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New Jersey Long Term Disability Lawyers

For those who pay a premium for Long Term Disability Insurance, it can be devastating when your disability insurance claim is denied.  Most are not experienced in this area since disability claims are not something you think about until your time of need.  There are many factors to be aware of when dealing with your disability insurance company. Utilizing a NJ disability attorney will help ensure that you are treated fairly and that your long term financial interests are protected.

Points to Consider When Filing a Long Term Disability Claim

  • Insurance companies typically have their best interest in mind, not yours. You most likely will be assigned a case manager when you file your long term disability insurance claim.  Keep in mind they represent the insurance company, not you, despite how friendly they may appear to be.

  • Be mindful of what you communicate to your case manager.   You should be truthful, but don’t allow yourself to be misled in a conversation – what you say can and most likely will be used against you should your claim be denied and/or in any lawsuit that may later ensue.

  • Prepare yourself before you speak with a case manager so you don’t mistakenly misstate information.  If you are unprepared, or are not in a position to have a conversation with your case manager, ask that they contact you at another time so you can collect and clear your thoughts.

  • You may be offered a onetime lump sum settlement or rehabilitation program.  While these may seem like viable options, you have to be very clear about what is being offered.  In most cases a settlement amount is less than what you would be paid long term – so be careful not to make a hasty decision.  Also, rehabilitation is sometimes offered as a method of reduction the amount of your long term disability benefits.

Required Social Security Disability Insurance Claim (SSDI) Filing

Most long term disability insurance plans require you to file for Social Security Disability (SSDI) benefits first. This is sometimes required because the amount of Social Security disability insurance you receive can be deducted from the long term disability insurance amount you would receive, therefore reducing payout amount from the insurance company.  It may be in your best interest to receive SSDI benefits, as it may increase your chances of obtaining long term disability since the long term disability insurance company will have to pay out less benefits.

You might be contacted by an insurance advocate to assist you in your SSDI claim.  Typically they work at no charge to you and are contracted by the long term disability insurance company.  As such, remember, they have the best interest of the insurance company in mind.

Common Causes for Denial of Long Term Disability Insurance Claims

Although there are many reasons LTD claims are denied, below are some reasons commonly utilized by insurance companies:

  • There is no objective evidence in support of total disability: This is fairly common regarding disabilities caused by depression or chronic fatigue.  You will need to double check your policy for details regarding this type of denial, and possibly your doctor for additional documentation.

  • Your doctor agrees with your insurance company: You will need to contact your doctor to confirm if this is accurate – and possibly obtain additional documentation.

  • Sedentary work: You may need to contact your employer for documentation regarding your responsibilities as well as your doctor regarding what type of work you are safely able to perform.

Long Term Disability Insurance Claim Appeal

Under the federal law that governs the majority of employer-provided health plans, the Employee Retirement Income Security Act of 1974, if your long term disability insurance claim is denied, you have the right to file a lawsuit; however, you may have to file an administrative appeal first.  There are specific parameters and deadlines associated with the administrative appeals process that are outlined in your insurance plan.  During this process you will need to provide additional information and documentation regarding your employment and health condition – including but not limited to a statement from your employer regarding your job responsibilities and employment history, medical literature pertaining to your condition, documentation from your doctors, medical progress reports, etc.

Hiring a Long Term Disability Insurance Attorney

As you can see this is a complex and arduous process and failure on your part to provide appropriate information or meet deadlines can have a negative effect on your ability to collect your long term disability insurance benefits.  In addition to being intimidated by representatives from large insurance companies, most likely you will also be attempting to manage this claims process while you are adjusting to the health issues/condition creating your disability as well as possible financial distress.

Studies show that those represented by a qualified disability attorney have significant greater chances of success than those that handle their own disability insurance claims.  It is important to consult with both a social security disability insurance attorney as well as a long term disability lawyer to ensure that you are treated fairly, are filing your claim(s) correctly and that you receive the insurance benefits you are entitled to.   The experienced NJ disability attorneys knowledgeable in disability law and will pursue your disability claim with your best in mind.

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