Fort Worth Long-Term Disability Lawyer

Suffering an injury that prevents you from working is a serious issue, especially if the injury results in a long-term disability. In Texas, disability determination services deny more than 60% of claims for disability benefits. To ensure that you can receive benefits for your disability, you need an experienced Texas long-term disability lawyer. The Law Office of Tom Hall can help you navigate the complexities of disability law and do everything possible to get you approved for benefits.

Qualifying for Long-Term Disability

You must meet many different qualifications to receive long-term disability payments.

First you should check to see how your employer’s long-term disability policy defines “disability,” if it offers a long-term policy. If an employer plan covers you or if you bought your own long-term policy, you may be able to collect benefits from that policy. In most plans, you are “totally disabled” if your illness or injury prevents you from being able to perform the usual duties of your job.

Your policy may allow you “partial disability” if you are not able to work full-time at your job, even if you can work full-time at another job. Some policies state that you cannot receive long-term disability if you are still on your employer’s payroll. Regardless, thoroughly look over your employer’s disability policy and determine if it qualifies you to receive any benefits.

The most important part of your application for disability is your doctor statement. Your doctor will need to fill out a form or write a statement outlining his or her opinion about your health and current capabilities. Along with a statement from your doctor, you will need to include objective proof of your injury in your application. The claims administrator will request all medical records regarding the injury or illness, including x-rays, MRI scans, lab results, and any other findings. You also must continue seeing a doctor or else the insurance company may cut off your benefits, claiming that you are healthy enough to work.

Other Requirements

If your long-term disability policy requires that you pay premiums, the insurance company may cut your benefits if you do not pay them on time.

Most long-term disability plans through employers require that you be a full-time worker at the time of the accident. For most plans, full-time people work at least 30 or 35 hours a week. Check your plan to be sure how your employer defines full time.

There are also requirements surrounding pre-existing conditions. If you have a pre-existing condition, you will not receive benefits for anything that occurs partially because of the pre-existing condition.

Additionally, many insurance companies require that you also file for Social Security Disability at the same time. If you win approval from Social Security, the insurance company can reduce some of its payments to you.

Common Reasons Insurers Deny Long-Term Disability Claims

Unfortunately, denied claims are common. One reason an insurer may deny your claim is if you do not have strong enough medical support. Medical records are the strongest form of evidence for a disability claim and if you do not have sufficient evidence, you may not receive benefits.

Because each policy has different definitions about disabilities, insurers reject many people’s benefits because their policies do not cover their specific injuries. Closely analyze your policy’s guidelines before filing for long-term disability.

Insurance companies will also deny a claim if they find evidence the you lied about the severity of your injury. For example, some people will make posts on social media revealing the truth about their injuries. Many insurance companies will search social media as part of their investigations. If there is any evidence that your injury is not as serious as you’ve claimed it is, the insurance company will deny your request for benefits.

Appealing a Denied Claim

If the insurance company denies your claim, there are steps you can take to appeal. It will send you a letter stating the reason for denial and your deadline to appeal. The first thing you need to do is focus on strengthening your application. Get any additional medical tests, look for missing medical records, and get more written medical opinions about the severity of your injury.

The appeals process is your last chance to add anything to your application. If the company denies your application again and you decide to pursue a lawsuit, you will not be able to adjust your application in any way. Once you have strengthened your application, you can re-submit it.

Long-Term Disability Attorney

If the insurance company denied your request for long-term disability benefits in Texas, you need help going through the appeals process. At the Law Offices of Tom Hall, we understand Texas disability law and will do everything we can so that you receive the benefits you need. Contact us today for more information about how we can help you with your long-term disability benefits.