Understanding ERISA Settlements and Court Awards in LTD Claims
What awards can you expect in ERISA settlements or court decisions, if you appeal a long term disability denial and win against your insurance company? As the above video explains, the money coming to you is limited, because there are no compensatory or punitive damage remedies available in ERISA cases.
This is not implying that ERISA settlements or court decisions are paltry; indeed they can produce substantial monetary payments that mean the difference between living disabled in financial ruin or with a secure and stable future. But when compared to other types of court cases, ERISA-based claim awards are limited for insureds.
Discretionary Clauses in Disability Insurance Policies
The ban on discretionary clauses in long term disability insurance plans has been going on for years, with more states pushing for change.
In addition to Texas, many states have amended their state insurance codes to limit or ban the use of discretionary clauses in both individual disability and group disability insurance policies.
How ERISA Limits Legal Remedies in Group Disability Claims
Has your group disability claim been denied? If so, you need to know that your claim is governed by the federal law known as ERISA. Not only does this limit your lawsuit causes of action; ERISA limits legal remedies in response to the insurance company’s violations.
In the video above, disability attorney Marc Whitehead explains how LTD insurers will use ERISA law to their advantage to deny your disability claim. It is actually the lack of legal remedies available in ERISA-based cases that hurts claimants—and the insurance companies are fully prepared to capitalize on that.
How ERISA Denies Due Process (Justice) in Disability Claims
Long term disability insurance for employees is regulated by federal ERISA law. As shown in our video above, it is clear that ERISA denies due process in group disability claims – allowing insurers to deny you the benefits you deserve.
What exactly is “due process” as it applies to disability insurance benefits? Due process of law refers to the constitutional guarantee to all persons of fair treatment through the normal judicial system. It is a basic principle of fairness in legal matters, especially in the courts.
Administrative Appeal in Group Disability Claims
In our video above, disability attorney Marc Whitehead discusses the importance of the administrative appeal in group disability claims.
Group insurance plans are governed by federal ERISA law. There are key differences between what you must do to prevail in a claim for group disability benefits under ERISA rules, versus the state contract laws that you would follow if your claim were filed under a private long term disability policy.
How a Social Security Disability Offset Can Cut LTD Insurance Benefits
Today’s video brings shocking news to many group disability claimants: If you are awarded disability benefits by Social Security as a lump sum (in addition to your group LTD insurance benefits), your insurance carrier can ask that you turn over your SSDI lump sum award to them.
Most employer-sponsored long term disability plans are explicitly written so that the insurer benefits when SSA approves a claimant’s SSDI claim.
What Are Disability Payment Offsets to LTD Insurance Benefits?
Disability insurance plans offered through an employer can provide critical disability benefits. However, there is another important fact about group coverage every employee should realize:
Most group disability plans have provisions that offset (reduce) LTD insurance benefits, if that employee has other sources of income.
The video above explains how an award of Social Security Disability Insurance can offset your LTD monthly benefit amount. As a rule, this stipulation affects long term disability benefits and only in rare situations affects short term benefits.
What the Denial Letter from Your LTD Insurer Does Not Tell You!
Have you received a denial letter from your long term disability insurance company? Now is not the time to fold in despair; it is time to take action! But first of all, what happened? Why did the insurance carrier deny your claim?
Remember that in group disability claims, your claim information is reviewed and evaluated by claims handlers who work for the insurance company. This reveals an inherent conflict of interest in most group disability cases.
How Medical Reviews by Insurance Companies Cause LTD Claim Denial
Biased medical reviews and exams can bring down a deserving disability claim. The above video discusses the process to appeal a disability insurance claim denial. Appeals often mean you must argue against the insurance company’s slanted medical reviews and subsequent mishandling or distortion of the evidence.
Filing an LTD Appeal – What You Need to Know
“Can you appeal a long term disability denial yourself? Yes, but it’s not a good idea.” As stated in the above video, this advice may be a rude awakening for many claimants. Why is filing an LTD appeal yourself a bad decision? The reasons become more apparent when you consider things from the insurer’s point of view.
Group vs. Individual Disability Insurance Appeal – What’s the Difference?
To prevail in a long term disability claim dispute, one of the first things to identify is the law that will govern your disability insurance appeal. There is a great difference between appealing a disability claim that is under group coverage, as opposed to individual, or private coverage.
Our video talks about ERISA law. The acronym ERISA stands for the Employee Retirement Income Security Act and is the federal law that governs group disability insurance plans. Group coverage is typically provided by your employer, or in some cases through professional associations and trade groups.
