follow you, social media monitoring is often the first step in the insurance adjuster’s surveillance plan. If they discover “damaging” information, the adjuster may decide to authorize more traditional forms of surveillance, using your social media feed as a guide.

What Kinds of Information Are Investigators Looking for Online?

You may think that simply because you’re not posting pictures of yourself running the Chicago Marathon or jet skiing on Lake Michigan, your social media feed is safe. However, insurance adjusters will sometimes take seemingly mundane images and posts and try to twist them into something more malicious.

When insurance companies track your online activity, they may look for a variety of “incriminating” photos and posts.

Social and Physical Activity

Insurance adjusters will sometimes scour your and your loved ones’ feeds looking for posts that show you celebrating a birthday, taking a walk, or dancing at a wedding. Because these images are taken out of context and don’t document the pain and difficulties you may have dealt with during the event, the insurer will deny or terminate your long-term disability benefits, arguing that your activity level is inconsistent with your alleged disability.

Puffed-Up and Outdated LinkedIn Accounts

If you’re like many of us, you have a LinkedIn account that you use occasionally. It may include job descriptions that inflate your role and importance. Your LinkedIn profile may even say that you’re actively looking for work. Unfortunately, the insurance company may take this information and argue that you’re able and willing to work. For example, it may take your puffed-up job duties and argue that you have the skills and abilities to perform either your current occupation or other work.

Check-Ins That Identify Your Daily Routine

Suppose your doctor suggests that you take a brief walk every day to help alleviate pain and improve your mental health. You may limp through your walk around a park and take a two-hour nap afterward. However, if you check in to the same location every day, noting that you’re “working out,” the adjuster may decide to send a private investigator to the park to take pictures of you that imply you’re much more active than you really are.

RELATED ARTICLE: Disability Insurance: Insurers May Conduct Surveillance

 

5 Ways You Can Protect Yourself From Social Media Monitoring

While it’s in your best interest to stop posting while you apply for or receive long-term disability benefits, we know that it’s hard to give up social media. If you’re not willing to close your Facebook and Instagram accounts, you should, at a minimum, take some precautions.

Keep Your Accounts Private

Typically, investigators and insurance companies only have access to your information that is publicly available. Before you file for disability benefits, check the privacy settings on all your online accounts. If they are not set to private or “friends only,” change them.

Ask Your Friends and Family Not to Share Your Information

It’s not uncommon for insurance companies to scan your loved ones’ accounts looking for information about you. To protect your privacy, ask your loved ones to refrain from posting your image or other information about you. This includes tagging you in posts or pictures that may be misinterpreted by a private investigator or insurance adjuster.

Review Your Profiles for Inaccuracies

You probably have several social media accounts, including some that are relatively inactive. It’s a good idea to do a quick audit of your accounts to make sure they’re accurate and up to date. This includes checking your LinkedIn account’s job search status and job descriptions.

Don’t Sugar-Coat Your Reality

Let’s be honest; most people are more interesting on social media than they are in reality. We all tend to depict ourselves as happier, healthier, and more active than we really are. However, this can backfire in a long-term disability claim. That doesn’t mean you have to be overly negative on your social media — just be honest about both your good and bad days.

Don’t Accept Friend Requests From People You Don’t Know

Most reputable investigators will not try to hack into your accounts or gain access by posing as someone else. However, there are always concerns that a private investigator could use excessive and unethical measures to get information. To protect yourself, never accept a request from someone you don’t know very well.

Bryant Legal Group: Experienced Disability Insurance Lawyers

Bryant Legal Group is one of Chicago’s most respected disability insurance firms. Our lawyers guide disabled individuals through their complex disability claims, helping them get the benefits they deserve. If you have questions about a long-term disability claim, please call 312-561-3010 or complete this brief online form.