Portland Long Term Disability Insurance Attorneys
Long-term disabilities can be physically and financially devastating for disabled persons and their families. Having your long-term disability insurance claim denied only adds to the stress.
The Portland long term disability lawyers at Rizk Law understand how difficult this situation can be and may be able to help you recover benefits, including filing an appeal for a denied claim. If you bought long-term disability insurance and are struggling to obtain benefits, we offer a free, no-obligation legal consultation to answer your questions and determine how we may be able to help you. We have recovered millions in compensation for Oregon residents.
Firm founder Richard Rizk is a former insurance defense and coverage lawyer, so he knows how insurance companies operate and has detailed knowledge of the laws that apply to long-term disability claims. He is fully licensed in federal and state court, which is where claims not governed by the Employee Retirement Income Security Act (ERISA).
No upfront fees or obligations. Phone: 503.245.5677
Do I Qualify for Long-Term Disability Benefits?
Our attorneys need to review the terms and conditions of your long-term disability (LTD) policy to determine if you may qualify for coverage. The consultation is free and comes with no obligation to take legal action, so there is no risk to you.
Generally, you must have a medical condition that makes you substantially unable to perform your job. There are many common medical conditions that may qualify for long-term disability benefits, including, but not limited to:
- Severe back problems
- Heart disease
- Lyme disease
- Traumatic brain injury
- Spinal cord injury
Many LTD policies have elimination periods between the time you become disabled and when you begin receiving benefits, typically between three and six months.
On-the-job injuries are excluded from coverage because they are generally covered by workers’ compensation.
Preexisting Condition Exclusions
LTD policies often have preexisting condition exclusions: medical conditions that were diagnosed or treated within a specified period of time before LTD coverage began. Often, the exclusion period is between 90 and 180 days. Usually, people cannot receive benefits for any preexisting condition for the first year they have LTD coverage.
There are also exclusions for specific medical conditions, meaning you will not be able to obtain compensation if you have one of these conditions.
However, the language of these exclusions may be unclear or have some room for interpretation. Insurers will try to use that to their advantage, which why having an experienced lawyer at your side may be very important. You should not take the insurance company’s word for it that you are not covered.
Rizk Law: 503.245.5677. We are here to help.
What Benefits Does LTD Insurance Provide?
These policies usually provide total or partial income replacement and benefits to help people return to work. They may also provide rehabilitation or return-to-work incentives, which are benefits to help you return to work.
Public employees in Oregon who are insured by the state receive income compensation based on monthly earnings on their last full day of work before becoming disabled. For private plans, the benefits provided depend on the terms of the policy, but they usually begin once your short-term disability benefits expire.
When purchasing a policy, make sure to clarify what it covers and other aspects of the plan. You can contact the insurer with questions after you have already purchased the policy.
Rizk Law’s Portland long term disability insurance attorneys are prepared to review the terms of your policy to find out the benefits that may be available.
Is Your LTD Insurance Claim Regulated by Federal Law?
For the most part, LTD plans provided by an employer are governed by a federal law: the Employee Retirement and Income Security Act (ERISA). Plans not provided by an employer are generally exempt from this law, as are plans provided by some public or church employers.
This law has a variety of regulations governing how LTD claims must be processed, the timeline for processing these claims and a claimant’s rights if a claim is denied.
If you are unsure if you claim may be regulated by ERISA, contact Rizk Law to discuss your situation. We have detailed knowledge of long-term disability claims and the laws that may apply.
Advantages of Non-ERISA Claims
While there are some advantages to having a long-term disability policy governed by ERISA, there are many advantages to policies that are not governed by this law. For example, punitive damages and damages beyond what is spelled out in the policy may be available in a non-ERISA claim.
Also, when plan administrators are not given discretionary authority to determine when someone is eligible for benefits, courts have narrow authority to review a claim that is governed by ERISA. Courts must defer to administrative findings if the conclusion of the plan administrator has a reasonable basis.
What Happens if My Claim is Denied?
Many long-term disability claims are initially denied, regardless of merit. That is why you should not let a denial discourage you from continuing to pursue benefits.
Unless you have already done so, obtain a copy of the LTD policy plan documents from the insurance company. You may need to request these documents in writing, and you should do so via certified mail with a return receipt requested. This helps to document your efforts to obtain benefits.
You should also review the denial letter you received in the mail. It should explain why your claim was rejected and other information that you may want to provide to attempt to overturn the denial. The denial letter should also tell you how to appeal the decision, including the deadline for filing an appeal.
You should strongly consider hiring an attorney, as insurance companies often take claims much more seriously when an attorney is involved. As there is limited time to file an appeal, it is important to contact a lawyer right away.
Make sure to continue your medical treatment and not miss appointments. Give your doctor plenty of details about your symptoms and how they affect you. This could make the difference between overturning the denial and not.
Call a Portland Long Term Disability Lawyer for a Free Consultation
Unsure if you have a valid claim or if you may be able to overturn a denied claim?
You should seriously consider meeting with an experienced attorney to discuss possible legal options. The Portland long term disability lawyers at Rizk Law offer a free, no-obligation legal consultation to answer your questions and determine if you may be eligible for benefits.
If you purchased a long-term disability policy, you should not rely on the insurance company to look out for your best interests. Insurers are businesses interested in making a profit. At Rizk Law, we are focused on our clients’ best interests. We understand how difficult a long-term disability can be, physically, financially and psychologically.
Our phone lines are open 24/7 to take your call. No risk to you. Call 503.245.5677.