Disability Lawyer in Huntsville, AL

Short-term disability (STD) and long-term disability (LTD) benefits support workers following an injury, illness, or other diagnosis that prevents them from doing their job. This partial wage replacement can make all the difference for households and individuals to live with dignity. When disability benefits are denied or you’re asked to pay back benefits you received, you need a lawyer to stand up for what’s right.

Attorney Tom Sinclair has fought for hard-working people throughout the state of Alabama. When your disability benefits are denied, we want to hear from you. Our law firm can help you fight back, file an appeal, and get the disability benefits you’ve earned.

If you’ve been denied your short-term or long-term disability benefits, the team at Sinclair Law Firm is ready for the fight. To request a free claim review with a qualified disability insurance lawyer in Huntsville, AL, contact our law office today.

How Disability Insurance Is Supposed to Work

Here’s how disability insurance should work following a serious injury, illness, or other diagnosis.

Short-Term Disability Coverage (STD): Short-term disability is meant to provide temporary financial relief while you are recovering from an injury or another type of health setback that prevents you from working. Workers typically receive 50% to 100% of their weekly pay.
Long-Term Disability Coverage (LTD): Long-term disability is intended to provide financial relief when an injury or medical condition prevents you from working for a year or longer. Workers typically receive 50% to 70% of their monthly pay.

Unfortunately, your disability coverage may be denied or you may not receive the full amount you expect through your insurance provider.

Common Reasons Disability Insurance Claims Are Denied in Alabama

Below are just a few reasons why STD and LTD claims get denied:

Lack of Medical Evidence: Insurance companies may claim that there is not enough supporting evidence to show your injuries affect your ability to work.
Incomplete or Insufficient Information: There may be missing information or incorrect information submitted as part of your claim.
Failure to Meet the Definition of “Disability”: Insurance policies have strict definitions of what a disability is, and insurers may deny that you have a disability based on their definition.
Failure to Follow Recommended Treatment: If a claimant does not follow a recommended treatment plan, this could be used to deny benefits or stop payments.
Condition Is Not Covered by the Policy: Insurers may claim that a certain injury or medical condition is not covered based on the language in the policy.
Pre-Existing Health Conditions: A pre-existing health condition could be used to justify a denial of claim.
Insufficient Work History: If you do not meet the minimum work history requirements in your policy, you may not qualify for disability benefits.
Accusations of Fraud or Misrepresentation: Insurance companies may claim you lied or falsified documents regarding your disability.

As soon as you receive that disability denial letter, it’s best to contact our Huntsville law office ASAP. Attorney Tom Sinclair can review your long-term or short-term disability claim and help you file an appeal.

Group Disability Insurance Policies vs. Individual Disability Coverage

Many people have a group disability insurance policy provided through their employer rather than individual disability coverage paid for outside of work.

If you have group disability coverage, a denied claim becomes more challenging. This is because employer-provided benefits are governed by the Employee Retirement Income Security Act (aka ERISA).

The Challenges of Employer-Provided Disability Insurance and ERISA

ERISA disability claims create new hurdles in the appeal process. You cannot file a bad faith claim when plans are governed by ERISA.

Strict Deadlines: You may have a very short appeal window, usually 30 to 180 days to appeal the denial of your STD or LTD benefits.

The Administrative Appeals Process: You must go through an internal appeals process with the insurance company that denied your disability claim.
No Juries in an ERISA Trial: If your appeal fails and you want to escalate the matter, your case is heard by a federal judge. There is no jury, and no additional evidence may be presented to the judge.
Difficult Legal Standards to Meet: Even if you have a strong case, a judge may uphold the denial of benefits if your appeal doesn’t meet the difficult legal standard for these kinds of cases.

For more information, we recommend that you read our resource on why you need an ERISA lawyer. Huntsville disability claim attorney Tom Sinclair is ready to help you with the ERISA appeal process.

How Sinclair Law Firm Fights Unfair Disability Insurance Denials

When you hire the Sinclair Law Firm, we will begin building a strong and compelling appeal based on your medical evidence and your job duties. Whether your policy is ERISA or non-ERISA, we can offer clear-headed guidance and answers about the process in a language you can understand.

