Long-Term Disability insurance is a private insurance choice – it may be offered to you through your employment or you may have chosen to purchase some on your own. Should you be unable to work due to long-term illness or a disability that renders you unable to work, Long-Term Disability insurance (LTD) can provide income you need to make ends meet.
If you suffer from a medical condition that makes it impossible for you to do your job in Maine, and you carry Long-Term Disability Insurance, you may be eligible to make a claim. You should review the requirements listed in your
policy to determine what the process and requirements are for your insurer. At the very least, you will need to prove, with medical evidence, that you meet your insurance policy’s definition of disability. You will need to gather your medical diagnosis; your, likely, extensive medical records and present the file to the insurer. The opinion about your health or condition provided by your treating physician is critical. As the claim continues, your physician will need to continue to provide evidence of his opinion as to your disability. Should you succeed with your LTD claim, you will receive a percentage of the wages you earned prior to being disabled.
A Long-Term Disability Claim Can Become Complicated
But even though this is an insurance policy carried by you, or sponsored by your employer, making and succeeding in the claim is not always easy. The insurer may have requirements regarding waiting periods, premiums and number of hours you worked prior to your disability. The insurer may have rules that exclude certain conditions, or have specific rules regarding timing of payouts. Some policies have exclusions for particular diseases or workplace accidents.
Most LTD policies require a claimant to simultaneously file for Social Security Disability (SSDI) so the government provided insurance can offset the payout for the private insurer. In this situation, a disabled worker may have at least two claims wending through two different bureaucracies at the same time, all the while dealing with the suffering resulting from the underlying medical condition.
Furthermore, in some circumstances, an insurer providing LTD may also require that a claimant apply for and exhaust his Short Term Disability policy benefits while waiting for the LTD benefit to begin. The LTD insurer may also require a claimant to file a Workers’ Compensation claim if the injury rendering you unable to work occurred at work. The LTD insurer may require you file all of these claims, each with its own paperwork, requirements and timing. Understanding what is needed to be done and when can be overwhelming. A Maine long-term disability attorney with experience dealing with insurance companies can be at your side to assist you with this complicated puzzle of paperwork, and will keep on top of all the various claims to help you receive the money you need.
Beyond providing the proper paperwork, prevailing in a claim for Long-Term Disability insurance can be a challenge in other respects. Insurance companies are of course a business, and they are aware of their own bottom line. Given that the insurer has a vested interest in granting, or not granting a payout to a claimant it can be very difficult to file a claim and gain success and any income you will receive from LTD. An attorney with experience in disability claims in Maine and who will have your best interests in mind can be key to the success of your claim.
Insurance Companies and Long-Term Disability Claims
Insurance companies have been known to use their vast resources to seek out details about a possible claimant. A claimant provides medical information and opinion and other material requested by the insurer. But sometimes the insurer will want its own picture of the claimant’s condition and will employ an investigator to record information about a claimant’s day-to-day activities. Insurers have been known to use these investigators to surreptitiously record a sliver of the activities of a claimant and then frame this information in the light most favorable to the insurer. The insurer may also hold a hearing with the claimant using the insurer’s own rules. An unknowledgeable claimant may sign releases at the request of the insurer thinking he should do whatever an insurer requests in order to move the claim along, which the insurer then uses to discover information to be used against a claimant. Similarly a claimant, thinking he should do as an insurer asks, may waive certain rights unaware of the full repercussions of such a waiver. Or a claimant acting on his own behalf may miss an opportunity to present evidence and then have a case closed.
An experienced attorney can help an injured party combat these tactics and get the job done. Your Long-Term Disability insurance should be there to provide a portion of the income you earned for time when you cannot work because of a medical impairment. When you can’t work and you don’t have income, an attorney with experience in LTD claims can protect your interests. Even if you initially succeed in receiving these benefits, the insurer can still deny you down the line. Best to begin your claim with the strongest argument possible. An experienced attorney familiar with LTD may be the help you need to pay your bills and take away the worry about money coming in after you suffer a health problem and cannot work.
If you or a loved one needs a Long-Term Disability attorney, contact the Law Offices of Joe Bornstein. Call 1-800-CALL-JOE (1-800-225-5563) or visit www.joebornstein.com. Your consultation is free, and you only pay a fee if we get you benefits. Offices in Sanford, Biddeford, Portland, Lewiston, Augusta and Bangor and serving all of Maine.