Getting long-term disability in DC can be hard. Even if your doctor says you can’t work and your employer agrees, the insurance company still has the final say. They follow strict legal rules and often try to deny claims, even when it seems obvious that you should qualify. This can feel unfair, but knowing the process can help you avoid mistakes and protect your benefits.
The Insurance Company Decides If You Qualify
The insurance company, not your employer, pays your benefits. Also, they decide if you meet the legal definition of “disabled” in your policy. Even if your employer supports you, the insurance company doesn’t work the same way. Their goal is to save money, so they look for reasons to deny your claim. Many people give up after being denied, which is exactly what the insurance company counts on. This is why it’s so important to be prepared and fight back.
Tips to Protect Your Claim
- Follow Your Doctor’s Orders: Don’t do anything outside your medical limits, even if you feel better. For example, the insurance company may watch you or ask for activity logs to find reasons to deny your claim.
- Know Who’s Advising You: HR staff may not understand your policy or ERISA claims. Plus, insurance reps don’t work for you, even if they seem helpful.
- Avoid Bad Advice: Friends and coworkers might mean well, but their advice could hurt your case. Instead, rely on trusted sources who have the right knowledge.
Filing a Long-Term Disability Claim
Long-term disability claims can be complicated. Because of this, most people need legal help to handle them. If your claim is denied, you might have only 180 days to:
- Review the insurance company’s file
- Collect medical evidence or evaluations
- Plan your strategy
- Write a strong appeal
You Might Only Get One Chance at the Appeal
Long-term disability appeals are legal arguments, so having an experienced lawyer is crucial. At the very least, send us your denial letter for a free review, and we’ll provide recommendations.
Have questions about your claim? Contact us at info@dkllp.com, and we’ll help guide you. You can even schedule a free and same day consultation by clicking here.