Long-Term Disability Lawyer in Birmingham, AL
Major injuries and serious medical conditions may prevent you from going to work. That doesn’t prevent your bills from showing up in the mail. That’s why people have long-term disability insurance. When you can’t work for a year or more, this safety net will help cover a percentage of your usual earnings until you’ve made a recovery.
At least that’s how things are supposed to go. Even if you have a legitimate injury or health problem, insurance companies may deny your long-term disability claim, leaving you without any means to pay those bills. You may be wondering what to do and what your best options are while you’re trying to get better. You need a lawyer who will advocate for you and fight for your benefits.
Attorney Tom Sinclair and his team can help if you or a member of your family was wrongfully denied their disability pay. To request a free claim review with an experienced long-term disability insurance lawyer, contact our Birmingham, AL law office today. You can also reach Sinclair Law Firm by calling (877) 249-0091.
Understanding Long-Term Disability Insurance
Long-term disability insurance is an income protection safety net that covers a portion of your wages if you are unable to work for an extended period of time. This disability may be the result of a serious physical injury, an illness, a neurological disorder, or a mental health condition.
While short-term disability tends to cover periods of disability that last three to six months, long-term disability covers periods of disability that last for a year, two years, or much longer.
How Much Beneficiaries Receive While on Long-Term Disability
This varies based on the individual policy, but people on long-term disability can usually receive between 50% and 70% of their pre-disability income. Payments may be lower if there are policy caps or if you are receiving other income or benefits.
The Duration of Long-Term Disability Benefits
How much time you will receive disability payments depends on your policy and the length of your condition.
If you have a fixed-term policy, you might receive disability payments for a few years or until you’ve recovered, whichever comes first. Many group policies and individual policies can provide benefits until people reach age 65 (the age of retirement) or they recover, whichever comes first.
Pre-Existing Conditions and Long-Term Disability
A pre-existing condition is defined as any medical issue you have experienced before the start date of your disability insurance coverage. If you have a pre-existing health condition that leads to a disability, your claim may be denied, or you may face certain limitations on your coverage.
For many insurance policies, you can be denied your long-term disability benefits if you become disabled within the first year to two years of coverage. Your claim can also be denied if you underwent professional care for the condition before your coverage began.
The Look-Back Period for Pre-Existing Conditions
When you file a long-term disability claim, your insurer will review your medical history during a set period of time before your coverage started. This is known as a “look-back period.” The look-back period can vary. Sometimes the look-back period is just three months, though it can be six months or even longer.
Insurers will look through your records to find out if you consulted a doctor about this condition, underwent treatment for this condition, or were prescribed any medication for this condition. Any of these actions during the look-back period can be used as justification to deny long-term disability benefits for your pre-existing condition.
Long-Term Disability Governed by ERISA: Why This Matters
If you have long-term disability coverage through your employer, your policy is governed by the Employee Retirement Income Security Act of 1974, or “ERISA.” This law was originally designed to protect employee benefits, but it’s since been used by insurance companies to protect them from having to pay valid claims.
Most people don’t know about ERISA until their employer-provided benefits are denied. If your long-term disability is governed by ERISA and your benefits are denied, you’ll face an uphill battle appealing the decision.
Why Choose Sinclair Law Firm for Long-Term Disability Disputes in Alabama
Tom Sinclair started his legal career representing automakers and insurance companies. He realized his true calling was helping Alabamians who were let down or mistreated by the system. This passion to assist others fuels all of the work we do at our Birmingham law office.
We Can Handle ERISA and Non-ERISA Claims
Sinclair Law Firm can help people with individual disability insurance and employer-provided disability coverage that is governed by ERISA. The latter poses some unique challenges when appealing denied claims and seeking those denied benefits in federal court.
We Have Access to Our Own Team of Experts
Insurance companies have their own experts who justify the denial of your long-term disability benefits. Sinclair Law Firm has a team of experts who are ready to dispute the insurance company. We’ll get you in touch with doctors who can conduct independent medical exams and functional capacity evaluations.
We Offer Free Legal Consultations
If you’re hurt or sick and unable to earn an income, the last thing you need is another bill. That’s why case reviews are free at our law office. Come in and speak with a knowledgeable long-term disability insurance lawyer about what’s happened to you.
We’ll Work with You and Your Financial Situation
We understand the struggles associated with catastrophic injuries and debilitating illnesses. Whenever we work with clients, we consider their financial realities. The team at Sinclair Law Firm can discuss what payment options make sense based on your means and your financial needs.
Request a Free Claim Review from a Birmingham Long-Term Disability Attorney
You don’t have to feel discarded by the system. At Sinclair Law Firm, we’re all about supporting people regardless of their class or their politics. Insurance companies know who we are, and that we’re not afraid to fight. To discuss your case with an experienced long-term disability attorney in Birmingham, AL, contact our law office today.
The Three Parts to a Long-Term Disability Claim
There are three parts to any disability claim, and they are of great importance to long-term disability benefits.
