Can a person make a claim under his or her long term disability policy on their own, with no help from a disability attorney? The answer is sometimes. The following list will help you determine if you are in over your head and need the assistance of Gisonni Law Firm.
10 Factors Used to Determine Whether to Hire a Lawyer to Help You with a Long Term Disability Claim
1. Your inability to work is caused by several different medical conditions.
Disability claims require proof. The more medical conditions you suffer from, the more proof you will need to give the long term disability insurance company. For each additional medical condition, you will be required to submit medical records and a statement by your physician of the reasons for your disability. If you are having challenges communicating with your health care providers and the insurance company is setting unreasonable deadlines for you to send in proof, that is an indication you need the assistance of an experienced attorney.
2. You are receiving treatment from several different physicians.
Coordination of your care across medical specialties is not only important for your overall treatment plan, but it is also mandatory for a successful disability claim. Often a physician treating you for one condition is unaware of the opinions of the physician treating you for a different condition. In order to minimize complications and delays in your disability claim, a disability attorney can help you and the disability insurance company make sense of treatment by your several physicians.
3. You have more than one disability policy.
If you are insured under several private policies or a combination of private policies and a group disability policy offered by your employer, your disability claim becomes more complicated. The reason is that you have the right to be protected by the language of each of your disability policies, and you have varying obligations under all of your policies. Sometimes the language of your policies differs, and the disability insurance company could use the language favorable to them and ignore the language that protects you most. A disability attorney seasoned in the interpretation of private and group policies can help navigate the differences and protect you in your claim.
4. You have more than one insurance company considering your claim.
If you have more than one policy and are insured by different disability insurance companies under each, the claim will be more challenging. That is because you must address numerous requests for proof by two different companies that might look at your medical condition and occupational duties very differently. Legal assistance dealing with more than one company at a time is often a lifesaver for your long term disability claims.
5. You are making a claim for Social Security disability benefits.
Individuals making a total disability claim will often also make a claim for governmental disability benefits. Once approved, often their disability benefits under their own policy will be reduced by the total amount of monthly benefits received from the Social Security Administration. Legal issues arise when the offset is calculated incorrectly or the insured receives a large back benefits check from the SSA, and the disability insurance company wants it all. In those cases, you need to discuss your rights and options with an experienced disability insurance claims lawyer.
6. Your medical conditions prevent you from advocating on your behalf.
Let’s face it. If you are not feeling your best because of your disability, having to communicate with your disability insurance company could really make things worse. Some disabled insureds rely on an attorney for help through the complicated process because they are just not up to it.
7. You were injured in an accident and have a personal injury claim.
Some group disability policies allow the insurance company to reduce or stop your disability benefit payments if you receive a personal injury award. This is a very complicated area of the law, and you would be well-served to have a disability attorney review your policy and discuss a future potential personal injury settlement with your injury attorney before it is too late.
8. You are constantly being barraged by insurance company phone calls.
Insurance company representatives are trained in calling you frequently and obtaining information. Often they will engage you in a discussion and leave you feeling uncomfortable. A seasoned disability attorney can serve as the go-between and minimize the influx of calls.
9. Your policy allows you to receive benefits while you work, and you are able to work on a part-time basis.
Partial or residual disability claims arise when your policy provides for smaller payments to you while you continue to work in some capacity and receive income while you are disabled. These types of claims come with ongoing and intensive financial calculations, and they require a thorough understanding of your policy language to discern how much of your benefit you are entitled to every month. The insurance company has a financial team on their side sizing up your financial records, so you need a person experienced in these types of claims to ensure the calculations are being made accurately. Some insurance companies have begun to play games with residual disability claims that allow them to not pay anything at all. Counseling with an experienced disability lawyer can mean the difference to you in many thousands of dollars in benefits.
10. Dealing with a savvy insurance company causes you distress.
If having to deal frequently with the insurance company just makes you feel worse, it is time to rely on a legal advocate who can ensure that your claim is administered with your best interests in mind. Not all disability claims require the assistance of an attorney. If you have experienced one or more of the 10 situations above, call Gisonni Law Firm to obtain an understanding of your rights under your long term disability policy.
Not all disability claims require the assistance of an attorney. If you have experienced one or more of the 10 situations above, contact Gisonni Law Firm to obtain an understanding of your rights under your long term disability policy.