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Long Term Disability & ERISA Lawyer

Nationwide Representation For Your Disability Claim
CaveyLaw.com > Practice Areas > Long Term Disability & ERISA Lawyer

Long-Term Disability Claims

Looking for a ERISA Long Term Disability attorney for your disability claim? Nancy Cavey guides you through the process of applying for and getting your long term disability benefits. You might have bought a private disability insurance policy, which is governed by state law, or a disability policy through your employer which is governed by a Federal statute called ERISA. By taking advantage of what many policy holders don’t know, long term disability insurance companies often intimidate policyholders or manipulate them into thinking their options are limited. Before you apply for long term disability benefits or deal with the long term disability carrier you should read a copy of our free book “Robbed of Your Peace of Mind? Important Information on Long Term Disability Insurance Policies, the Claims Procedures and How to Win Your Long Term Disability Benefits”.

Nancy Cavey, a Tampa ERISA Disability Insurance Attorney who can help clients Nationwide, understands your fear of financial ruin because as a teenager her father became disabled and had to rely on his long term disability and Social Security Disability benefits to support his family. Don’t let your benefits be like bicycle accidents, where the person always gets hurt.

Obtaining Disability Benefits for Your Disability Claim

The process of obtaining long term disability benefits from your private disability or ERISA disability insurance carrier can be overwhelming and frustrating. You paid for this disability insurance to help you if you became disabled and the promise of those benefits seems hollow. We will help you understand your disability insurance policy, what traps are waiting for you in the application process, the disability claims appeal process and the common mistakes you can make. Nancy Cavey, a long term disability insurance lawyer will review with you:

1. The Summary Plan description of your disability insurance policy.

2. Review your medical records and help develop the medical and vocational evidence necessary to file the initial disability claim application.

3. File an appeal within 180 days if your ERISA claim is denied. We obtain and review your file from the long term disability carrier, meet with your doctors and obtain supplementary reports, arrange for you to have a functional capacity or vocational evaluations, do medical research and file a detailed and exhaustive disability claim appeal of your private disability or ERISA claim denial.

4. If necessary, file a lawsuit in court.

Protect Your Rights to Your ERISA Long Term Disability Benefits

Nancy Cavey, a St. Petersburg ERISA attorney who handles long term disability cases Nationwide, has extensive experience in handling complex medical conditions that cause disability such as spinal injuries, fibromyalgia, chronic fatigue syndrome and many other diseases. For assistance in obtaining your long term disability or ERISA disability insurance benefits or to order our free book Robbed of Your Peace of Mind?”, please contact our disability insurance firm today or click the picture of the book on the homepage.

If you or a loved one are disabled and the long term disability claim has been denied, contact our offices for a free case assessment today. We also represent those with Individual Disability Policies across the United States.

With offices in St. Petersburg, Florida, The Law Offices of Nancy L. Cavey represents clients Nationwide and all over Florida including: Tampa, St. Petersburg, Pinellas Park, Sarasota, Bradenton, Venice, Ft. Myers, Naples, Orlando, Lakeland, Gainesville, Daytona, West Palm Beach, Ft. Lauderdale, Miami, Miami Beach, Jacksonville, Tallahassee, New Port Richey, Hudson, Safety Harbor, Largo, Palm Harbor, Port Richey, Clearwater, Indian Rocks Beach, Dunedin, Spring Hill, Brooksville, and all other cities in Florida.

If you or someone you know has a disability or social security disability claim in Florida, do not hesitate to Contact Us before you speak with an insurance company or apply for social security disability. We handle many complex disability cases. There is no obligation to hire a lawyer and the consultation is FREE.

LTD FAQ’s

What is the difference between Long Term Disability and Social Security Disability?

The Social Security Administration uses a five step sequential evaluation, the five step sequential evaluation asks whether or not you have engaged in gainful activity, whether you have a severe impairment, meet a listing, whether you can return to the work that you did in the past and whether you are capable of performing other work in the national economy based on your age, education and transferable skills.

On the other hand, each long term disability policy has their own definition of disability that generally the definition is the inability to engage in the material and substantial duties of your occupation.

The definitions are not the same.

In the Social Security determination, advancing age is factor in determining whether to award benefits and it treats advancing age as a limiting factor in ability to adjust to the work. On the other hand, long term disability carriers do not use age in assessing whether or not a policy holder meets its definition of disability. If your disability benefits have been delayed or denied, call long term disability attorney Nancy Cavey today at 727.475.7435 no obligation consultation.

What should I do if my Long Term Disability Benefits have been denied?

If your long term disability claim has been denied or terminated, the ERISA rules provide that you’ll have 180 days in which to file an appeal. You should request a copy of your complete file from the long term disability carrier and hire an experienced long term disability attorney to represent you in the appeals process.

Once the appeal letter is submitted under the ERISA statute, the long term disability carrier will have 90 days in which to review the material and decide whether it’s going to overturn or uphold the denial.

ERISA FAQ’s

What is ERISA?

ERISA is shorthand for the Employer Retirement Income Security Act of 1994. It’s Federal legislation that governs how insurance companies handle disability claims and it gives disability carriers a “get out of jail free card.”

