The Legal Rights Every Long-Term Disability Applicant Should Know
Long-term disability claims are never easy, especially when your health is in jeopardy. The governing laws for LTD are put in place to protect you, but you have to know your rights to protect yourself. Whether you file a claim or appeal a denial, knowing the legal framework of LTD benefits will help you make informed decisions to take immediate and decisive action. The following article has pointed out some of the important features of your rights as an LTD applicant and also gave you some useful tips on how to go through this process as smoothly as possible.
Your Right to Your Policy
Your disability insurance policy is the backbone of your LTD claim and reflects the terms and conditions upon which benefits are granted. You have a right to have access to this policy. It will provide critical information such as what constitutes a disability, waiting periods, exclusions, and limitations. These are all important points to know when filing for disability benefits, so it will be important to request your policy from the employer or the insurance company. Understanding it will help to determine whether benefits will be applicable under the policy for you, and will prepare you for almost any obstacle that may arise.
Your Right to Appeal a Denial
Among these rights, one of the most important is that if your claim is denied, you have the right to appeal. In most cases, in writing, insurance companies are legally obligated to state a reason for denial. Once you receive this notice, you can disagree with the decision by utilizing the appeals process described in your policy. Federal law, including ERISA, requires insurance carriers to re-evaluate denied claims in a non-arbitrary way. It is also during this stage that the services of an attorney can be truly useful in building your case, as most appeals require substantive medical and vocational evidence.
The Right to Be Free from Retaliation
Federal law does offer protection against retaliation if your LTD is provided through your employer. An employer cannot demote, punish, or otherwise discriminate against you because you have filed a disability claim. Any adverse actions are considered retaliatory and are against the law. If this does occur, you are entitled to take further legal action. You can safeguard yourself by making a paper trail of the retaliation and finding a LTD lawyer when necessary.
Right to Present Supporting Evidence
In LTD claims, the burden is on your part to prove that your condition meets the policy's definition of disability. You are at liberty to submit any document you think will serve your case. It can be medical reports, statements by your doctors, test results, and employment records. In the case of difficult or subjective impairments such as chronic pain and problems with mental capacity, expert testimony is required from specialists and sometimes vocational experts as well. The ability to present proof enables you to substantiate the fact that you are unable to work completely.
Right to a Prompt Payment of Claim
Insurance companies should pay your claim within a very reasonable time. Delays in payment simply add to the trauma and financial hardship of any disaster. Federal law, such as that provided for under ERISA requires that all insurers respond to an original claimant within a certain time usually 45 days-with extensions allowed in specific situations. If your insurer does not work within these timelines, you are well within your rights to hold them in default. The secret to having your claim processed in record time is monitoring deadlines and maintaining communication with your insurer.
Right to Sue
You have a right to sue if your appeal was denied or your insurance company acted in bad faith. Sometimes, the only answer is to resort to filing an action in the court. As provided under ERISA, taking it to federal court will afford an evaluation by a judge based on evidentiary matters presented along with insurer actions. This would also somewhat apply if it were a strictly private policy or one subjected to state statutes, but one thing remains: you have legal rights when these options have been deemed exhausted.
Knowing your rights is the first step to a successful claim in the long-term disability application. Access to your policy, appealing a denial, and litigating all forms of rights meant to protect you from any unfair play. That is tough, but knowledge and perseverance are all that is important. If you are facing difficulties, then professional advice will help in preserving your rights and your claim getting due consideration.
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