Long term disability claims are made when you are injured and unable to perform your work duties without experiencing significant pain. It is not easy to obtain long term disability payments from an insurance company, and even if you are granted the benefits it does not guarantee that you will be able to keep them for an extended period of time.
You may lose access to your benefits for a number of reasons, including missed deadlines, a change in your disability, a change in your doctor’s opinion of what treatment you require or, possibly, the insurance company finding out that you don’t require the benefits consistently anymore.
In order to be eligible for benefits you must be able to prove that you require regular medical care in order to care for a disability that prevents you from performing your work duties. You must be able to prove that your injury or condition fits the insurance company’s definition of “disabled,” which may differ from your own definition or your doctor’s opinion. The insurance company’s definition is the only definition that matters.
Even if you are approved for benefits, this does not mean you are now free from continuing to prove your disability to the insurance company. You must continue to provide documentation to the insurance provider, in a timely manner, which proves you are receiving medical treatment for your disability or condition. In fact, the most common reason benefits are put on hold is because a deadline was missed to send documentation to the insurance company.
You may also have your benefits halted if the insurance company finds out that you no longer require the benefits. In some cases, insurance companies may actually hire or employ agents who check up on long term disability benefits recipients to see if they are truly disabled, and that they are truly encumbered to the level that their insurance claim reports them to be.
For example, if these inspections reveal that you were capable of raking your yard and digging a hole for a new mulberry bush, and you had been receiving long term disability claim benefits due to a back injury that prevented you from working your job as a landscaper, then the insurance company can use this as a reason to end your benefits package. They would, however, be required to notify you of this intention before cutting off the benefits.
If your benefits are suddenly ended
If you suddenly lose access to your long term disability payments, time is of the essence. You have a limited amount of time to file an appeal of this decision, and it will not be easy to prove that you deserve to keep the benefits once the insurance company has decided otherwise.
Certain cases, such as a missed deadline or a missing piece of medical documentation, may be easier to clear up than other cases, such as if the insurance company uncovers some type of proof that you were not as disabled as you once had been, or claimed to be.
The only way to ensure a good chance to continue receiving your benefits package is to consult with an attorney. A good attorney can pour over the details of your specific case, talk to your physicians and your insurance company and work out the specific reasons for why your benefits were cut off.
If there is an avenue to win your benefits back, the experienced legal team at Altman & Altman LLP will find it. We have over 40 years of experience going against insurance companies in court and advocating on behalf of our clients. We can take the necessary steps and time to make sure your case is properly argued and give you the best possible chance for success.
Call us for a free consultation today at 617-492-3000 or toll-free at 800-481-6199. We are available