Disability Insurance Claims Law – How to Handle the Details

If you are filing a long term disability claim when you have been injured or become ill and cannot work, it is helpful to know that disability insurance is more complicated than most insurance. There are very strict rules that must be followed.

Be careful about time limitations and deadlines. In the policy it will say when a claim must be filed. Most policies have a 60 day filing window. Be sure to file paperwork ahead of deadlines, and sending all documents and records by overnight registered mail.

Keep your disability claim information private. Do not post details or comments or complaints on Facebook, LinkedIn, or any disability-related forums, bulletin boards, chat rooms, social networking sites, or other online places. It does not matter if you have just filed a claim or the insurance company has been paying your benefits for ten years – putting this information on the web could lead to your losing the benefits.

Insurance companies monitor social media for their claimants very carefully and more than one person has lost their benefits or had a judge render a different decision based on their online comments. If you are filing for a disability claim and post vacation photos that show you hiking in the mountains, the insurance companies will consider the photos evidence against your claim.

Once a claim is received by the disability insurance company, they will send you forms that are required to process the claim. Among them will be a claimant statement, attending physician statement, and authorization forms permitting access to health, financial and occupational materials from third parties.

Financial records are used to evaluate income, assets and earnings. This feels intrusive and prying but providing the information correctly is important. For salaried employees, tax returns and W2 earnings statements will be simple enough to provide. If you own a business or are a partner in a professional practice or another complex earnings situation, the request for financial records can be overwhelming. It is important to check the specific language of the policy to learn what the disability insurance company is entitled to – and what is none of their business. The policy is the contract that governs the entire process. If you are asked to provide something that is not included in the policy, contact the insurance company to clarify and explain the request. Carefully document questions to minimize non-compliance issues.

Most disability policies require you to undergo an IME – Independent Medical Exam. Keep in mind that the doctor performing the examination is being paid by the insurance company. Disability insurance company doctors are not independent. Be careful! Disability claimants who believe they are speaking with a sympathetic doctor are always shocked when the doctor who seemed so nice reports that they are perfectly able to go to work. Many recent court decisions, including several in our own practice, have found it very clear that the medical exams paid for by the insurance companies are not independent. This inherent conflict of interest is something the courts are watching carefully.

The insurance company may NOT ask that a disability claimant undergo an invasive test or require claimants to travel a far distance to have an examination performed. The insurance company is obligated to schedule an IME within a reasonable distance from your home.

If you are ordered to take a Functional Capacity Evaluation (FCE), be careful. Read your policy closely to determine whether or not it specifically requires you to take this test. If the FCE is not in the policy, the law does not require that you take it. The FCE is used to test maximum effort. If you do go for an FCE and are asked to do anything that you know you cannot do without pain or discomfort, say no and do not perform the action. There is controversy surrounding this test and it can be dangerous. Document how you feel after the test and if you can, go to the doctor to make sure to document what injuries you might have suffered from taking the test.

Why Disability Insurance? Chances Of Becoming Disabled Are Greater Than Your Chances Of Not

If you and your loved ones depend on your salary for support, then you probably need long term disability income insurance.

Think about it: if you were to become disabled, even for a few months, how would you and your family manage? Who would pay your bills? Disabling illness or injury is one of the leading causes of bankruptcy in the United States.

Most people do not realize that their chances of becoming disabled are greater than their chances of dying prematurely. Yet they are more likely to buy life insurance than disability insurance. For this reason, people in the insurance industry call disability “the forgotten risk.’ According to statistics from the Journal of the American Society of Chartered Life Underwriters, if you are age thirty to fifty-five, your chances of becoming disabled are two to three times greater than your chances of dying.

If you are thirty-five years old, you have a 50:50 chance of experiencing a disability lasting last three months or longer before you retire. One in seven workers will become disabled for more than five years before he or she reaches age 65.

Many people mistakenly believe that the government or Worker’s Compensation will pay them an income if they become disabled. Actually, more than 80% of the people who apply for Social Security disability benefits are rejected. Social Security does not pay benefits for partial or short-term disability. Your disability has to either last a year or be expected to last a year before you can collect Social Security. Worker’s Compensation pays only if you were injured on the job and benefits are often limited to a few years.

Your health insurance will cover your hospital, doctor and other medical bills, but you will still not have a salary. Long-term care insurance only covers bills from nursing homes or assisted care center. Disability insurance, however, does not pay bills. Instead the insurance company gives you money on a regular basis. It is designed to replace your salary so that you and your family will not experience financial hardship during any period when you are too sick or injured to work.

What should you look for when you are buying long term disability insurance? First, the insurance company itself should have a top rating from Moody’s, A.M. Best, and Standard and Poor. These agencies rate companies in terms of capitalization, growth, earnings and other indicators of financial stability.

Secondly, you should make sure you understand the terms of your policy. Some policies require a waiting period before you start receiving benefits. For example, your policy may have a six-month waiting period before benefits are paid. In this case, your benefits would begin six months from the time of disability.

The waiting period is often called the elimination period. Choices usually range from 30 days to 720 days.

Look for a waiver of premium provision. This means if you become disabled, you will not have to keep paying for your disability policy.

What are the conditions for renewing the policy? If you’re policy is not automatically renewable, the insurance company has the right to cancel it.

Payment period options are another consideration. Some policies will only pay for a certain period of time, sometimes for only two years. Other policies last a lifetime. The most popular policies pay benefits until you reach retirement age, when you can begin to collect Social Security payments.

