If you have submitted a long-term disability claim and your insurer has denied your claim, delayed processing your claim, or significantly undervalued your benefits), you may be entitled to appeal the decision of the insurer and litigate against your insurer for wrongful denial.
Long-term disability benefits are intended to replace your earned income for an extended period of time. Whereas short-term disability benefits may expire after six months, long-term disability benefits often last until retirement age (i.e., age 65 or older) or until you have sufficiently recovered such that you are capable of returning to work. The assumption of long-term disability coverage is that the long-term disability at-issue will not necessarily be fully resolved.
For example, if you suffer an accident that renders you a paraplegic, you may qualify for long-term disability insurance coverage. This coverage is not intended to be a “stopgap” measure, as your disability will not resolve itself after some length of time has passed.
Critically, however, insurers will attempt to lower their payouts by arguing that your health condition is such that you are only partially disabled, and not fully disabled. If you are capable of working a lower-paying job, then the insurer will assert that you should take on the alternative position and they will pay out lower benefits or no benefits as a result. With the aid of a skilled Houston long-term disability lawyer, however, you can demonstrate that the positions you are equipped to handle pay significantly less than your pre-disability income, such that you are still qualified to receive full benefits.
Appeals and Litigation
If your insurer has denied your claim, it’s important that you consult with an experienced long-term disability attorney. Your attorney will help you gather necessary evidence of your condition and will ensure that a comprehensive record has been created. Depending on the reasoning behind the denial, your attorney will submit the appropriate evidence on appeal . Going through the appeals process ensures that your legal claims against the insurance company are preserved. If the appeals process does not go as desired, you may be able to file a lawsuit.
In the wake of a debilitating injury, the process of obtaining disability benefits (to which you are entitled) can be a particularly challenging and emotional ordeal. Here at Berg Plummer Johnson & Raval, LLP, we understand the unique difficulties posed by the fight to obtain long-term disability benefits, and are well-equipped to assist claimants. Our Houston long-term disability lawyers bring decades of combined experience providing best-in-class representation to disability claimants, helping injured claimants to appeal the denial of their benefits, provide evidence supporting their disability claim, , and bring an action against their insurer for wrongfully denying or otherwise impeding the payout that the claimant is entitled to.
Every client has different needs and limitations, and here at Berg Plummer Johnson & Raval, LLP, we are committed to personalized service — to that end, we work with our clients to develop unique fee arrangements that are well-suited to their objectives and budget.