In most ERISA governed claims, a court can only overturn the long term disability carrier’s decision if you prove that the denial was “arbitrary and capricious.” That’s the highest burden of proof in a civil court and it’s the “get out of jail free card” that disability insurance companies, like UNUM Provident, MetLife, Cigna/LINA, Aetna, Lincoln Financial, Prudential and The Hartford use to “play hardball.”

What Does ERISA Do?

ERISA, an Employee Retirement Security Act enacted in 1974, requires employers to provide participants with information about the plan, plan funding and important features. This information is to be provided regularly and automatically. Information can be available free of charge or it can cost money.

ERISA also sets the standards for employers for benefit accrual and funding rules. It is defined by the law as when an employee becomes eligible to participate in a plan, accumulate benefits, and have a right for those benefits. The funding of plans is also controlled by the law.

ERISA also guarantees the payment of specific benefits if a plan is terminated through a federally charted corporation, also known as the PBGC (Pension Benefit Guaranty Corp). Handling ERISA cases is our specialty and our knowledge allows us to serve our clients professionally and courteously. Our goal is to provide you with quality legal counseling and have you rest assured while we handle you ERISA case.

What Does ERISA Stand For?

ERISA stands for “Employer Retirement Income Security Act.” It was passed in 1974 for the purpose of protecting employee benefits for group plan participants. Unfortunately, disability insurance policies are subject to the ERISA regulations, which long-term disability carriers refer to as “Everything Ridiculous in the World Since Adam.”

ERISA, which is a federal statute, pre-empts state law. That means that there are no state law causes of action, including bad-faith claims handling.

Claims denial and appeal

If your long term disability claim has been denied or terminated, the ERISA rules provide that you’ll have 180 days in which to file an appeal. You should request a copy of your complete file from the long term disability carrier and hire an experienced long term disability attorney to represent you in the appeals process.

Once the appeal letter is submitted under the ERISA statute, the long term disability carrier will have 90 days in which to review the material and decide whether it’s going to overturn or uphold the denial.

View More About The Claims Denial and Appeal Process

Filing the law suit

Once the internal appeals process is exhausted, you’ll have the right to file a lawsuit in Federal court. However, no additional evidence can be submitted. The Judge is limited to reviewing the claims file. There are no depositions, hearings or even trials. That means that neither you or your treating physician is going to be able to testify.

The court will simply review the medical and vocational proof in the claims file. The appeals letter is, quite frankly, your trial and that’s why it’s crucial that you have an experienced disability attorney represent you in the appeals process.

How the Federal Judge makes a decision in an ERISA case

In most ERISA governed cases, the Federal court must defer to the long term disability decision so long as there is a “rational basis” or a “reasoned explanation for the decision.”

The Federal court will only overturn the insurance company’s denial, if you can show the denial is “arbitrary and capricious.” Even if you’ve been accepted as being disabled by the Social Security Administration, the long term disability carrier isn’t bound by that determination. The discretionary clause in the disability insurance company is their “get out of jail free card.”

When you file a lawsuit the best you can hope for is to recover the past due benefits that you are owned and have your monthly disability check reinstated. Unfortunately, there are no bad faith or punitive damages and attorney fees are rarely awarded. Most cases settle for 10% to 50% of the past and future value of your benefits.

What you should do today

Let’s be frank. Long term disability insurance claims are complicated. There are short deadlines and the appeal is your trial. There are a number of legal issues in many appeals including limitations, benefits due to mental illness or self reported conditions, exclusions for pre-existing conditions and even arguments about overpayments or reduction of benefits.

You would owe it to yourself to get help with your long term disability claim, appeal or lawsuit regardless of whether or not your long term disability policy is a group sponsored long term disability plan or an individual disability income policy.

Contact long term disability attorney, Nancy Cavey, who has helped hundreds of people with the long term disability insurance. She’ll personally consult with you, review your claim, prepare your appeal, and if necessary, file suit and represent you in court.

You purchased a long term disability policy to provide you with peace of mind. But, when you least can afford it, your disability carrier has denied your benefits and has rejected your appeal.

Your next and only recourse is to hire an ERISA/long term disability attorney to sue your long term disability carrier. Your attorney will file what is called a complaint which outlines the facts of your case and why you are entitled to benefits. There generally is no activity for 60 to 90 days after a claim is filed. Why? The complaint is filed and then served on a defendant who, in turn, has to “answer” the complaint within 20 erisa lawsuitdays after the lawsuit is filed.

Their “answer” is nothing more than the formal denial of the allegations of the complaint.

After the answer is filed, the court will issue a scheduling conference order directing the attorneys to confer about the scheduling of events in your case including, taking depositions, disclosing experts, filing motions, mediation, pretrial and trial.

The scheduling conference takes place about two to three months after the law suit is filed and establishes a time table for the parties to complete the discovery, conduct mediation and have a trial date.

Each court has their own local rules. These dates might vary depending on where you live. In any event, it may seem that nothing is happening until the scheduling conference. And, quite frankly, that’s incorrect. Many ERISA long term disability attorneys are drafting what’s called interrogatories and requests to produce which they can file as soon as the scheduling conference order is issued.

Need Help With Your ERISA Lawsuit? Contact an ERISA Attorney

You can learn more about the ERISA mediation process by contacting ERISA disability attorney Nancy Cavey who can help you with your claim regardless of where you live in the United States.

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