Long Term Disability
How We Help
How We Help
Long Term Disability
We understand what you’re going through: you have a serious health issue and the financial lifeline you thought you had – disability insurance – is demanding paperwork, more proof from your doctor, answers about surveillance and threatening the long term disability (LTD) benefits you have earned and need . Our local LTD and ERISA attorneys are here to help you every step of the way.
Why local matters?
If you are considering a national law firm to handle your long term disability case, think twice. There are very important reasons why local matters when it comes to LTD. We are Arizona lawyers who focus specifically on ERISA law and LTD claims, which means we know AZ judges, AZ doctors, and local resources to help you prove your claim. If your doctor cannot complete a form, we can help you get an independent review of your claim by another Arizona doctor. We have longstanding relationships with the Arizona attorneys that represent your insurance company. National firms cannot get the local insight like we can if you live in Phoenix, Scottsdale, Mesa, Tucson, Flagstaff or anywhere throughout Arizona.
We are in front of Arizona judges in state and federal courts every day and are licensed to litigate in AZ. If your long-term disability case requires a lawsuit, a national firm not based in or licensed in AZ would need to hire an Arizona ERISA or Insurance Bad Faith attorney to help. When it comes to your long-term disability benefits, these local advantages make a difference. Too much is at stake to get passed around later when you can work with a top Arizona disability attorney from the start.
Long-Term Disability Claims Process
Contemplating Filing an LTD Claim
If you are considering filing for long-term disability insurance benefits, you should understand your LTD policy fully, so you are aware of the stipulations and limitations specific to your coverage before you stop working or apply for long term disability benefits. We can help you with this. The sooner you get us involved the better.
Before you apply for long term disability insurance benefits, it is important to talk with the doctor most relevant to your disabling condition to gain their support. Primary care or family doctor opinions are good, but they do not carry as much influence as a specialist. Without such support it can be difficult to get your long- term disability claim approved.
Before filing, you will also want to understand what is in your medical records and ensure you are not using insurance company forms alone to document your claim. Be mindful in determining your date of disability as this can affect many aspects of your claim from establishing pre-existing conditions, affecting limitations in the policy and whether you had coverage at the time. It is best to talk with an experienced long-term disability lawyer before filing a claim.
Ready to File for LTD Benefits
When applying for benefits, focus on the primary medical conditions and functional limitations that make you unable to work rather than secondary mental conditions, such as anxiety or depression, that often result from being disabled. Be honest and complete in your answers, avoiding statements that can easily be challenged. Rather than use words like “never” and “always” it is better to say “frequently” or “seldom” when describing your functional limitations.
Insurance company forms can have loaded questions where they just ask for Yes or No. Do not feel like you must answer by selecting options they provide on their forms. Being disabled is not cut and dry like that. You will have good and bad days and your responses should reflect that reality. Attach and additional sheet explaining in detail how functional you are on a good day versus a bad day, and how many good versus bad days you have in a week or month.
You may have short-term disability benefits available also. Some policies require that you remain disabled during the whole period of your short-term disability benefits (usually 90-180 days). You can apply for long-term disability benefits a few weeks before your short-term benefits end, so you know if your long-term disability benefits are going to kick in. You can’t assume that because you were paid short-term disability you will automatically roll into long-term disability benefits. For this portion, you should have your disabling condition well documented.
Your medical records and proper documentation of your occupational and functional deficits are important to the success of your LTD claim. The insurance company may ask providers treating your disability to fill out monthly forms and it is not uncommon they will want to interview them about your disabling conditions as well. Therefore, before you decide to file a long-term disability claim, find out how supportive your doctor can or will be. Many large practices don’t allow doctors to fill out forms or give disability opinions. Some specialists require that your primary care physician complete forms. One missed, incomplete, or error on a form could result in a denial of benefits.
When you file a long-term disability claim, your insurance company will ask you for additional information, including phone interviews appointments with their doctors, or they may have a doctor whose never seen you provide a written review of your records, When dealing with insurance companies, it is very important you understand your rights and what is in your best interest. All of this can quickly become overwhelming and ERISA is a very complex area of law, but we help make it much easier for you.