Most policies have a residual disability clause. If you suffer a disability, very often you will return to work part-time at first. Or because you were off work for a while, it may take you time to build your business back to the level it was before you became disabled. Your insurance should provide income for both these scenarios.

Check over the policy for a recurrent disabilities benefit. A recurrent disability is one that happens after you recover from your original disability. Your insurance should waive a new waiting period and/or not require proof that the two disabilities were related.

When you buy disability insurance, you buy it according to your income level. The more money you make, the larger the benefit of your policy. But you also have to figure that your income will rise as you get older. For this reason you want a future increase rider or automatic increase rider. These riders allow you to keep your policy but increase the amount of your benefits based on your increased earnings as you grow older.

When you buy your insurance, certain factors will affect your price. You will pay less for the insurance if you decide to replace 50% of your income instead of 80%. You also pay less if you opt for a longer elimination period. The insurance company factors in your current health and may exclude preexisting conditions. Women and smokers may pay more for disability insurance because they make more claims than non-smoking males. If you are in a high-risk job, your policy may cost you more.

Disability insurance policies can be confusing. It is always best to sit down with a professional insurance agent to discuss the terms of the policy together and to ask questions until you completely understand the details of the policy quotes being presented.

The Insurance Science of Disability

If you are young and healthy, you probably have given little thought to the notion of disability insurance. Most employees in this age-range may even scoff it off as negligible in view of their youth.

“Disability insurance? “Compensation if I become unable to work?” they may exclaim. “Why, this is coverage that I do not really need.”

If you would speak to the professionals – those in the trenches when it comes to related liability and insurance claims, you would hear a very different story. In fact, the discussion would lead you to be ever so grateful that you are covered!

Deep down, every person understands that any blessing we have in life should never be taken for granted. Car accidents, business mishaps, home devastation – all these things happen. Likewise no one can guarantee that sickness or illness will not disrupt a life once devoid of it – regardless of the current station one finds oneself in.

Need more on the matter? Here are the sobering facts:

• 1 in 4 young people in the age bracket of twenty years suffer from a long-term illness or injury.

• Each year, there are over 700,000 paid workers and employees that are awarded social security disability insurance benefits.

• In general, 1 in every 15 employees files a short-term disability claim per year.

• Almost fifty percent of all Americans do not have the money to fund a four hundred dollar medical emergency.

• Breaking or fracturing a leg may cause a three month or longer employment disruption.

• On the average, a long term disability insurance claim lasts longer than two years and six months.

• A work related physical disability can be the result of varying factors, including chronic headaches, ongoing backaches, cancer related treatments, treatment, the birth of a new baby, loss of eyesight, heart disease, mental and emotional illness and stokes as well as other maladies and situations.

• The average income of newly graduating higher education students is approximately $1,101. Weigh that with the average long-term disability maximum claim of $125,450 of loss of income.

With the current available data about young working people, a disability that renders someone incapable of working would have devastating effects without the proper insurance coverage.

Did you know?

• Thirty five percent of young employees experience difficulties in meeting everyday monthly costs.

• Close to 70 percent of all US citizens do not have even a thousand dollars in savings.

• To make matters worse, thirty-one percent of those in the age bracket of eighteen years to thirty years have no savings at all.

Life has its monetary responsibilities. These may include rent, mortgage, student loans, auto payments and more. Shield your earnings and the ability to make ends meet by making sure you have protective indemnity of disability insurance.

Here’s What You Must Know About Social Security Disability Insurance Law

If your medical condition prevents you from taking a job or find employment, you might be eligible to get disability benefits under the Social Security Disability Insurance Law. To qualify for Social Security Disability Insurance (SSDI), the Social Security Administration has set up a few norms.

– The person cannot work as before

– The person has a condition, usually physical disability, which prevents him in engaging in profitable activities to earn a living.

– The disability is expected to last at least for a year or has been the same for more than a year.

– The person has a disability that can eventually result in death

– The person cannot take up or adjust to a job, because the medical condition makes it hard to do so.

It might be confusing for people to understand if they qualify for SSDI benefits, which is why many choose to get in touch with a lawyer. As for the amount paid, it largely depends on the average of past earnings of the person. As for 2017, the monthly disability payment on an average was $1171, with maximum benefit reaching about $2,687.

When to seek legal help?

Thanks to the formalities involved, one can be denied SSDI benefits, and such cases are not uncommon. In fact, legal experts and lawyers can solve the issue for you. The first step is to understand if you are actually eligible to get the benefits under Social Security Disability Insurance Law. Your lawyer will explain everything in detail, following which the follow steps are to be taken.

– Completing the application. The paperwork involved in Social Security Disability Insurance Law application can be complicated at best. Many people are not sure of how to go ahead, which is why they seek legal expertise on the matter. The lawyer’s team can ensure that the trail of papers is completed as per requirements.

– Assistance with the reconsideration. Applications are often rejected, as mentioned earlier, and if that has occurred, do not panic or lose hope. Talk to your lawyer, who can file a request for reconsideration. Do not delay with the step, because the reconsideration request must be filed within 60 days after the first application is rejected.

– The third step is about Administrative Law Judge Hearing, which is required when the request for reconsideration is denied, as well. Another application will be moved by your lawyer before an Administrative Law Judge.

If your lawyer is competent, you can win the case in your favor in no time. It is important that you choose the right attorney for Social Security Disability Insurance Law application and follow-up procedures, if required. Take your time to evaluate the legal services available, and don’t shy away from asking relevant questions. Keep in mind that your lawyer can save considerable time and money, and their payments are usually linked with the services they provide. Ask for references and meet your legal team in person before taking the final call on moving an application.