Attorneys Answer Frequently Asked Questions about Disability Claims
When you can no longer work because of illness or injury, you question how you will cope and what might happen next. The disability attorneys at Marc Whitehead & Associates want to help you understand the entire process, and your options along the way.
The following FAQs reveal common issues that arise for our clients during the claim process, from application to litigation. Our hope is to arm you with the facts and legal insights that can help you shape a winning outcome for your disability claim.
See how we make it easy for our clients.
Do you have questions about your disability claim? Call 800-562-9830 to discuss your case.
FAQ Categories:
SSD & Long Term Disability (1)
How To Apply for LTD
Application for LTD Insurance Benefits: Make Yours Rock Solid!
When you file your initial application for LTD insurance benefits, a lot is at stake. Our video explains why disability insurance companies deny so many legitimate claims. But sometimes a claim is denied because of mistakes and omissions made on the application, by the applicant. Without skilled legal guidance, it is a rare case for a claimant to submit an irrefutable disability claim. One that would stand up in a court of law, if needed. Yet it is understandable why most people who are dealing with a disability and can no longer work will go ahead and submit the application for LTD …
How to Set Your Initial LTD Claim Up For Success!
https://www.youtube.com/embed/yTYoJkpQEOI In the video above, we explain the first steps in filing a group disability claim. But what’s the secret to filing an initial LTD claim that is successful? Most people find the process of applying for disability insurance benefits — and actually getting the monthly payments they need — to be far more difficult and distressing than they ever expected. The complex nature of the application process, and the documentation required to prove you are disabled, is overwhelming. Many have turned to our disability law firm for help with their initial long term disability application. What’s the Secret to a Winning Initial LTD …
Attorney Representation
What Is a Board Certified Attorney?
What is a Board Certified Attorney?(Should You Hire One?) We’re often ask by clients what “board certification” means. Why are some lawyers board certified? For instance, what is the difference between a civil trial attorney and someone who is a board certified civil trial attorney? This a good question. There is a big distinction when someone takes the steps to earn board certification in a specialty area of law. Just as doctors and dentists focus on a specialty area of medicine or dentistry in which they develop expertise, attorneys may choose to specialize in a specific area of law. While some large firms are …
Why Report Your Actual Job Duties in a Group LTD Claim?
When filing a long term disability claim under an employer-sponsored plan, it is important to describe the job duties that you really do. Not realizing the importance of this, many applicants write in their job title and the brief, standardized job description provided by their HR department. Often these descriptions are too general or not representative of the work you truly do each and every day. Those who become disabled and can no longer do their jobs are surprised when the insurance companies deny their claims. Little do they know that how they portray their occupation can play an important role in …
What Is a Functional Capacity Exam?
https://player.vimeo.com/video/74244228 Our video mentions several ways we help our clients prove disability, one being to establish a correct functional capacity rating. To reach this rating, we start with a functional capacity exam, or evaluation (FCE). The resulting information enables us to reach an objective rating of your level of physical disability, and whether you can perform the duties of your occupation. This is a vital part of appealing a disability denial or preparing an initial disability claim. The FCE serves as a valid and reliable assessment of whether you can work, or return to work. But the evaluation must be performed properly, and is …
How Do Group vs Individual Disability Claims Differ?
As our video explains, there are big differences in how disability claims filed under group vs individual disability insurance plans are governed. There seems to be a big divide in logic when examining ERISA laws (governing group benefits) versus state insurance and contract laws (governing individual disability insurance plans). For the disabled claimant under a group policy, the system especially appears to work against them if an insurer denies their claim for benefits. It helps to know some basic information about the insurance industry, and why a group disability plan is so different from an individual disability insurance (IDI) policy. Let’s take a …
How Do Disability Appeal Lawyers Win Denied LTD Claims
https://www.youtube.com/embed/MW5u_EEnmis Today’s video explains how disability appeal lawyers can really help when the insurance company denies your claim. One of the main ways we assist is to fully “load the administrative record” with favorable evidence during the appeals process. What does “load the record” mean, and why is it so important? You know that to file a successful initial disability claim includes a lot more than just filling out forms. This holds true for appealing a long term disability insurance denial. Appeals require insight and knowledge of how to use the forms – and also how to supplement the appeal beyond the insurance company’s …
Policy Language Explained
Why Does the Definition of Disability Shift in Group LTD Plans?
https://player.vimeo.com/video/90683920 Our video explains that in long term disability insurance claims, there is no single, comprehensive legal definition of disability. Each insurance company writes its own definitions. As a claimant, you will receive disability benefits only if you satisfy the precise description of disability as stated in your policy. Why is it then that so many insureds are awarded short term disability (STD) benefits, only to have the benefits cut off, or denied for long term disability (LTD) benefits – under the same policy? This is because most group disability policies have two definitions of disability: one for short term, and one for …
Why Do Insurers Misrepresent a Physical Disability as Mental Disability?