SSDI Benefits for Spinal Cord Disorders – Use SSA Listing 11.08
If you suffer from a spinal cord injury or disease, you may be eligible for Social Security Disability Insurance (SSDI). There are two ways to qualify for SSDI benefits for spinal cord disorders:
• meeting Listing 11.08 as defined by SSA, or
• if the impairment does not meet the criteria of a listing, it can medically equal the criteria of a listing.
In either case, your condition must limit your functioning so much that you cannot work and earn a living. The following presents the basics you need to know about filing for critical SSDI benefits you need and deserve, or appealing a claim denial for SSDI benefits for spinal cord disorders.
Get Social Security Disability Benefits for Cerebral Palsy Using SSA Listing 11.07
What does Social Security look at when deciding to award disability benefits for cerebral palsy (CP)? Even with the strongest claims, many CP disability cases are initially denied. Having good legal help after a claim denial can make the difference between winning and losing much needed compensation.
Cerebral palsy is an umbrella condition for several different movement disorders. In many cases, it has also been shown to negatively impact hearing, eyesight, speech, and reasoning, and it can also cause seizures. Those with severe cerebral palsy may be able to get disability benefits from Social Security – if they qualify.
Win Weight Loss Disability Benefits Using SSA Listing 5.08
How does Social Security evaluate and award weight loss disability benefits? While many people fight to drop a few pounds, those who have an ongoing weight loss problem know just how frustrating and scary it can be.
Most of the time, persistent trouble maintaining weight is a symptom of a serious medical disease. Depending on the nature of the related medical disorder, you may be experiencing a variety of serious associated symptoms that make it difficult to engage in regular activities of daily living or even concentrate for long periods of time.
Win SSDI Benefits for Short Bowel Syndrome Using SSA Listing 5.07
Do you qualify for SSDI benefits for short bowel syndrome? How does Social Security evaluate this digestive system impairment for disability?
Anyone who has short bowel syndrome (SBS) knows how hard it is to live with. Not only are you often weak and tired, you have to deal with frequent heartburn, cramping, and bloating. And, of course, the diarrhea can be so severe it can lead to malnutrition and death if you aren’t properly treated.
For Bronchiectasis Social Security Disability Benefits Try Using SSA Listing 3.07
People with bronchiectasis not only experience frequent trouble breathing, they tend to have repeated, serious bouts of issues like pneumonia, bronchitis, or even respiratory failure. If this sounds like you, there’s a good chance you’re having trouble handling the activities of daily living, much less successfully going to work and holding down a job.
The SSA understands how difficult living with this condition is, which is why they have included bronchiectasis in their Social Security Disability Listings of Impairments – a compendium of recognized debilitating medical issues with clear definitions and specific criteria you need to meet in order to get disability benefits.
Cystic Fibrosis Qualifies for Social Security Disability Using SSA Listing 3.04
Cystic fibrosis (CF) is a life-threatening disorder that causes normally thin and slippery fluids like sweat, mucus, and digestive juices to become thicker and stickier. The fluid then build up in important areas of your body such as your digestive tract and – quite commonly – the lungs. Too much buildup and you won’t be able to breathe.
CF is a disabling condition that necessitates daily care and makes it a lot harder to do things that most of us take for granted, such as going to school or work.
For Pneumoconiosis Social Security Disability Benefits, Try SSA Listing 3.02
Do you work in conditions that require you to regularly inhale asbestos, coal, silicon, or beryllium? Is it often difficult for you to breathe? Sometimes, when you breathe in certain dust-like particles, they can stay in your lungs and lead to inflammation and more mucus that obstructs your airflow.
When you can’t breathe, it makes everything you do that much harder. Physical exertion can become next to impossible, and many people find that they’re just not able to work. Because of this, the Social Security Administration includes pneumoconiosis and other chronic respiratory disorders in their Listings of Impairments. In other words, if you have it, it is possible that you can qualify for social security disability benefits.
How Insurers Limit Disability Benefits in Group LTD Claims
Our video discusses how disability insurance companies can reduce or limit disability benefits in group, or employer-sponsored, LTD plans. This is achieved through the wording and terms written into the disability insurance policy.
Do you know what benefits are limited in your disability plan?
Neck Pain and Cervical Disorders – Get the LTD Benefits You Deserve!
Neck pain and cervical disorders may qualify for long term disability (LTD) benefits from your insurance company. Yet don’t be surprised if your disability claim is denied.
While insurers may promise to pay LTD benefits if you are unable to work, many will deny valid claims, lowball payments or resort to delay tactics – hoping you will give in and abandon the claim.