Long Term Disability Claims
Long term disability insurance is designed protect you from 100% income loss if you become ill or suffer an injury that prevents you from working for an extended time. Under most insurance policies, long term benefits kick in immediately once your short term benefits have expired – usually after 26 weeks (180 days), but the length of time depend on the specific terms of your employer’s plan. Long term disability benefits last much longer than short term benefits because they are intended to help a person make up for lost income when they are disabled for many months or even years. These benefits are paid until you can return to work or for the number of years set forth in the policy. If you need help applying for benefits or appealing a denied claim, contact a Chicago long term disability attorney at Bryant Legal Group PC today.
Conditions Typically Covered by Long Term Disability Insurance Policies in Illinois
Claims related to most physical and mental conditions are covered by long term disability insurance policies, including substance abuse. However, long term disability insurance policies frequently limit coverage related to certain conditions.
First, policies may limit coverage for claims related to pre-existing conditions. This type of limitation often expires after a certain period of time has passed that an insured has been covered without making a claim. If you have a history of treatment for a particular medical condition, you should not assume that you cannot make a related disability claim. The specific terms of the long term disability insurance policy will determine whether or not a claim is viable and details like the following are crucial to making that assessment for our Chicago long term disability attorneys:
- the period in which medical treatment was received,
- the length of long term disability insurance policy coverage, and
- the timing of a disability claim.
Second, long term disability insurance policies commonly cover disability due to mental illness, but limit the maximum benefit period to 24 months unless the insured is hospitalized. Policies do also usually offer coverage for claims related to substance abuse; policies, however, do often require specific types of treatment (i.e., in-patient rehabilitation program participation) for the claim to be payable and may also have a limited maximum benefit period. It is a misconception that substance abuse related claims are not covered by long term disability insurance policies. The specific terms of the long term disability insurance policy at issue will ultimately determine the circumstances under which a mental illness or substance abuse related claim is payable.
Third, physical conditions are typically covered by long term disability insurance policies. Here to though individual long term disability insurance policies may limit specific types of physician conditions. These conditions that may be limited are often conditions where they are diagnosed primarily based on subjective reported symptoms. Claims related to fibromyalgia, chronic regional pain syndrome (CRPS), chronic fatigue syndrome (CFS) and similar conditions are frequently, like mental illness, limited to a maximum benefit period of 12 or 24 months.
Fourth, some employers even purchase long term disability insurance policies that limit payment of claims related to certain back conditions to 24 months.
Our Chicago long term disability lawyers know what to review long term disability insurance policies for and how to translate those terms into plain English for insureds. Understanding what your long term disability insurance policy coverage really includes or excludes can be critical when determining whether or not an insured wants to invest in additional disability income policy coverage or make additional plans for potential future claims.
How to File a Claim for Long Term Disability Benefits in Chicago, IL
When contemplating filing a disability claim under a long term disability insurance policy, it is important to retain legal counsel with an experienced long term disability lawyer in Chicago. At Bryant Legal Group, we usually recommend starting the process by requesting a copy of the current long term disability insurance policy. That long term disability insurance policy will include all requirements for payment of disability benefits, like how quickly a claim needs to be submitted, what type of proof of loss the insurance company requires, and how disability is defined.
Most insurance companies administering and insuring long term disability claims require the completion of an initial set of forms in order to begin the review of a claim. The forms usually include:
- a claim form for the insured,
- a form for the insured’s employer,
- a broad authorization form in which the insured gives medical providers, financial institutions, government agencies permission to disclose information to the insurer, and
- an attending physician statement.
If you become sick or injured, the insurance company may make it very difficult for you to collect the benefits you are due by providing you for instance this set of forms and failing to detail what additional information or evidence the insurer really needs to fairly consider your claim. The filing process can be fraught with pitfalls for someone filing a claim. The Chicago long term disability attorneys at Bryant Legal Group PC know the various tactics insurance companies use to delay payments and deny coverage. When we are retained to represent individuals at the filing stage, we work with them to provide the best possible evidence in support of their claim early on and we make recommendations about what to avoid in the process.
Appealing Bad Faith or Unfair Denials & Unreasonable Delays
Long term disability insurance policies offered through most employers are covered by the Employee Retirement Income Security Act of 1974 (ERISA), a federal law that sets minimum standards for most voluntarily established pension and health plans in private industry to provide protection for individuals in these plans. ERISA provides the only remedies available in relation to claims under ERISA-covered long term disability insurance policies. Other state law causes of action, like breach of contract and bad faith, are preempted.
A claim being covered by ERISA does not mean that you have no recourse against an insurer for an unfair denial or unreasonable delays. Instead, ERISA provides a specific set of related regulatory requirements for an insurer is supposed to handle disability benefit claims. And ERISA permits an insured to file a lawsuit in federal court to seek award of benefits unfairly denied after appeals with the insurance company have been exhausted.
ERISA does not prevent an insurer from considering an insured’s request to negotiate a lump sum settlement of a claim nor does it prevent an insurer from considering pre-litigation attempts to resolve disability benefit claims. Every Chicago long term disability attorney at our firm is experienced in dealing with insurers in these circumstances as well as assessing whether or not an individual claim may be resolved in one of these two ways.
Assisting Clients With the Filing Process and Appealing Unfair Denials
Sadly, if you become sick or injured, the insurance company may make it very difficult for you to collect the benefits you are due. The lawyers at our Chicago long term disability law firm very aware of the various tactics insurance companies use to delay payments and deny coverage even when a claim for disability benefits is legitimate. We carefully guide our clients through the claims filing process, working hard to obtain all the documents and records needed to properly support their claims. It is very important to make sure that every piece of evidence is submitted during the claims filing process because if the insurance company denies coverage and the dispute ends up in court, you are generally precluded from adding any new information to your file.
Our attorneys know how to build a claims file that will give you the best chance of getting the long term disability benefits you deserve. We draw upon decades of industry knowledge to collect and assemble the most persuasive evidence for your case, including MRIs, CT scans and other medical tests and vocational evaluations. While you may think that that you can manage the process on your own, you run the risk of making a mistake that could cost you your benefits. When you work with a Chicago long term disability lawyer at Bryant Legal Group, we will make sure that everything is done right so that you can maximize your chances of success.
Contact a Chicago Long Term Disability Attorney at Our Firm to Protect Your Right to Benefits
If you are unable to work because of an illness or injury, you should contact a disability attorney as soon as possible. The attorneys at Bryant Legal Group PC have over 100 years of joint experience helping clients get the disability benefits they need to help make up for a loss in income. Our lawyers concentrate their practices exclusively on representing policyholders – we never represent the insurance companies. This focus and commitment ensures that we will do everything in our power to achieve an optimal outcome for you. Contact a long term disability attorney in Chicago today by calling 312-818-3648 or emailing firstname.lastname@example.org so that we can help you take the right steps for your particular situation.