Long-Term Disability

A long-term disability plan offered through your employer is likely covered by ERISA (Employee Retirement Income Security Act). The intent of the ERISA law is to protect the rights of employees to receive the benefits promised by their employer. In reality, ERISA law does more to protect insurance companies than employees with long term disability claims.

Once your long term disability claim has been denied, you have 180 days to file your appeal. The insurance company then has up to 90 days to decide your long term disability appeal. During your long term disability appeal, you are probably not working, and you likely have little to no income.

If your long term disability claim has been denied, you must make sure that your written appeal is filed by the deadline, or you could lose your right to appeal. When you file your long term disability appeal, it is vital that you include all the evidence necessary to prove your cases. This is because the long term disability claim examiner will only consider the evidence that has been submitted. They will not contact you to request additional information or to let you know that something is missing. They will just deny your appeal.

If your long term disability appeal is denied, you can then file a lawsuit in U.S. District Court against the insurance company. However, ERISA long term disability cases are not handled like other types of cases. The court will only consider the evidence that was submitted to the insurance company during the appeal process. So, if you did not submit the necessary evidence to prove your case during the appeal, it is unlikely that a judge will see it differently. The court will not permit new evidence, and they will not allow testimony from witnesses. ERISA cases are also non-jury cases. This means that the final decision is left solely to the judge.

A long term disability attorney will make sure that you meet your deadlines, deal with the paperwork, help you with medical specialists, and give your case the best chance of success. A long term disability claim lawyer will make sure that all the evidence to prove your case has been submitted during the appeal. Moreover, a long term disability attorney will prepare and file your case and represent you at all court hearings.

Our experienced Kentucky long term disability lawyers charge no upfront fees. This makes it easy for anyone to have an experienced lawyer represent them in their long-term disability appeal.

You must follow the process and procedure outlined by your long-term disability plan. Your employer's human resource department is required to provide you with a summary of your plan and its benefits. They may be able to help you fill out the forms.

If your long term disability claim is denied, you may have a short period in which to file an appeal. This time period will be set forth in your long term disability plan documents. (That should have been supplied by your employer). It is strongly recommended to seek experienced ERISA help in preparing your claim appeal. You must ensure that you meet all of the legal terms and conditions of your plan. Most people don't realize, until it is too late, that the record you submit is ALL that you may be able to use later in Court, so it is VERY critical to get experienced legal help with any appeal.

A long term disability insurance company will review the records associated with any medical examinations to look for limitations and restrictions that doctors have indicated in order to determine whether you meet the plan’s definition of disability.

An insurance company can use whatever evidence is available to them in determining whether you meet the plan’s definition of disability, including social media posts showing your activities.

It is recommended to not post pictures on any social media because they can display an inaccurate portrayal of what is going on with your body! We all smile when having our picture taken – even if we are in pain! We all do things for 10 seconds that are not reflective of what we can do continuously for a work day. If someone posts a video of you, then the insurance company can find that and claim it is proof that you can work, even though you cannot sustain that activity for a long period of time.

Yes. The law requires them to give you documents.

If you can no longer work, you can use your PTO or FMLA to continue to be paid while you process any claims for disability.

Always be honest with your employer about what you can't do. It is best to ask for the employer to make accommodations for you if you think you can work a different job that they have available. Do not simply quit your job without explanation. Let your employer decide whether they can continue to use you in your condition.

A mental illness which prevents you from working may be covered or expressly excluded by the terms of a long-term disability policy.

Even if it is expressly excluded, the physical problems associated with the mental illness may qualify you for long-term disability benefits. The exact language of your long-term disability plan is key to this determination.

Your employer’s policies will determine whether you are still considered an employee while on long-term disability.