My doctor has told me I am disabled. Why did the insurance company deny my claim?

An insurance company does not have to accept your doctor’s conclusion that you are unable to work.

What does ERISA mean?

ERISA stands for Employee Retirement Income Security Act. The law was passed by Congress in 1974 and has, since then, been construed by courts in such a way that LTD claimants have very little ability to enforce their claims.

Can I sue my insurance company for punitive damages?

Not if your LTD falls under the ERISA statute. At best you can obtain the benefits owed to you in the first place, plus interest. Sometimes courts will also award attorney fees. ERISA preempts state law.

I know that the insurance company will deny my claim on appeal. What is the sense in appealing?

You must do the internal appeals even though you are appealing to the same insurance company that denied your claim in the first place. Otherwise you cannot have your case heard in court.

I have missed an appeal deadline. Must I give up on my case?

Not necessarily. Consult a lawyer experienced in handling LTD cases.

How soon should I consult a lawyer for my LTD case?

Normally the sooner the better If your case needs to go to court a lawyer experienced with LTD claims will attempt to get sufficient medical and other documentation into the administrative record. Otherwise the court might not allow the documentation on appeal.

Do I have to apply for Social Security benefits?

Most policies require that the claimant apply for Social Security benefits. The LTD benefit is typically offset by the Social Security benefit.

Is my LTD case automatically denied if my Social Security case is denied?

No. The claims are considered different, although similar. The Social Security decision is relevant to the LTD claim but it is not binding. Generally a disabled person will receive better treatment from the Social Security Administration than she will from an insurance company.

I am not working. How do I pay a lawyer to help me?

Some law firms, including this one, will represent LTD claimants on a contingent fee basis.