- Diagnosis: You need a medical diagnosis with supporting documentation that your health condition prevents you from working at your job for an extended period. For many long-term disability policies, that period is at least 12 months.
- Restrictions and Limitations: Limitations in long-term disability insurance mean that certain conditions or situations are excluded from coverage. For instance, you may not be paid benefits for injuries or conditions that are self-inflicted, the result of criminal activity, or related to substance abuse.
- Vocational and Policy Analysis: Vocational analysis refers to insurers evaluating how your diagnosed condition affects your ability to work. Policy analysis refers to insurers reviewing the terms of your coverage to determine if your condition meets the policy’s definition of a disability.
Insurance companies may claim that your condition does not restrict you from working, or that you technically do not have a disability based on the language in your policy. If your claim is denied, Sinclair Law Firm can help you get the benefits you deserve.
Legal Help for ERISA Long-Term Disability Claims
When appealing ERISA claims, you have a strict set of deadlines to meet and are required to exhaust internal administrative appeals. If your appeals are unsuccessful, you can’t file a bad faith insurance claim and have the case decided by a jury of your peers. ERISA preempts Alabama state law, with cases heard before a federal judge without a jury. In addition, new evidence may not be admissible if your case goes to a federal judge, and there is a difficult standard of review that gives insurance companies the benefit of the doubt.
On top of all this, you are only entitled to back pay for denied disability benefits if the federal judge rules in your favor. ERISA makes it so you cannot also seek compensation for loss of income, pain and suffering, or punitive damages.
As soon as you receive a denial letter and see “ERISA,” you need to speak with a long-term disability lawyer. Our Birmingham law office has worked on many ERISA disability claims, and we are ready to take on insurance companies.
Long-Term Disability vs. Social Security Disability Insurance (SSDI)
Long-term disability insurance and Social Security Disability Insurance (SSDI) are both meant to help people who are disabled and unable to work. These are two separate programs, however, and they should not be conflated even though you are able to collect both.
How SSDI Can Affect Long-Term Disability Payments
If you are receiving both long-term disability benefits and SSDI, your insurance company will lower your usual monthly disability payments by the amount you receive from the government. This is known as an offset. Your insurance company will be looking for other offsets to reduce its obligation to you, including any state disability benefits and workers’ compensation benefits.
It can take a while to finally be approved for SSDI, and the government will usually issue a lump sum payment for the previous months of disability that you are owed. If your long-term disability coverage is governed by ERISA, the insurance company may try to collect that SSDI lump sum from you to account for the amount that would have been offset in previous months. This is known as arrearage, and you don’t have the accept it.
We Can Fight Insurance Companies That Try to Take Your SSDI
If your insurer is trying to claim your SSDI back pay, you may be able to dispute them and retain your lump sum payment. To do so, it’s important that you contact our law office in Birmingham. Attorney Tom Sinclair and review your long-term disability and SSDI issue and help you understand what steps you can take next.
The fact is, there are not many SSDI lawyers who also handle ERISA cases, and there are not many ERISA attorneys who also handle SSDI cases. At Sinclair Law Firm, we know qualified SSDI attorneys here in Alabama, and we can consult and collaborate with them to support you.
Contact an Experienced Long-Term Disability Lawyer in Birmingham, AL
When you’re sick, hurt, and unable to work, you can count on Sinclair Law Firm to help secure your disability benefits. Our team is eager to take on insurance companies and fight for Alabamians just like you. To set up a free consultation with a long-term disability lawyer who cares, contact our Birmingham, AL law office today. You can also reach us by phone at (877) 249-0091.
Long-Term Disability FAQs
Disputes over long-term disability can be complicated and contentious. That’s why we’ve compiled a list of some common questions we’ve received from people in Alabama about their disability benefits. If you have additional questions about long-term disability, our Birmingham law office can get you the answers you’re looking for.
Can I Work While Receiving Long-Term Disability Benefits?
Potentially, yes, but it must be in a limited capacity, meaning only part-time and in a less-demanding field. Keep in mind that your insurer will offset your long-term disability benefits based on earnings from your other line of work.
Is There a Waiting Period Before Receiving Long-Term Disability?
Yes. This is also known as an elimination period. You must be continuously disabled and unable to work for a certain amount of time before you can receive long-term disability payments from the insurer. This elimination period can be as short as 30 days from the date of diagnosis or as long as a year. Be sure to check your policy for details on your elimination period.
What Happens to My Long-Term Disability Coverage If I Leave My Job?
For employer-provided disability coverage, your policy ends when your employment ends. In some cases, you may be given the option to convert your group policy to an individual policy, though this must be done within a specified timeframe after you’ve left your job. The terms of this individual policy may not be the same as your group policy with your former employer.
What Are LWOP Claims?
“LWOP” stands for Life Waiver of Premium. This is a provision that may be included in a life insurance policy that allows the beneficiary to stop paying premiums but continue receiving benefits if they become disabled. We can determine if this applies to your situation and help you understand this separate claims process.