Do You Need a Long Term Disability Lawyer?

Long term disability insurance, or LTD insurance, insures an employee’s income against the risk of an injury or illness causing them to not be able to earn a paycheck. Long term disability insurance is meant to replace a portion of the income of a person who works, whether they are a highly skilled professional, a blue-collar worker or a manager. Anyone whose family depends upon their income should have long term disability insurance. Many larger employers provide this insurance as part of an employee benefit package.

Long term disability lawyers Jason Newfield and Justin Frankel have dedicated their legal careers to representing claimants who have been wrongfully denied their disability insurance benefits. Both partners have received the highest recommendations from prestigious legal sources as Martindale, Super Lawyers and Avvo. They each hold the AV-Preeminent 5 out of 5 Peer Rating from Martindale-Hubbell, one of the world’s largest legal publishers. They both have been named to the Super Lawyers list for a number of years and both enjoy top 10.0 rating from Avvo.

Types of Long Term Disability Insurance

There are three primary types of long term disability insurance policies. How your case will be handled depends upon the type and terms of your long term disability policy. We represent claimants with the following types of plans:

Group Long Term Disability Insurance

Most people get their long term disability insurance through their employer, as part of an employee benefit package that often also includes health insurance, life insurance, and retirement benefits. Disability insurance companies or their agents sell disability policies to employers. They are known as “group” policies, as they are part of a group of employees who have the insurance. They are most often governed by a Federal Law (ERISA).

Private or Individual Long Term Disability Insurance

Some individuals purchase their own disability insurance, directly with an insurance company because they are high income earners and the disability insurance provided by their employer would not be enough to maintain their family’s lifestyle if they were unable to work. These policies are known as “private” disability policies or “individual” policies and they are generally more expensive than group policies. Often, the rights afforded to a person with an individual policy are greater than those with a group policy.

Association Long Term Disability Insurance

People who belong to associations, like the American Dental Association or the American Association of Family Physicians, can often purchase disability insurance through their association that is more reasonably priced than private policies, although they can often by more restrictive in the coverage provided. Most large national associations have an affiliation with a large insurance company and provide this as a service to their members.

Please note that Frankel & Newfield does not represent claimants in Social Security Disability matters.

Clients Choose Us Because We:

  • Have recovered $200M+ for our clients.
  • Have seen your situation before.
  • Are aggressive in our approach.
  • Know the tactics used by the insurance companies.
  • Hold high AV Ratings & received the Super Lawyers designation each year.

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How Can A Long Term Disability Lawyer Help?

A lawyer who represents claimants in long term disability matters has experience in a number of different kinds of law. They need to know contracts law, as a disability insurance policy is a contract between the disabled worker and the disability insurance company. They also need to know the federal law known as ERISA – Employee Retirement Income Security Act. This is a federal law that was created to protect employee benefits from employers, but has been hijacked by disability insurance companies to use against claimants. ERISA is used to control the process governing group disability claim. It proscribes the process of appealing a disability claim denial or termination, and is different than the legal processes used in a regular court of law in a number of significant ways.

Why You Need A Long Term Disability Lawyer for Your LTD Claim

Working with an experienced long term disability lawyer is the best way to protect the claimant and their family – make no mistake, this will be an adversarial process with the insurance company. Frankel & Newfield enjoys an excellent reputation among their colleagues and adversaries. Their many years of practice in the area of disability insurance law includes speaking at conferences and professional meetings, where lawyers and claims managers from disability insurance companies and their outside counsel attend to learn more about long-term disability insurance litigation.

Justin Frankel and Jason Newfield know the tactics that the long term disability insurance companies use. Their vast experience in this field has allowed them to see all of the tactics utilized by the insurance companies. They regularly monitor legal decisions in courts around the country to stay in the forefront of the law concerning long term disability matters and how the Courts are treating various issues of significance. With many years of experience in disability insurance matters, they are familiar with all of the aspects of disability claims management, the politics at work in the insurance companies and how market forces impact claims. They have seen your situation before, in great likelihood, and can develop strategies to combat the insurance companies.

Please note that Frankel & Newfield does not represent claimants in Social Security Disability matters.

Success Story: CIGNA Claim Termination Is Overturned by Frankel & Newfield

A 63-year-old corporate quality control offer could no longer perform the duties and tasks of her job. She suffered from diabetes, painful diabetic neuropathy and extreme chronic nerve pain. She was not able to sit at a desk and focus with any degree of effectiveness because of the level of pain. She was getting paid disability benefits for a while by CIGNA, and then her claim was terminated. She came to us to fight back on her behalf.

CIGNA’s doctor conducted a paper review of her file and never presented a review of his medical records. He relied on a summary written by the nurse case manager. This is not an unusual fact pattern for CIGNA. In addition, the doctor did not consider the large number of medications the woman takes and the side effect of these medications. The disability insurance company had a vocational analyst prepare a transferable skills analysis, but she was never provided with medical records and had no knowledge of the restrictions and limitations that were provided by her doctors. Frankel & Newfield worked closely with her treating physicians to show CIGNA that she was disabled and could not work. Our appeal was successful, and our client received her benefits.

FAQs

Long term disability coverage periods can be more than six months, or years, or in most cases, decades. Every long term disability policy is different, and must be carefully reviewed to determine the time period of coverage.

Many disability policies limit the number of months that certain conditions are covered to 24 months. This usually includes mental health or psychiatric claims. Other illnesses, like Chronic Fatigue Syndrome and Fibromyalgia are limited in some, but not all, long-term disability insurance policies. Often the insurance company will seek to apply a limited benefit period, even when its not in the contract.

Which illnesses qualify for long term disability?

The qualification for long-term disability is less about what type of illness the claimant has, but more on the severity of the disability, and their ability to perform the tasks required by the person’s occupation. The focus of our development of support for a disability insurance claim is upon the functional restrictions and limitations of a claimant. Frankel & Newfield have represented claimants suffering from a wide variety of illnesses, including but not limited to:

How does the long term disability claim process work?

The long term disability claim process is very dependent on the terms of the policy. In some cases, a claimant must go through applying for short-term disability before they are permitted to file a claim for long-term disability. In others, a waiting period, also known as an elimination period, must take place first before a claim can be filed. Speak with an experienced disability insurance lawyer before even starting the claims process. There is simply too much at stake. We often advise claimants PRIOR to the beginning of a claim, in order to spot issues BEFORE they become problems. We work to “prevent the spill” to avoid having to “clean the mess.”

What are disability buy-ups and do they help highly compensated employees?

Regular group disability insurance is the basic disability insurance provided by many employers for their employees and coverage varies, but it usually covers about 60% of a person’s income. For highly compensated employees, an additional layer of disability insurance coverage is known as a “group disability policy buy-up,” or enhanced LTD coverage. This is typically offered to individuals with very high earnings who need a larger percentage of their income protected. The employee usually pays for this coverage with regular deductions from their paychecks. This can often bring the total percentage of benefits to 70% of one’s income (although often with a cap at a certain monthly benefit).

Is it easy to work with Frankel & Newfield?

Our disability insurance law firm is very proud of the client testimonials we receive, and the high ratings we hold from our legal colleagues. Clients benefit from working directly with a partner, and they have our full attention. We understand that this is a difficult time in their lives and do everything we can to make sure that their case is handled with respect and dignity and that all issues are timely addressed to minimize the impact upon our clients.

Justin C Frankel

Written By:

Justin C. Frankel

Disability Insurance Attorney