Disability Insurance Lawyer in Birmingham, AL

Unplanned life events can take many forms. This includes a disabling event from an unforeseen medical condition, physical or mental disability, or injuries from a motor vehicle accident or a defective product. We normally plan for the unthinkable by purchasing disability insurance to serve as a safety net in our family’s time of need.

Your bills do not stop when you get injured, but your disability benefits may be denied when you need them most. There are different ways to appeal a denied disability insurance claim, and a lot of that depends on whether your insurance is provided by your employer or not. Attorney Tom Sinclair can help Alabamians seek disability benefits in either situation.

If you’ve been denied short-term or long-term disability benefits, Tom and his team are ready to level the playing field and advocate for you. To request a free claim review with a trusted disability insurance lawyer, contact our Birmingham, AL law office today. You can also reach Sinclair Law Firm by calling (877) 249-0091.

Understanding Disability Insurance

Disability insurance is designed to provide a vital safety net for you and your family. It replaces the lost income resulting from being out of work following a serious injury, illness, or medical condition that adversely affects your physical health, psychological well-being, or cognitive function.

According to the Pew Research Center, approximately half of Alabamians obtain their insurance through their employer’s benefit plans. Many disabled individuals also purchase individual insurance products, like an Individual Disability Income insurance policy. Combined, your work and personal insurance policies constitute your family’s safety net.

Employer-Provided Disability Insurance vs. Private Policies: Why This Matters

You were smart enough to plan for the unexpected with disability insurance. Ideally, it should not matter that you paid premiums for the policy from your own account or through payroll deduction at your job. Disability insurance should be there for you when you need it. Sadly, as we will explain, the type of disability insurance you have matters, and we don’t mean short-term or long-term disability coverage.

Employer-provided benefits and disability insurance purchased outside of the workplace are subject to different laws. If your claim is denied, there is a different process for appealing the denial of disability benefits.

Disability Insurance Purchased Outside of the Workplace

If you purchased your disability insurance outside the workplace and paid the premiums directly from your own account, your claim will likely be governed by state law, which can provide a great benefit to you.

When we talk about state law claims for denied disability benefits, we typically use the phrase “Bad Faith Claims.” This is how lawyers and courts reference the various state laws governing the wrongful denial of someone’s disability benefits.

State law claims for disability benefits typically require an experienced attorney to get you what you should have been paid. If an appeal fails, you can present a case in court before a jury of your peers to obtain the disability benefits you were wrongfully denied.

Employer-Provided Disability Insurance and ERISA

If you paid premiums on your disability policy through payroll deduction or purchased your disability insurance through your employer’s group disability policy, your claim may be governed by a little-known federal law: The Employee Retirement Income Security Act of 1974, or “ERISA.”

ERISA was originally designed to protect employee benefits. Over the course of five decades, ERISA has become the law that protects insurance companies from having to pay a valid disability claim. ERISA also makes the appeal process harder for employees who were wrongfully denied their disability benefits.

If ERISA applies to your claim, it is not a good thing. There is a different appeals process involved. If your case goes to court, you will not have a traditional bad faith claim. Instead, your ERISA claim will be heard by a federal judge rather than a jury of your peers.

Why Choose Sinclair Law Firm for Disability Claims in Alabama

Taking on insurance companies can be frustrating, time-consuming, and confusing. Instead of going it alone, Sinclair Law Firm is ready to provide the support and guidance you need to appeal a denied disability claim. We are also prepared to represent you in state or federal court in your disability benefits case.

We Can Handle ERISA and Non-ERISA Claims

Disability insurance claims can be complicated, particularly in ERISA cases. We are familiar with both ERISA and non-ERISA claims. Our team can appeal your denied benefits and provide a detailed overview of what to expect as your disability case moves forward.

We Have Decades of Legal Experience

Attorney Tom Sinclair began his legal career representing automakers and insurance companies. After a change of heart, he started representing clients whose claims were denied. He’s built his legal practice on a core philosophy of fairness, and he strives to be a guardian for Alabamians who’ve been let down by the system.

We Offer Free Legal Consultations

We believe that the law should apply equally and uniformly to everyone, regardless of class or politics. That’s why we offer free consultations and claim reviews. We want to make sure the people of Alabama have access to sound legal counsel when it comes to their disability benefits.

We’ll Work with You and Your Financial Situation

We know that times can be tough if you were counting on disability payments. We can discuss your financial situation during the consultation process. Our team will work out a payment arrangement that makes the most sense based on your current circumstances.

Request a Free Claim Review from a Birmingham Disability Insurance Attorney

We know that some insurance companies flag Tom Sinclair’s name when it shows up in a file. They know our reputation when we represent clients, and that pleases us to no end. If you feel overwhelmed or uncertain about what to do, we can help even the odds. To get a free claim review with a trusted disability insurance attorney in Birmingham, AL, contact our law office today.

Different Sources of Disability Insurance Coverage

Disability insurance forms the backbone of your financial safety net. You have many different potential sources of disability insurance coverage. Below are three examples of disability benefits. We can discuss your coverage and policy details during your consultation at our law office.

