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Disability insurance may sound easy enough -- you're too sick or injured to work, you file some paperwork, and you get your benefits. But, as anyone who's been through the disability claims process can tell you, it's not always that simple.
Or maybe you're stuck in the middle of the process right now -- drowning in disability paperwork, trying to decipher your policy, or you've had your benefits claim denied and don't know where to turn. This is when you'll need an experienced attorney on your side. Here's how a disability lawyer can help:
Breaking Down the Basics
As you'll see in this article, what sounds like a fairly simple process can be extremely complex. Disability benefits are there to give us money if we're too sick or injured to work. But trying to figure out the disability system, from determining eligibility to appealing a denial, can be difficult.
A good disability attorney should have extensive experience in the field, and will be able to walk you through the process, answering all of your disability questions from injury to monthly benefits, so you don't have to learn the entire system on the fly.
There's not just one system that governs all disability insurance. The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that governs disability insurance plans provided by private employers. While ERISA is focused mainly on retirement plans, there are important provisions that cover disability claims.
Along with being a complex federal statute, ERISA is constantly being updated, including adding amendments for the Consolidated Omnibus Budget Reconciliation Act (COBRA) which can continue health coverage for some workers and their families after the loss of a job, and the Health Insurance Portability and Accountability Act (HIPAA) which can extend coverage for preexisting medical conditions.
A disability attorney can explain how this law could affect your disability claim, including certain key deadlines for filing claims and appeals under ERISA -- missing a deadline or failing to comply with ERISA's filing or procedural requirements can mean you may have no way to receive your disability benefits.
If you're not covered by a private disability insurance plan and ERISA, you may be covered by Social Security Disability Insurance (SSDI). SSDI is a disability insurance system funded by paycheck deductions and is available to those who have been paying into the system. It is important to note that SSDI functions differently than private disability insurance, and it is essential to know which insurance applies to your case.
Determining whether you are eligible for SSDI benefits and how to apply for those benefits can be complicated. A disability attorney with SSDI experience can explain how the system works, assist you with the initial filing process and aid you with any appeals.
Proofreading Your Policy
It's guaranteed that your disability insurance policy was written by an attorney. So it may help to have an attorney help decipher it. While your policy may look like dozens or hundreds of pages of meaningless legal mumbo jumbo, all those unfamiliar phrases and clauses are really important when it comes to your disability claim. You'll need to know:
Unfortunately, most disability insurance policies weren't written with the layperson in mind and you'll probably need legal help interpreting all the legalese in your policy.
Negotiating With Your Nemesis
While your disability insurance carrier isn't necessarily your enemy, it can sure seem that way if there's a disagreement regarding coverage or benefits. Remember all those times you've argued with customer service reps on the phone? Imagine that, only with an infinitely more complicated claims process and with your health and family finances on the line.
Because disability lawyers know the intricacies of the disability insurance and have experience filing claims and appeals, they can be your best advocate when dealing with the insurance carrier. Not only can a disability attorney take the hassle of negotiation off your hands, but he or she can often get you a better deal when it comes to your benefits.
Dealing With Denials
Not all disability claims are accepted, and there can be many reasons why a disability claim is denied. Was your paperwork all there? Did you file it all on time? Were you truthful on all of the forms? Did you complete all of your medical treatment or rehabilitation? Or did the insurance company's doctor just disagree that you were sufficiently ill or injured?
No matter what the reason for the denial, a disability lawyer can help with what comes next. It may be possible to appeal a disability claim denial, and you'll want a good attorney on your side if you don't want your claim denied again.
There's a lot an experienced disability attorney can do for you -- you may want to consult with one near you.