A successful surgeon has an accident, leaving her with limited hand motion. She is trying to postpone surgeries in the hopes that her hand motion will return – but unfortunately, she can no longer safely wield the surgical tools without putting a patient at risk.
A bond manager at a big Wall Street Firm receives a diagnosis of a degenerative neurological disease. He is determined not to let this stop his million-dollar career. But when performance numbers for the end of year come in, it is clear that the disease cannot be overcome by sheer will.
No one wants to file a long term disability claim. Despite the insurance industry’s portrayal of claimants as malingerers (at best), most people who file claims are hardworking and dedicated and who would like nothing more than regain their health and well-being and continue to work.
Unfortunately, many individuals do not speak with an attorney before filing a claim. This is their first mistake. We think it may be because they don’t understand how complex a long term disability insurance claim is, or that the road to benefits is mined with pitfalls and complications, many of which are deliberate.
The second mistake is thinking that a long term disability insurance claim is the same as any insurance claim – fairly straightforward and easily done. The stakes are too high, both for the claimant and for the disability insurance company.
Consider the difference – an automobile accident costs the insurance company $1400 in repairs. A disability insurance claim can cost $1400 per month, multiplied by twelve months a year – which could be multiplied by anywhere from 20 – 40 years, depending on the age of the claimant. Disability claims are expensive.
A highly successful insurance salesman is sure that he can handle the paperwork for his long term disability ERISA claim. After all, he works for an insurance company and helps clients deal with claims as part of client service. He is denied benefits because his primary treating physician did not include the occupational tasks that he can no longer perform as a result of his illness in his medical record. The insurance company claims he has no claim because there is no indication that he cannot perform the necessary tasks. He starts asking people in his business circles who to hire to represent him, and considers the local real estate attorney who has been referring him business for several years. BIG mistake.
Another common mistake that claimants make is retaining an attorney without experience in this specific area of the law. Just as doctors are specialists because of the complex nature of medicine today, most attorneys focus on a particular practice area. Disability insurance law is complicated. It draws on law concerning contracts, insurance law, and some knowledge of medicine.
Even an attorney who practices Social Security Disability law does not necessarily know the ins and outs of ERISA disability claims or private policy claims. A real estate attorney whose practice includes an occasional insurance claim matter is simply not prepared to do battle with a big disability insurance company.
Frankel & Newfield works with individuals at all stages of the claim process from before actually filing a claim to when the claim has been appealed and denied. If you are considering filing a claim, or if your claim has been denied and you don’t know how to fight back, call our office today at 877-583-2524. You are not in this alone.