Claim Denied and Need to Appeal
Insurance companies deny more than half of all LTD claims. If your claim gets denied, you can appeal to try to get the decision overturned or to set the matter set up for lawsuit. Working through the internal appeals process is necessary before you can file a long-term disability lawsuit. Don’t think you can add information after your appeal is complete. If you have to litigate your claim, it is very difficult to include additional evidence that you didn’t present to your insurance company in the appeals process.
Regardless of what your claim adjuster may tell you, you must do more than send in a letter or their form that says you appeal. The requirements of the appeal process vary based on the law governing your long-term disability policy. If you are a group policy holder where your claim is governed under federal ERISA law, you have 180 days from receipt of the initial denial to present an appeal. Shorter appeal times are permissible for additional voluntary appeals. Long term disability appeals on claims governed by state insurance bad faith laws have differing appeal times.
If your benefits have been denied, you should keep the denial letter with the envelope it came in (so you know that the date the letter was sent is the same as the date on the letter). Do not wait to contact a local, highly experienced long term disability attorney in Arizona because too much is at stake to attempt to go it alone. It is essential to know how to fully prepare the evidence for the appeal because judicial review is often limited to the administrative record. Our Arizona attorneys are experienced in long term disability appeals and know how to build substantial evidence to prove the physical and mental conditions that keep you from being able to work.
Keep in mind, insurance companies work against you when you appeal. Our LTD attorneys will obtain all relevant medical records, diagnostics, medical evaluations or opinions, and statements from your doctors so you have substantial documentation to support your appeal, so that if filing a lawsuit is required you are prepared for the best possible outcome.
Long Term Disability Litigation
The evidence submitted during the appeal is critical because it is the only documentation for your disability claim that will be considered by the LTD insurance company and the Court. Given this, it is necessary to set your claim up for a successful LTD lawsuit during the appeals process. This is very complex even for most attorneys, and why it is so advisable to work with a lawyer that deeply understands and focuses primarily on ERISA law like our attorneys who routinely fight big insurance companies and know what it takes to prevail.
When legitimately disabled claimants handle the LTD appeal process on their own, denial of their benefits is sustained by the insurer, and we are not contacted until they want to pursue the final step of a lawsuit, it is truly unfortunate. If we are not involved in the development of the appeal, there is not much we, or any attorney, can do to help the case at this point . Avoid feeling overwhelmed and cheated by your insurer. Call us as soon as you receive the denial for the best chance of securing LTD benefits you have earned and rightfully deserve.
When Your Insurance Company Works Against You, Get Schiffman Law on Your Side.
We’re here for you. With so much at stake, don’t wait or go it alone.
Receiving LTD Benefits Is Just the Beginning
The insurance company will require ongoing claim forms throughout the life of a long-term disability claim. The insurance company will request these forms with more frequency during the first two years of the claim. Some will ask for the forms monthly. After you have been disabled for a while, the requests for completed forms could decrease to quarterly, semi-annually, or annually but this can vary by insurance company and the amount of your disability claim. The LTD insurer will demand that these forms be completed within a specific timeline and will often threaten that if the forms are not completed on time, benefits will be terminated. The LTD insurer will terminate benefits if the forms are not completed. The annual forms may seem repetitive and unnecessary, but their importance cannot be overstated. It is also important that you and your doctor are consistent in the way forms are completed. Do not get a false sense of security if your adjuster tells you that you will get LTD benefits until your retirement age or sends a form to a mortgage company that says you will receive benefits for another 10 years. These promises are always made provided you continue to meet your LTD policy’s definition of disability.
Ongoing Claims Management to Maintain Your Benefits
Our LTD attorney and legal team guide clients through the ongoing claims management process so it is less stressful for you. When our firm assists clients with winning their appeal, we also provide ongoing claims management. Our attorneys and staff are well versed in the tactics that LTD insurers use to try and deny or terminate a claim at every level. It is not unusual for an LTD insurer to review annual claim forms and see something in the forms that they will use against you and terminate your LTD claim based solely on one response on an annual claim form. Having the help of Schiffman Law for your appeal and ongoing claims management helps ensure that the LTD insurer pays your benefits through the maximum benefit period stated in your LTD policy.