Learning to live with a new disability presents many challenges, including the challenge of replacing income from work when you are no longer able to work full time. Many professionals and skilled workers have long term disability policies that can replace work income. The lawyers at Berman & Simmons have the experience to help you navigate the complex world of disability insurance and get the benefits you need. We will review your long term disability insurance claim prior to filing and help you appeal if your insurer denies your valid claim. Whether you are relying on company-provided LTD insurance governed by federal ERISA law or private insurance, we have you covered.
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Getting Back on Your Feet When Recovery Isn’t Possible
No one expects to become disabled, but it can happen to any of us. You can become permanently disabled due to a car accident, brain or spinal cord injury, or surgical error. Although you may be awarded damages through a lawsuit, this is not always enough to support you for the foreseeable future. Living with a disability is expensive, and long-term disability is designed to keep you on your feet. You just need to make it through the process of getting approved.
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We are the leaders in Maine in the use of state-of-the-art technologies in the courtroom, including anatomical and computer models and dynamic presentation of studies such as MRI and CT scans. We produce professional videos to help us show the true extent of injuries and the impact on you and your family.
This allows us to present complex evidence in a straightforward way that judges, jurors and insurance companies can easily understand. By demonstrating the impact, we put the opposition on their heels as they try to deny you compensation.
Who is eligible for long term disability insurance?
If you have a disability insurance policy in effect when you become disabled, and your disability prevents you from working full time at your job, then generally speaking you would be eligible for long term disability benefits. Your eligibility depends on the exact language and terms in your policy. It is important to review and understand the terms of your policy.
Am I eligible for long term disability insurance if I am able to work part time?
Most LTD policies provide for partial benefits to those who are able to earn less than 80% of former income. The exact amount of the partial benefit is based on a formula. If you are able to earn less than 20% of your former income, most LTD policies will consider you fully disabled.
Can I be denied long term disability insurance because I can still work at another job?
Some LTD policies will terminate benefits after two years if you are able to work at “any occupation.” Despite what it sounds like, this does not mean your benefits will be terminated if you can work at any job whatsoever. “Any occupation” means an occupation that compensates you at a reasonable rate and is related to your skills, training, education, and experience.
If you purchased an individual LTD policy or if you work in a highly specialized profession, you may have an “own occupation” policy. This type of policy provides benefits when you are no longer able to work in your specific field or sub-specialty.
Can I be eligible for long term disability benefits if I do sedentary work?
Yes. Any type of work can be impacted by a disability, not just physical work. People in professions ranging from attorneys to business owners to doctors to managers can be eligible to receive long term disability benefits.
What is ERISA?
The Employment Retirement Security Act, first passed by Congress in 1974, protects and regulates retirement, short term disability, long term disability, and other benefits provided by employers to workers. If your LTD policy was provided through your employer, ERISA law probably applies. There are exceptions to this, and whether your policy is an individual policy or an ERISA governed employer-provided policy is not always obvious.
ERISA is a complex body of law consisting of federal statute, regulations, and court decisions.
If my LTD policy is governed by ERISA, what does that mean?
ERISA impacts when and how you can file a lawsuit to contest your insurance company’s denial of long term disability benefits, and what evidence the judge can consider in such a lawsuit. Therefore it is very important to involve a lawyer early in the process, in order to ensure that your rights are preserved and the judge is able to consider all relevant evidence if you need to file a lawsuit.
I am receiving Social Security Disability Benefits—does that make me eligible for long term disability benefits?
Not necessarily. The law and regulations that determine eligibility for Social Security disability benefits differ from the law that governs LTD benefits. You may have to submit more or different evidence to prove your eligibility for long term disability benefits.
The insurer denied my claim for LTD benefits. Is there a deadline to appeal?
Yes. The deadline to file an appeal to your insurer will be determined by your insurance policy. It is important to review and understand the policy.
What is the deadline to file a lawsuit for denial of LTD benefits?
The deadline depends on whether your LTD policy is governed by ERISA or not. The deadline to file a lawsuit is also determined by terms in your LTD policy. It can depend on how several different terms in the policy interact with each other. You can be in a situation where you need to file a lawsuit in court before you have filed an appeal with the insurance company. In that case, you can ask the court to ‘stay’ the case in order to put the lawsuit on hold while you file an appeal with the insurance company.
Get Maine’s best injury lawyers on your side
Berman & Simmons is widely recognized as Maine’s best personal injury and medical malpractice law firm. While we are honored by such accolades, we are never complacent or satisfied. For us, it is not enough just to be the best trial firm in Maine. Rather, we strive every day to be one of the very best trial law firms in the Country. With our unmatched resources, expertise, and determined advocacy, we have recovered over $1 billion for our clients.
Our long track record of success comes from our commitment to providing clients with excellence in legal representation coupled with genuine care and concern about their well-being. We work hard to earn your trust. When you hire us as your lawyers, you can expect us to listen to your concerns, answer your questions, and give you sound guidance. You will have our pledge to use all our experience, skill, and tenacity to maximize the compensation we obtain for you.
And, with Maine’s best injury attorneys in your corner, you can focus on your health, and get back to living your life.
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Call the long term disability lawyers at Berman & Simmons today for your free consultation
Please contact Berman & Simmons today at (207)784-3576 to arrange for your free consultation to discuss your questions and concerns about your long term disability claim. You pay nothing unless we win. We welcome the opportunity to help you.
Many states have strict deadlines for filing claims.
You’ll need help navigating your medical care and dealing with financial pressures.
Even if you don’t end up hiring us, a conversation could help determine your best path forward.
Consultations are always free, and we don’t get paid unless you do.