We are often contacted by individuals when they learn their insurance company has mischaracterized their claim from being a claim for a physical disability, to a claim for a mental disability. Why would they do that? As our video states, most disability insurance policies have a clause that limits mental health disorders, or “mental / nervous conditions,” to a pay period of only 2 years or less. Although most disabling mental disorders will outlive 24 months, the insurance carrier will not pay benefits beyond what the policy says. It only follows that some insurance companies use this to their advantage. Many insurers …
What Is a Pre-Existing Condition Exclusion in Disability Insurance Claims?
https://www.youtube.com/embed/Oppz2OQtIm8 Most long term disability insurance policies have limits in what they cover. These limits are written into the policy, and are called exclusions. Their purpose is to eliminate coverage for certain risks the insurance company is not willing to take on. One very common example is the pre-existing condition exclusion. If you have a mental or physical condition that existed prior to the effective date of your disability insurance policy, that is a pre-existing condition. The exclusion clause in your policy prevents you from being eligible for LTD benefits for an illness or injury that existed, and that you knew about, prior to …
What Are Disability Insurance Riders? Are they Part of a Denied Claim?
Disability insurance riders are additional coverage you buy to add to your privately-purchased base policy. Riders can affect your ability to collect full benefits if you become disabled. Even so, insurance companies may still deny a valid claim no matter what coverage you have paid for under the policy. There’s no guarantee that, because you have added a rider to your LTD policy, your claim will result in the award of benefits associated with that rider. Disability policies are inherently complicated. In fact, sometimes by adding further benefits and exclusions through riders, the policy becomes even more baffling. Your private insurance policy is …
Individual Disability Insurance Policy or Group Disability Plan?
Our video shares what we consider to be ten important features to consider when choosing long term disability (LTD) insurance. There are two basic types of coverage: an individual disability insurance policy or a group disability insurance plan. What are the differences? Do they offer the same protection? The most prevalent type of LTD insurance is group disability coverage through an employer. Even so, most employees are not aware of the limitations and hidden costs of group disability coverage, or the amount of coverage they will actually get. Individual disability insurance (IDI) is a policy that you privately buy from an insurance agent. …
Are there Hidden Costs in Group Disability Claims?
If you are filing a claim for LTD benefits, you need to know there may be some hidden costs with group disability claims. Specifically, (1) if your income includes a base salary plus bonus income, the bonus income may not be covered, and (2) you may have to pay taxes on your benefits. As explained in the video above, most group disability policies pay a percentage of the salary you were earning before you became disabled. If you are awarded disability benefits, this “salary percentage” provision can work to your advantage. The provision ensures that you would collect a percentage of your …
What Is the Dictionary of Occupational Titles in LTD Claims?
When you are fighting to receive disability benefits, you may hear reference to the Dictionary of Occupational Titles, or DOT. The above video mentions this as a source of vocational definitions. The DOT is a database that identifies and defines the skills and knowledge a person needs to normally perform an occupation in the U.S. economy. DOT is actually no longer updated – in fact, the last update was in 1999. Information now is often sourced from the Occupational Information Network (O*Net) – which technically replaces the Dictionary of Occupational Titles (DOT). As you can see, each database links to the other …
ERISA (Group Claims)
After I’ve Made an LTD Benefits Claim, Will The Insurance Company Talk To My Friends and Neighbors?
Insurance companies are run to make a profit. To them, having to pay long term disability benefits to a policyholder who's become too ill or injured to work is a loss. To avoid a loss, the insurance company will often go to great lengths to show the policyholder is not disabled and can work, even spying on them while at home or out in public. They'll clutch at any straw — even quoting the unsubstantiated gossip of friends, family or neighbors — as an excuse to avoid their responsibilities to their policyholders. If an insurance company has relied on questionable evidence …
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? The only way to know what benefits your policy may restrict of exclude is to read it as thoroughly as you would any contract. It is important to carefully read your policy when your first become covered by the plan. You may decide you need to supplement the group policy with an individual policy. Also keep a copy of …
Erisa Disability Claim Litigation and Limited Discovery
In the video above, attorney Marc Whitehead explains why group disability insurance claims that have reached the Erisa disability claim litigation stage can be difficult to litigate in court. If your insurance company denies your disability claim, there is a big difference in what you can do depending on whether your claim is under a group disability policy, or is a private disability policy. The only way a group disability claim can reach the litigation stage is by exhausting the administrative appeal process. In other words, if the insurer denies your original application for benefits, you must seek approval by following the …
What Are the New ERISA Disability Regulations?
How will new ERISA rules affect your disability claim or appeal? Beginning January 1, 2018, the regulations that control ERISA claims and appeals will change. This is good news, because the new ERISA disability regulations will give short and long term disability claimants a much needed layer of protection. It is well-known that group disability claims are fraught with deceptive practices. This is largely because existing ERISA regulations make it easy for insurers to deny valid disability claims without penalties. Under ERISA, legal remedies and due process for claimants are very limited. The new ERISA disability regulations will help level the playing field …
SSD & Long Term Disability
What Should You Not Tell Your Disability Doctor?
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