Did you know that approximately one in four, or 2.7 million, adults in Pennsylvania have a disability? If you are suffering from a disability, you’re certainly not alone. Still, insurance providers can make you feel alone when they don’t take your disability seriously. After all, their entire business model relies on them denying as many claims as they believe they can get away with, whether your disability was caused by a personal injury or illness.
As a disability claimant in Pennsylvania, you should know your rights and common mistakes to avoid. Whether you are making your first claim or trying to appeal a denied claim, a long-term disability lawyer from the law offices of Frankel & Newfield, PC can help with your disability law needs. Contact us today for a free consultation.
One of the most important factors to remember is that Pennsylvania does not require employers to offer short-term disability insurance. Long-term disability insurance is a different story. Depending on the kind of policy you have, your benefits could last as long as your disability lasts or until you reach the age of 65. In most cases, mental disability insurance only provides twenty four months of benefits.
Depending upon your policy, after the initial period of coverage in which you cannot do your job (“own occupation”) due to your disability, your policy may only continue to pay if your disability prevents you from doing any job (“any occupation”) you are capable of doing. If your insurance carrier denies your disability claim, you can file an appeal. Depending upon the type of policy you have, if that does not work, you can proceed with a private lawsuit. If it is a policy governed by ERISA, there are other requirements which must be met prior to filing a lawsuit. An experienced Pennsylvania disability attorney can help you at any stage in the process.
Disability insurance claim denials happen for various reasons in Pennsylvania, but the following are among the most common.
There is always a chance that your long-term disability insurance does not cover your specific disability. Make sure to review the details of your disability insurance benefits policy to discover whether or not your disability is covered.
The filing process for disability benefits can be complicated, and form and documentation errors are more common than you might think. If you have errors in your documentation or parts are still incomplete, many insurance providers will disregard them by default. Even filing at the wrong office location can be a problem. Work with an experienced disability claims attorney to help complete all documentation accurately and on time.
To demonstrate your disability, you must provide medical evidence supporting your claim. Unfortunately, a note from your doctor is not good enough. Proper evidence includes collecting your medical records, history, and proof that your disability prevents you from doing your job. Objective evidence must also be included, such as blood tests, MRIs, or whatever diagnostic tests your specific disability requires.
Insurers do not accept late applications, so if you miss important deadlines, your claim will not get approved. In most cases, you must submit a claim notice within 20 to 30 days of your disability’s onset date. Then, the insurer will send you the relevant forms. After you receive them, you generally have 90 days after the elimination period to submit the documents. The elimination period is the time between the onset of your disability and the first date you can get benefits.
Similar to employers, insurers will often examine your social media posts to find evidence to discredit your claim. Make sure that none of your posts on social media platforms contradict your claims of disability.
While it will not get the job done on its own, a written opinion from your doctor is an essential part of the claims process, as it gives credence to your disability. If you ignore your doctor’s advice for your medical condition, the insurer may use that to deny your claim by blaming you for your continued disability.
If your claim was denied, we’re happy to offer free consultations to determine your options for proceeding with your Pennsylvania long-term disability appeal.
If your claim is denied, there are a few steps you can take to help move your claim in the right direction.
The first step when your insurance claim is denied is to contact a disability insurance attorney who is familiar with Pennsylvania disability insurance claims. Our firm handles claims nationwide and we litigate in federal courts in Pennsylvania. The insurance company has a team of lawyers, so having an experienced Pennsylvania long-term disability attorney on your side will help you make your case as strong as possible. We offer free consultations to help evaluate your case and your options.
Reviewing your insurance policy is a great way to understand your plan’s precise coverage. Note the reason for your denial and compare it to what your policy covers. If there is a contradiction, it will be easier to appeal your denial. If your policy comes from an employer, the Employee Retirement Income Security Act of 1974, or ERISA, requires them to disclose your policy details.
To empower your appeal as much as possible, you must collect evidence of your impairment. This includes records from your doctor that demonstrate your disability and specific lab results like blood tests, X-rays, etc. A skilled long-term disability claims attorney in Pennsylvania can communicate with your doctor to inform them of all the necessary documentation for supporting your case.
The appeal primarily consists of the evidence gathered, but it also needs to persuasively argue why you need benefits due to the hardship your disability has caused. The appeals process is far more likely to succeed with an experienced long-term disability insurance attorney at your side.
When you hire a long-term disability lawyer serving Pennsylvania, you will receive an array of benefits that can help make your case stronger. An attorney can help you review your disability contract and the reason you were denied to help spot any contradictions. They can even communicate with the insurance company on your behalf and assemble the relevant medical evidence to support your case.
Doctors are a significant resource for evidence, but they do not always know how to word their report in a way that provides the needed evidence to support your disability case. A lawyer can communicate with your doctor to help them write a report outlining your disability needs while accurately representing your medical condition.
The disability attorneys at Frankel & Newfield, PC have been serving clients throughout Pennsylvania in Philadelphia, Harrisburg, Lancaster, Pittsburgh, York, Allentown, Delaware County, and beyond for 20 years. Our clients have provided us with plenty of testimonials for support. When you work with our law firm, you can expect to work directly with our experienced partners. Contact our team today at 877-583-2524 or fill out the form on our site for a free consultation.
Justin Frankel and Jason Newfield are able to represent disability insurance claimants in any state, including Pennsylvania.
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