Short & Long Term Disability Benefits
While employers are not required to provide disability, pension and retirement plans for their employees, they get tax benefits if they do. In exchange for those tax benefits, they must meet certain standards for funding and managing those plans. In 1974, Congress passed the Employee Retirement Income Security Act (ERISA) in order to make sure that benefits promised to employees were there when they needed them.
Today’s employers often offer short term disability benefits and long term disability benefits. These benefits are most frequently promised to you in exchange for premiums paid by you or your employer through insurance coverage.
If your health is making it difficult for you to keep working, contact us to discuss your disability. Our staff is trained to gather the basic information relevant to your potential disability claim, so that we can provide you with our advice on how to proceed: review of documents, consultation, or representation. If we cannot help, we will promptly notify you and refer you to an organization or other firm that may be able to assist you at your request.
If you have already filed a claim for disability benefits and have been denied, contact us for an initial interview. Did you receive a letter denying your benefits? Did the insurance company tell you:
- MetLife – While Ms. REDACTED did have some restrictions and limitations as of that date, those restrictions would not have prevented her from performing any other gainful occupation for which she was reasonably fit by education, training or experience.
- CIGNA – We have completed our review of your client’s appeal for LTD benefits under the above captioned policy and must advise you that we are reaffirming our previous denial of benefits dated May 4, 2011 and March 27, 2012. Please refer to our previous denial letter for specific policy definitions and previously reviewed information.
- Dearborn National – In conclusion, the medical evidence does not support your inability to perform the material duties required of an Assembler. Therefore, your claim is being closed at this time, and no benefits payable.
- Unum – We have determined the medical evidence does not support your inability to perform the duties of your occupation. Because you are not disabled according to the policy, benefits are not payable.
- Guardian – This letter provides you with a claim determination based on the available information contained in your file. Please note, we are in receipt of your 2011 calendars and the additional Profit and Loss Statements and appreciate your submission. However, this information does not alter our position outlined herein.
- Unum – Your claim was previously closed on November 20, 2012 when we determined that you were able to perform the duties of your occupation and that you were not seeking appropriate care for your condition.
- CIGNA – In our letter dated April 30, 2012 we advised you that we were conducting an evaluation to determine your eligibility for benefits beyond November 25, 2012, which is when your policy’s definition of disability changes. We have completed our review and determined that you no longer remain disabled as defined by your policy.
- The Hartford – We have completed our review of your claim for benefits and have determined that we are unable to complete our investigation. Because of this, we must deny your claim.
- The Hartford – We have completed our review of your claim for benefits and have determined that the evidence submitted in support of your claim does not establish that you continue to meet the Policy definition of Disability. Accordingly, LTD benefits are not payable to you under the terms of this Policy beyond October 24, 2012.
- MetLife – Based on a thorough review and evaluation of all the documentation contained in your claim file, we find that you do not qualify for LTD benefits as the medical documentation received does not support your inability to perform your own occupation. …medical documentation was reviewed with our Clinical Specialist who found that while you may continue with weakness and fatigue there is no medical documentation to support that you are unable to perform your occupation.
- Lincoln Financial Group – We have completed our review of your Long Term Disability appeal. Based on the information provided, we have determined that we are unable to approve benefits beyond 09/28/12. In our appeal review process, all information previously submitted as well as any new documentation was used to make a determination.
- Prudential – Based on the information in your file, you do not continue to satisfy the definition of disability above. Therefore, we have closed the handling of your claim effective April 26, 2013, the date of this letter.
- Sedgwick CMS – This letter is in regard to your claim for benefits under REDACTED Long Term Disability Plan. At this time, it has been determined that you do not qualify for disability benefits under the Plan. As a result, your claim for benefits is denied for the period beginning September 21, 2012.
Specific deadlines vary based on the type of disability claim. Remember that you usually have a limited amount of time to appeal a claim denial, so contact us today!
We strongly recommend that you seek the advice of a disability attorney once you receive a denial of benefits. If involved early on, Bryant Legal Group PC can lay the foundation for your case with a thoroughly developed appeal for an award of benefits, or for settlement, or for litigation of your claim. Our experience litigating disability cases means that we have a wealth of information about how insurance companies handle claims. We make that knowledge work for you!