Questions Often Heard At Toledano Disability Law
The Employee Retirement Income Security Act of 1974 (ERISA) is a complex area of law even for plan administrators, attorneys and judges. It is not surprising when clients bring up issues such as those below. To ask questions of your own, contact the firm and discuss your concerns with attorney Reagan Toledano.
What steps should I take to make a claim for long-term disability benefits?
Inform your employer that you will be making a claim and ask to review the terms of the policy through which you intend to file a claim. Obtain an application and seek a thorough medical evaluation (perhaps through more than one doctor visit). Then request both employment and medical records to document your application. As you complete the application, focus on the key aspects of your disability that prevent you from continuing to work full-time. Recognize that the insurance claims administrators will look for reasons to deny your claim. Bolster your claim accordingly with evidence that addresses those points. After you submit your application, be ready to respond promptly and adequately to further requests for information. Consult with an attorney who can determine whether the insurer’s claim evaluation process is ERISA-compliant.
What are common reasons that insurance companies give for denying claims?
Insurers may deny claims for technical reasons (such as alleged missed premiums or belated applications), substantive medical reasons (such as insufficient evidence presented by doctors), policy exceptions (such as noncoverage for preexisting conditions) or procedural reasons (such as when a claimant fails to respond promptly or appropriately to requests or directives), to name a few. To protect your rights, get legal counsel early in the process.
How does the disability law attorney at Toledano Disability Law help clients overcome denials?
Ideally, he has the opportunity to advise a client from the beginning of the claims process. Along the way, he helps them document their disabilities in ways that will be difficult for insurers to refute. He helps clients prepare explanations with ample documentation confirming the impediments to working on the basis of qualifying disabilities. He represents claimants in correspondence, hearings and, if necessary, trials in state or federal courts.
What other types of employee benefits fall under ERISA? Does your law firm handle these kinds of cases?
Besides long-term disability benefits, ERISA’s rules may encompass claims for short-term disability, accidental death, health insurance and long-term care. The legal team at Toledano Disability Law has a deep record of experience and success on behalf of clients making claims for these and other covered employee benefits.