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Reinstating Long-Term Disability Benefits: A Comprehensive Guide

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Davidson Cahill Morrison LLP

The lawyers of Davidson Cahill Morrison LLP are expert courtroom advocates for a wide range of civil litigation matters including insurance law, medical malpractice, appeals, personal injury and municipal litigation.
A disability insurance form.

The complex world of long-term disability (LTD) benefits can be a lifeline for those unable to work due to illness or injury. However, navigating the maze of approvals, denials, and reinstatements is no small feat. This comprehensive guide is designed for those who have faced the denial or discontinuation of their LTD benefits. By understanding the importance of these benefits and the steps to secure them, claimants can move forward with confidence and regain financial stability.

Understanding Long-Term Disability Benefits

What are Long-Term Disability Benefits?

Long-term disability benefits provide financial support to individuals who cannot work due to a chronic illness, injury, or mental health condition. These benefits often cover a significant portion of the claimant’s salary, ensuring they can maintain a basic quality of life while unable to work. Generally, LTD benefits are part of an employer’s group insurance plan or are purchased individually.

Common Reasons for Denial or Discontinuation

Understanding why benefits are denied or discontinued is the first step in addressing the issue:

  • Insufficient Medical Evidence: Inadequate documentation proving the extent and impact of the disability.
  • Policy Exclusions: Specific clauses in the policy that exclude certain conditions.
  • Independent Medical Examination (IME) Results: Discrepancies between the claimant’s medical reports and the IME findings.
  • Claimant’s Ability to Work: Insurers may argue that the claimant can perform other types of work.

Case Studies

Case Study 1: Settlement For Retirement Aged Teacher

In November, 2023, our lawyers recovered $130,000 for a teacher near retirement age who left work due to disability. The claim was initially denied but settled shortly after litigation.

Case Study 2: Reinstatement of Benefits for Disabled Professional

In September, 2023, our lawyers successfully had a professional’s long-term disability claim reinstated in addition to recovering $97,000 in arrears and legal costs shortly after litigation.

Strategies for Reinstating Benefits

Gather Comprehensive Evidence

The foundation of a successful lawsuit is solid evidence. Collect all relevant medical records, doctors’ notes, test results, and any additional assessments that support the claim. Ensure that the documentation clearly outlines the nature of the disability and its impact on daily functioning.

Work with Experienced LTD Lawyers

Hiring a lawyer specializing in long-term disability claims can significantly enhance the chances of a successful appeal. These professionals understand the intricate details of insurance policies and can effectively challenge denials.

Prepare for Independent Medical Examinations

If an IME is required, prepare thoroughly. Understand that these exams can be biased towards the insurer’s interests. Bring all relevant medical documents to the appointment and consider having a supportive healthcare provider present if allowed.

Practical Tips for Claimants

Communicate Effectively with Insurance Providers

Maintain open and clear communication with your insurance provider. Keep records of all interactions, including emails and phone calls, and follow up promptly on any requests for additional information.

Document Everything

Keep meticulous records of your medical treatments, appointments, and any correspondence related to your claim. This documentation can be crucial in proving the legitimacy and extent of your disability.

Maintain Medical Records

Ensure that your medical records are up-to-date and accurately reflect your condition. Regularly visit healthcare providers and comply with prescribed treatments to demonstrate ongoing efforts to manage your disability.

Conclusion

Long-term disability benefits are essential for those unable to work due to illness or injury. Despite the challenges of denials and discontinuations, understanding the process and knowing how to gather evidence, work with lawyers, and prepare for IMEs can significantly improve your chances of reinstating benefits. If you’re facing difficulties with your LTD claims, seeking professional legal advice is a crucial step. Remember, your health and financial stability are worth fighting for.

For more detailed guidance and support, consider reaching out to our expert team of LTD lawyers at Davidson Cahill Morrison LLP.

Ready to take action? Contact us today and start the process of getting your benefits reinstated. Your road to financial security begins here.

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