LONG TERM DISABILITY (LTD)
There are several different types of long term disability claims. What type of claim you have, and – more importantly – how that claim should be handled, often depends on how you obtained the long term disability insurance in the first place.
If you have long term disability because of your employer, the claim probably falls under ERISA, or the Employee Retirement & Income Security Act of 1974 (“ERISA”), which is a complex piece of Federal legislation that covers most employee benefit plans. This typically includes short term disability, long term disability, retirement and pensions, AD&D and medical policies. Whether the claim falls under ERISA (or not) often determines how employers and their contractors (usually an insurance company) deliver those benefits to employees.
For most Coloradans, their insurance benefits (life, medical, disability, vision, dental) are earned through our employment. That means that in most cases, these benefits fall under the ERISA statute, including claims for Long Term Disability and Short Term Disability. Unfortunately, many lawyers do not have substantial experence with ERISA or its complicated claim process.
Do you really need an ERISA lawyer? In many cases you do. In many cases, having representation early in the claim process can be the difference between winning and losing because ERISA dramatically alters your common law rights. Most of these claims (including Long Term Disability, Short Term Disability, and medical and other benefits) have very short deadlines. There are also rules about what documents and information a Court can consider. If you do not know and protect your rights early, you may lose your ability to effectively protect your claim. Click here for more information about ERISA, and our ERISA Disability and benefit claim practice, and how ERISA may affect your rights.
However, and in some cases (employees of the government, non-profits and in other unique circumstances) employee benefits fall outside of ERISA. In other cases, you may have purchased the long term disability policy directly from the insurance company. For example, many people purchase disability policies when they take out a loan, or buy accidental injury or death policies as part of their financial planning. In those cases, regular contract rules apply. In fact, the case is handled in a completely different way the ERISA claims, because many of the rules and restrictions of the ERISA statute do not apply. You may even be entitled to compensation beyond the amount of benefits (something that is not usually allowed under ERISA). For example, if the insurance company acts in bad faith, or unreasonably delays or denies payment (remedies NOT available under ERISA), damages for delay may be available, including attorney fees and costs.
Whether you have a private policy, a non-ERISA claim, or an ERISA claim, do not wait to seek experienced counsel until it is too late! It is critical to know what type of policy you have — and what law applies — as soon as possible. This is especially true in ERISA cases, because the rules and tactics are very different from the beginning. ERISA drastically affects your rights. Under ERISA, you have no right to a trial, or trial by jury. Your case will most likely be decided based on how the claim was handled before suit is even filed.
We have handled claims involving a wide variety of medical conditions including:
- Anxiety and Depression, and related mental health disorders
- Back injuries, and chronic back pain
- Bipolar disorder
- Brain injuries, Traumatic Brain Injury and concussions
- Cerebral palsy
- Chronic pain, including Lyme Disease, Fibromyalgia, Chronic Pain Syndrome-RSD
- Heart Disease
- Herniated discs
- Inner-ear/Balance disorders, vertigo-tinnitus
- Knee, shoulder and joint disorders
- Lung disease
- Morbid obesity
- Multiple sclerosis
- Neck injuries
- Parkinson’s disease and Dementia
- Post-traumatic stress disorder
- Rheumatoid arthritis
- Seizure disorders and Epilepsy
- Spine injuries
- Long Term and Short Term Disability Applications;
- Long Term Disability and Short Term Disability Appeals and Administrative Reviews;
- Litigation of Employee Benefit Claims in State District Court (Adams, Arapahoe, Boulder-Broomfield, Jefferson and Denver Counties) and U.S. District Court, and the U.S. Court of Appeals, Tenth Circuit.
Under ERISA, you also lose your right to claim compensatory and other damages. It is therefore very important to structure your claim correctly in order to maximize the (limited) recovery possible. The attorneys at Silvern & Bulger, P.C. have the knowledge and experience required to properly manage your claim from the beginning of the administrative process; through litigation. This is critical because, on most cases, if the administrative process is not handled correctly the litigation will not likely succeed. The sooner you consult with an attorney, the more likely your chances for success. At Silvern & Bulger we are experienced with all types of insurance benefit claims, including those that fall under the ERISA statute. We handle both ERISA and non-ERISA insurance benefit claims, including Long Term Disability, Short Term Disability, medical and dental, and life insurance claims. However, ERISA claims are a highly specialized practice area. Because of our experience in handling ERISA cases, we are listed in the U.S. Directory of Boutique Law Firms, in the ERISA category.