If a disability appeal is not successful, we still have your back. Our law firm can review the potential for a bad faith claim or an ERISA trial. We will help you make the best possible decision based on your circumstances and the available evidence.

Why Huntsville Trusts Tom Sinclair with Disability Claims and Appeals

The Sinclair Law Firm has built a strong reputation for legal excellence throughout Alabama. Here’s why people in and around Madison County choose Tom and his team for their short-term and long-term disability claims:

We Know How Insurance Companies Work: Tom began his legal career representing automakers and insurance companies. He had a change of heart when he saw how the system mistreated working people. Tom now advocates for regular Alabamians like you who simply want to be treated fairly and with respect.
Insurance Companies Know Us By Name: We know that when insurance companies see Tom’s name, they flag those files. We must be doing something right. They know that the Sinclair Law Firm fights hard to even the odds for working people in Huntsville and throughout Alabama.
We Work with Our Own Experts: Insurance companies have a team of experts that will dispute and deny your disability claim. Sinclair Law Firm works with its own team of experts who can provide supporting evidence and build a strong legal foundation for your appeal.
Free, No-Obligation Claim Reviews: Whenever the system lets people down, our law firm picks them up. We offer free and completely confidential consultations so you can understand your situation and make an informed decision about your options.
We Work with You to Find a Fair Payment Plan: A serious injury or health problem can jeopardize your income. During your consultation, we can review your financial situation and figure out a fair and reasonable method to pay for our services. We just want to help you in whatever way we can.

Contact a Huntsville Disability Insurance Attorney Near You

If you’ve been denied short-term or long-term disability benefits, the Sinclair Law Firm is here to work for you. We’ve dedicated ourselves to leveling the playing field for people throughout the state, no matter their background or politics. For a free claim review with an experienced and proven disability claim lawyer in Huntsville, contact our Alabama law firm today.

Disability Insurance FAQs

Below are just a few common questions we’ve received from past clients. We can’t possibly answer all of your questions about disability benefits on this page. If you have a question about STD or LTD coverage that was not answered here, contact our Huntsville law office to get the information you’re looking for.

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

It depends on your disability coverage and whether your policy is governed by ERISA.

For ERISA disability claims, you usually have 30 to 180 days to file for an administrative appeal starting on the date you receive the denial letter.
For non-ERISA claims, you may have anywhere from 30 to 90 days to file an appeal. The deadline will be noted in both the denial letter and/or your individual insurance policy.

As soon as your claim gets denied, contact an Alabama disability insurance attorney about what happened. Your lawyer can let you know the best steps to take next.

What Documents Do I Need to Support My Appeal for Denied Disability Benefits?

If your disability benefits get denied, our law firm recommends gathering the following documents to help with your appeal:

A copy of your disability insurance policy and plan documents
The denial letter
The insurer’s complete claim file
Your medical records and any treatment notes from your doctor(s)
A description of your job and regular work duties

There may be other documents required to build the strongest appeal possible. In fact, you may need to see another doctor for new documentation and testing or get a detailed description of what you do for work and how your condition has impacted your ability to work from your supervisor.

Your Alabama disability denial attorney can review your claim and help you obtain the key documents and evidence needed to improve your chances for a successful appeal.

How Do Medical Records and a Functional Capacity Evaluation (FCE) Impact My Disability Appeal?

A functional capacity evaluation (FCE) and clearly worded medical records are among the most important documents to include in your disability claim appeal. Your FCE is especially important as it evaluates and assesses your physical abilities and limitations related to work.

Your Alabama disability claim attorney can help you obtain strong evidence that establishes the severity of your condition and how it impacts your ability to work and earn a living.

What Are Own-Occupation and Any-Occupation Standards for Disability?

Insurers have own-occupation and any-occupation standards when determining whether you are eligible for disability benefits.

Own Occupation: This means that you are unable to perform the duties of your own job, even if your disability allows you to work a different job.
Any Occupation: This means that you are unable to perform the duties of any occupation based on your experience and training.

Own-occupation standards tend to be more favorable for those who are insured. Policies and standards differ, so it’s important for an Alabama disability attorney to note these standards when assessing a client’s health condition and the justification for a claim denial.