Short & Long-Term Disability Claims
What We Do...
We handle short-term (“STD”) and long-term (“LTD”) disability benefit denials both under group policies obtained through your employer called ERISA plans, as well as through private, non-ERISA disability insurance policies (“IDI”) obtained by you out on the private market. Disability policies obtained either through your employer or purchased on the private market are intended to provide income replacement for you and your family in the event that you are no longer able to work due to injury or sickness.
CONTACT ESSEX RICHARDS
Unfortunately, however, insurance companies often deny or terminate deserving disability claims, even though the evidence of disability seems clear. We have seen countless justifications offered up by insurance companies for denying or terminating credible disability claims. However, some of the most common reasons asserted by insurers include:
- Failure to meet your policy's definition of “Disability” or “Totally Disabled,” including satisfying “Own Occupation,” “Regular Occupation,” and “Any Occupation” provisions in the policy.
- Inadequate medical proof or a lack of objective medical evidence. This basis is routinely offered in claims involving chronic pain, headaches, fatigue, dizziness, or cognitive impairment, including memory loss and concentration limitations.
- Exclusions found in the policy, such as for pre-existing conditions.
- Policy Limitations for disabilities caused by mental, nervous, or psychological impairments, disabilities caused by certain chronic conditions, or even simply because of the self-reported nature of your disabling condition.
- Online/social media or video surveillance of you that is allegedly inconsistent with your disability claim.
- A doctor paid by the insurer has determined that you are not disabled, regardless of what you or your treating doctor says. Oftentimes, the insurer’s doctor has never examined you or even spoken to you or your treating doctor before finding that you can work.
- Or simply because you have a condition that is commonly denied by insurance companies such as Alzheimer’s disease, arthritis, back disorders, bipolar disorder, brain injuries, cancer, cardiovascular disease, carpal tunnel syndrome, chronic fatigue syndrome, chronic pain, COPD, degenerative disc disease, dementia, depression, diabetes, Fibromyalgia, heart disease, HIV/AIDS, lupus, lyme disease, multiple sclerosis (“MS”), neuropathy, Parkinson’s disease, PTSD, psychotic disorders, substance abuse, and others.
When such denials and terminations do take place, strict deadlines and procedural rules govern your ability to challenge to the insurer’s decision. We have significant experience successfully handling claims and appeals, as well as litigating when necessary in all state and federal trial and appellate courts, against most major disability insurers, including Aetna, Cigna, Hartford, Liberty Mutual, LINA, Lincoln, MetLife, Northwestern, Prudential, Reliance Standard, The Standard, Sun Life, United of Omaha, Unum, USAble, and most other major disability insurers.
While we are physically located in Charlotte, we regularly represent individuals throughout the entire state of North Carolina. For additional information or to determine if you need assistance with a claim, please complete the form below or give us a call at (704) 377-4300.