Group Insurance

Because many ERISA benefits are provided by the employer at no cost to the employee (no payroll deduction is required), many people are unaware of the ERISA-governed benefits they have at work. Of those who are aware of the benefit, very few can identify how much coverage they have.

One of the most basic group insurance coverages we see is group disability insurance, which pays a percentage of your pre-disability monthly earnings should you become disabled from an accident or injury.

Individual Disability Insurance (IDI)

IDI is a tailored policy typically issued to high-wage earners and sold on an individual basis. These policies are very expensive to maintain, with yearly premium costs in the thousands of dollars. However, while expensive, they provide much more favorable terms to persons claiming disability under the policy terms.

From specialized definitions of disability fitted to your occupation to longer durations of benefits (sometimes lifetime benefits), IDI policies are a key component of your safety net. 

Social Security Disability Insurance (SSDI)

Social Security disability insurance provides a set amount of monthly benefits based on your earnings history.

While we do not handle Social Security disability insurance claims, our Birmingham law office does work with SSDI lawyers in Alabama who specialize in this field. We can coordinate your efforts to obtain the benefits you were denied.

How Long Do I Have to Appeal a Denied Disability Benefits Claim?

This depends on whether or not your policy is governed by ERISA. There are different deadlines for ERISA and non-ERISA disability claims:

• For ERISA claims, you typically have 180 days from the date you receive the denial letter to file for an administrative appeal.
• For non-ERISA claims, you may have anywhere from 30 to 90 days to appeal, depending on what’s stated in the denial letter and/or your individual insurance policy.

Once you receive that denial letter, you need to take that countdown seriously. A delay in action could mean the loss of your benefits. Regardless of whether it’s an ERISA or non-ERISA policy, it’s in your best interests to contact a Birmingham disability insurance attorney ASAP. The team at Sinclair Law Firm will get the process started and discuss what steps to take next.

Appealing an ERISA Disability Claim That’s Been Denied

For policies governed by ERISA, you need to file for an internal administrative appeal. After exhausting your options for an internal appeal, your case will be heard by a federal judge.

As we noted earlier, you cannot file a bad faith insurance / state law lawsuit with ERISA claims. These federal cases have a much more difficult standard of review that gives insurance companies the benefit of the doubt. If the federal judge rules in your favor, you’ll be able to collect the denied disability benefits, but you will not be able to seek additional damages.

Why You Need an Experienced ERISA Attorney

If your ERISA disability claim is denied, you cannot afford to go it alone. These cases are complicated and require someone familiar with the appeals process and how insurance companies operate.

Birmingham disability insurance lawyer Tom Sinclair has helped numerous Alabamians with their ERISA claims. He can explain the unique challenges these cases pose and fight the insurance company. Our team will pursue the best possible outcome for you and your household.

Bad Faith Claims for Non-ERISA Cases

If your disability benefits have been denied in a non-ERISA policy, you can appeal the claim. If the appeal is not successful, you can then pursue a legal action stating that the insurance company denied your disability benefits in bad faith. Our Birmingham disability insurance attorney can help you seek compensation through a bad faith lawsuit.

Why You Need a Skilled Insurance Bad Faith Attorney

Unlike ERISA claims, bad faith cases allow plaintiffs to seek damages beyond the denied disability benefits. In addition, these cases are decided by a jury of one’s peers rather than a federal judge.

As an experienced disability insurance lawyer, Tom Sinclair will share your story in court to illustrate how your benefits were denied in bad faith. By centering your story and the evidence that backs up your claim, we can improve your odds of receiving benefits as well as additional compensation for the difficulties you’ve been put through.

Contact an Experienced Disability Insurance Lawyer in Birmingham, AL

Don’t go it alone when your disability benefits have been denied. A skilled lawyer can do the paperwork, analyze the fine print, and meet important deadlines. Sinclair Law Firm is here to help mend and strengthen your safety net. For a free claim review with an experienced disability insurance lawyer, contact our Birmingham, AL law office today. You can also reach us by phone at (877) 249-0091.

Disability Benefits FAQs

You likely have more questions about disability insurance and what to do when your benefits are denied. We’ve compiled just a handful of common questions we’ve received from past clients. If you have any additional questions about disability insurance we haven’t answered, reach out to our Birmingham law office. We’d be happy to provide you with additional information.

How Long Can You Claim Disability Benefits?

Disability benefits are paid for the length of the policy “maximum benefit period” so long as you meet the policy definition of disability, and no exclusions apply. How long those benefits are paid also depends on the coverage in question, and most group policies end at either age 65 or your normal Social Security Retirement Age. Some individual Disability Policies can pay benefits even longer.

What Benefits Can a Disabled Person Claim?

The answer depends on the terms of the insurance policy. Typically, it varies from a percentage of your pre-disability earnings to fixed monthly benefit amounts.

What Disability Benefits Can I Claim If I’m Over 65 Years Old?

If you have a disability insurance policy, the amounts payable will be defined in the policy itself. Individual policies typically stop paying benefits at your normal retirement age as set out by the Social Security Administration, which is based on your date of birth.