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Filing a Long-Term Disability Claim

Posted in Long Term Disability. Tuesday, May 30th, 2017

When a person is injured in a car crash or other type of accident, he or she may find it difficult, if not impossible, to hold down a job. This in turn, can make it challenging to stay on top of medical bills, pay household expenses, and support a family. In an effort to avoid this type of situation, many Ohio residents purchase long-term disability insurance, so that in the event of an injury, they will be able to pay their bills until they can return to work. However, insurance companies are sometimes reluctant to pay out valid claims, leaving policyholders with little to no income. Fortunately, those whose claims have been denied do have legal recourse, so if you are suffering from a disability and have questions about the status of your own claim, it is important to seek the advice of an experienced long-term disability attorney who can walk you through the filing and appeals process.

Employers and Private Insurers

Many employers provide their workers with long-term disability insurance policies, under which they can collect compensation for injuries or illnesses that keep them out of work. Even when an employer does not offer this type of policy, individuals can purchase their own from private insurers. In either case, before a policyholder files a claim he or she should carefully review the language contained in the policy, which will specifically state which disabilities are covered and how to go about filing a claim. It is also critical to receive medical attention as soon as possible. Delaying this step can make it much more difficult to collect compensation, as the first thing an insurer will do is request documentation detailing the claimant’s diagnosis, which usually includes medical records.

A policy’s coverage depends on whether it is a group or individual policy and its cost. However, policyholders are generally eligible to receive long-term disability benefits when the company determines that they have a physical or mental impairment that falls under their definition of disability and has resulted in a loss of income.

Some companies only require that claimants demonstrate that they can no longer work in their own occupation to collect benefits. In these cases, the insurer will compensate the claimant even if he or she accepts a different job as long as it is with another company and in a different position. However, the insurer will often only pay claimants the difference between what they were making in their old job and what they are making currently in their new position. This often occurs when a claimant is only able to work part time. Other policies only provide benefits when a claimant can demonstrate that he or she cannot do any type of work.

Appealing a Denial

Many insurers deny valid long-term disability claims on a regular basis. Fortunately, almost all employer-sponsored long-term disability policies fall under the purview of the Employee Retirement Income Security Act (ERISA), which means that claimants who have been denied can file an appeal in federal court after exhausting a company’s internal appeals process.

Contact an Experienced Long-Term Disability Attorney Today

If you live in Columbus and are unable to work as a result of a disability or illness, please contact the Law Office of Mike Gertner by calling 614-463-9393 to speak with a compassionate long-term disability attorney who can answer your questions.