When you are injured to a point that it prevents or limits you from working, you will be looking at avenues to replace your income. Attempting to file a successful claim with the disability insurance company in order to receive benefits can be a frustrating process. Your claim will need to be immaculately detailed, yet still, the insurance companies will try to find ways to deny you or give you less than you deserve. To counter this, it is advisable to seek the guidance of a knowledgeable disability insurance attorney serving New Jersey. Let the attorneys with the Law Office of Justin Frankel handle the insurance company on your behalf and file an appeal if necessary.
Becoming disabled is never a planned event, yet it happens for a variety of reasons, often beyond your control. Because of this, it is imperative to have disability insurance in New Jersey not only for future protection but also to provide you with peace of mind should something happen.
Essentially, this type of insurance serves to replace a portion of your previously earned income should you become disabled as the result of an illness or injury and are unable to work. You will need this compensation to help pay living expenses, including your mortgage, car payment, utilities, food, and more.
Policies can be for temporary short-term disability or long-term disability insurance. The short-term disability insurance is strictly for any temporary disabilities you suffer and will usually provide partial compensation until you can return to work, typically lasting three to six months. Long-term disability insurance, on the other hand, will last much longer.
Disabled individuals will need to make a disability claim under their insurance policy. A long-term disability claim deals with injuries that did not happen at work and most often provides you with coverage until you reach retirement age. If you have this long-term disability insurance, you either have the group policy, which is governed by ERISA, or an individual policy which is governed by state law.
The claims process for filing for long-term disability insurance benefits in New Jersey is similar to filing a claim in most states. It is critical to begin by locating the original copy of your disability insurance policy. This step is crucial, as the policy is a contract, and the provisions in the policy will determine everything about how your claim is processed, what time restrictions you must comply with, and what medical records are needed to document your claim. We say the policy is the road map to the treasure chest (benefits), and thus, we must follow the map and understand the rules and potential pitfalls.
The Law Office of Justin Frankel can help with both New Jersey individual and group disability insurance claims. It all starts with reviewing your disability insurance policy to determine whether you need to first qualify for short-term disability before you can apply for long-term disability. Disability insurance policies have elimination periods which must be satisfied before moving forward.
We recommend New Jersey residents call our office for a free consultation with an experienced disability insurance attorney. During that discussion, we will discuss your claim issues, the type of disability insurance policy you own (whether group, association, or private), and the insurance company itself. The tactics used by different disability insurance companies will have an impact on your claim. Some will pay for a period of time and then, for a variety of reasons often lacking in quality, terminate your claim, even though your condition has not improved.
Our long-term disability insurance attorneys have represented many people who live and work in New Jersey and are at different stages in their disability insurance claims. The best time to contact a disability insurance attorney, however, is before you file that claim. The New Jersey disability lawyer will work with your treating physician to help ensure your medical records contain the documentation of your condition and why you can no longer perform the material duties of your occupation.
With your complete medical records reviewed, we will then help to frame the issues of your occupation and how and why you are unable to engage in your work and occupational duties. In other words, we will help to merge the medical issues with the vocational limitations and prove why your claim is entirely valid.
The United States Court of Appeals for the Third Circuit is the federal court serving New Jersey, Pennsylvania, Delaware, and the Virgin Islands. Any federal court cases concerning a resident of New Jersey take place in the New Jersey District Court, within the Third Circuit — unless there is the ability to bring suit in another venue based upon the insurance company or some other nexus to a more favorable jurisdiction.
Our New Jersey disability lawyer regularly reviews case law emanating from the Third Circuit in order to be familiar with the judges, the tenor of the court, and whether their decisions tend to favor individuals or businesses. Trends are not a guarantee of decisions, but the information is useful in our representation of clients in federal court and in guiding our clients throughout the process.
Suffering a disability is already challenging enough. Filing a disability claim does not have to be if you seek the legal advice and support of a dedicated New Jersey disability lawyer.
There are several possible reasons that your insurance company can use to deny your claim. The most common of these include discrepancies in your documentation, incomplete or missing medical records, and failing to fall within the insurance policy’s definition of disability. We explore each of these below.
Long-term disability claims require plenty of documentation to prove you are unable to work due to your injury or illness. Within these various documents, if there are details that are inconsistent or inaccurate in any way, the insurance carriers can use these findings to deny the claim.
You need to include medical records that explicitly state the illness or injury you have suffered and how it impacts your job performance. Your records will also need to show the limitations created by your disability. If anything is missing from your records to show these conditions, the insurance company can deny your claim.
The numerous policies available today define disability differently, meaning your illness or injury might not qualify under your particular policy. If your illness or injury keeps you from working, you should request a copy of your policy information to check if you are covered. Sometimes there are exclusions that deny disability coverage depending on what caused your disability.
A dedicated and experienced long-term disability lawyer can help you understand the scope of your policy and what you are potentially owed by your insurance company and how best to secure these benefits. The earlier you consult with an attorney who practices in this area, the less chance a denial will occur due to incomplete records or discrepancies in your paperwork. If you are denied for other reasons, we can build your case for appeal, develop strong support for your claim, guide you through the process, and provide legal representation to go before the federal court if necessary.
Receiving a denial or termination letter for your disability claim can be disappointing, frustrating, and anxiety-producing. What you do next will be important.
While all disability cases are different, there are certain actions to take to continue your claim for benefits. Your next steps depend on the type of policy you hold. If you are not already working with a New Jersey disability claims lawyer, now is the time to do so. It is highly advised that you seek out an attorney’s guidance, as the appeals process can be tedious.
Your appeal will depend on two important factors: the type of denial you received and your policy. In addition, how the appeal is filed and within what timeframe will depend on whether you have an individual policy or a group policy.
Individual disability insurance appeals are governed by state law, and claimants will need to be familiar with the requirements involved. Not every claim requires an appeal, although one may still have significant value. Consulting with a New Jersey attorney knowledgeable in disability law will be beneficial at this point to help keep your claim active.
A group policy is usually offered through your work or association and is governed by federal law, or ERISA, the Employment Retirement Income Security Act. This Act includes strict deadlines which must be adhered to in order to maintain your rights to receive long-term disability benefits.
Depending on the particular group policy, policyholders or their attorneys may only be allowed to file a single appeal. The period of time for filing that single administrative appeal is usually 180 days from the date of denial of your claim. Should this appeal be denied, your next step for seeking benefits will be to file a federal lawsuit.
Whether you have an individual or group policy, you need an experienced claim appeals attorney to help you through the process. Depending on the particulars of your policy and the denial letter, your experienced attorney may take any or all of the following steps.
Receiving long-term disability benefits after filing a claim is essential in order for you to maintain your life and avoid additional financial hardship. Insurance companies, unfortunately, are only concerned with their own bottom lines and will not hesitate to find a reason to deny your claim.
The disability attorneys with the Law Office of Justin Frankel understand how the process works and stand ready to defend your rights. In addition to our knowledge of disability law, we offer accessibility to our experienced partner so you never feel left out or just another case number. The attorney-client relationship is important to us, and we are dedicated to each case we take.
Our law firm has successfully served the New Jersey area for two decades. For help with your disability claim or appeal, contact our law offices today by calling 888-583-4959 and scheduling a free consultation and case evaluation.