You Counted on Their Promise to Pay. Make Them Keep It.
We Have Been Making Them Keep Their Promises for 30 Years
If your claim for long-term disability benefits under an ERISA-governed employee benefit plan was denied, you have the right to appeal the denial. However, federal ERISA rules are strict and tend to favor the insurance company, thereby making it even harder on a disabled claimant to pursue benefits. Here are six critical points you must …
A resource for disabled attorneys whose insurance providers have wrongly denied their long term disability insurance claims. Accidents and illness can happen to anyone. For attorneys, investing in long term disability insurance protection is especially relevant. You invest enormous time, energy and money into your careers; a disabling illness or injury could mean financial devastation. …
We witness improper denial of health insurance claims on a continuing basis. It has become routine practice by many insurance companies to stonewall or deny claims in order to profit at the expense of the insured. A rejected claim can be financially devastating to the sick or injured person. In some cases, it can lead …
The DSM-IV has been used by the medical community and long term disability insurers trying to define mental disorders since the year 2000, so changing over to the DSM-V was no small task. However, it was a change that many welcomed because of a number of problems – both perceived and real – with the DSM-IV. Whether or not the relatively small changes made in DSM-V will actually fix the issues that bothered people about the previous Diagnostic Manual remains to be seen, but there were plenty of reasons to want to move on from the DSM-IV.
When you look at the definitions for how much physical labor a job requires, it’s pretty easy to see how someone with a disability might have difficulty with most of them. After all, you probably don’t imagine someone in a wheelchair transporting boxes constantly, or an individual who can’t lift his or her arms operating heavy machinery.
And then there are Sedentary jobs. By definition, these are positions where workers sit for at least two-thirds of the time and only rarely exert themselves physically, lifting up to a relatively paltry 10 pounds when they do. At first glance, it seems like Sedentary jobs could be performed by just about anyone.
I began this series on understanding your long term disability policy by saying that it’s not as simple as merely paying your premium and filling out the application after you start suffering from problems. Every policy has specific requirements that you have to meet in order to qualify for benefits, and so far we’ve covered some of the most common provisions.
After detailing the definition of disability in the first part of the series and covering elimination periods, earnings caps, and more in part two, today the focus is going to be on policy limitations and appeals issues.
