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You shouldn’t have to fight for your disability insurance benefits when you’re already struggling to recover after an injury. Fortunately, a Los Angeles disability attorney can do the fighting for you.
Serious injuries can be debilitating and life-altering in every facet of life, from the personal to the professional. After a serious accident, you may be unable to work for a short- or long-term stint. It’s an unfortunate truth, but many workers find themselves with injuries that can put them off the job for a few weeks. Some are even out of work for good.
When you began your job, you might have been provided or purchased disability insurance, but when your accident has left you injured and unable to work, how do you file a claim for those benefits? These benefits can help you keep going after a serious accident, but filing a disability insurance claim can be confusing and difficult, especially when you’re dealing with unfair claim denials.
California disability insurance rules are often strict, and when you have been hurt and left disabled, that can feel overwhelming. But with the help of a Los Angeles disability lawyer at Haffner Law, you can get the help you need to handle your disability claim.
Types of Disability Insurance in Los Angeles
After your accident, the first step is to look at what sort of disability insurance you have and what you need for your situation. Disability insurance comes in two main types: long-term and short-term. Your coverage will depend on the plan you have chosen through your employer or purchased through a private insurer, but there are a few key differences between the two.
Short-term disability refers to insurance that covers you for a short period of time. This insurance usually lasts between three and six months, but in California, your policy may last up to a year. These policies tend to be less expensive, but they will not last as long as a long-term plan.
Long-term disability, on the other hand, can support you for a lifetime. If your disability lasts for longer than six months, long-term disability should cover your needs for as long as your disability lasts. Unfortunately, these policies can be significantly more expensive, and it is common to find yourself waiting for a few months before these benefits are available.
Am I Eligible for Disability?
Many Los Angeles residents find themselves on disability before they retire, and you may be one of them. The process can take some time, and it does involve several steps, but you may receive a significant portion of the wages you were previously earning.
If you believe you deserve disability compensation, you may need to follow a few steps to get it:
- Review Your Plan – If your employer offers insurance or you have purchased your own plan, now is the time to review it. Be sure you know what type of disability insurance you have, whether you meet the requirements, and whether it will cover your needs.
- Visit Your Doctor – A medical professional will review your case and make sure you meet the definition of disabled. The opinion of a doctor can help strengthen your claim and the likelihood that you will receive your benefits.
- Submit Your Claim – If you receive disability insurance from your employer in Los Angeles, you will need to submit as much medical evidence as possible, as well as any required supporting documents. Having as much information as possible will typically help you get your claim approved without any need for appeals or denials.
- Receive Your Claim Decision – Within roughly forty-five days, you should receive an answer about your claim. This could be an approval for your coverage, a denial, or a delay. You may be asked to provide more information, so be sure you are as prepared as possible.
If you receive an unfair delay or denial after following these steps, call a disability lawyer in Los Angeles as soon as possible.
Why Do Disability Insurers in Los Angeles Deny Claims?
Wouldn’t it be great if the benefits you’ve been paying for were there when you needed them? Alas, we’re dealing with insurance companies here, and they care about only one thing: profits. Disability insurers are no different than any other type of insurance company—they will do whatever they can do get out of paying on a claim.
The law really doesn’t support the insured; instead, it allows the insurance companies to issue policies, interpret those policies to their own ends, and be the decision-makers on whether you meet their policy requirements. If that sounds crazy to you, that’s because it is. That’s why it’s so important to have an attorney on your side.
An insurance company is far less likely to take advantage of a claimant who has legal representation. Even when you think you have the most legitimate claim ever filed, you can still be denied, sometimes for the silliest of reasons. Take a look at some of the common reasons disability claims are denied in Los Angeles:
- Paperwork Issues – Believe it or not, one of the common reasons insurers deny disability claims is because of paperwork issues. Sometimes, it’s a mistake made on the paperwork; sometimes it’s missing documentation; and sometimes it’s because you didn’t file the paperwork within the set deadline.
- Insufficient Medical Evidence – If you’re claiming disability, you will obviously need to have proof that you are disabled. The more medical evidence you can collect, the better. If you fail to provide the insurer with all the medical documentation it is requesting, it will deny you.
- You Don’t Meet Their Definition of Disabled – Every insurance policy will have a definition of what is considered “disabled.” If you don’t meet the exact definition, the insurer will deny you. Your attorney can help you prove that your injuries do meet the definition and that you’re qualified to recover benefits.
- They Have Evidence That Contradicts Your Disability – Some insurance companies will actually investigate you and your claim to determine your claim’s legitimacy. They will take photos and videos of you in an attempt to catch you engaging in activities that you’ve said you can’t do.
These are only a few of the many reasons insurers might deny your disability claim. To boost your change of getting the money you so desperately need, call a disability lawyer in LA who can protect your rights and fight for you.
Appealing After a Disability Denial
What happens if you have been disabled in an accident, but your Los Angeles disability claim is denied? This does not have to be the end of your claim: Even most private insurance plans give you the option to appeal your denial.
If you received a denial, your insurance company should provide a detailed note on why your claim was denied. This document will be key to getting the benefits you need. When you receive this notice, study it carefully. What is missing? What could you add when you submit your appeal?
Missing evidence is an especially common issue when filing a disability claim. Anything that can show that you have been disabled can help with your claim.
If you did not do so with your first claim, be sure to include an official medical opinion in your appeal. This can be used as evidence that you are, in fact, disabled. It’s the word of a medical professional—a voice of authority may help convince the insurance company of your need.
Once you have received notice that your claim has been denied and that you have a chance to appeal, it’s important to review any parts of your policy that you don’t understand, especially if they led to your denial. If you have trouble with your policy information, a consultation with a Los Angeles disability denial attorney may help. We can decipher your denial and help you gather all the evidence you need.
Your Los Angeles Disability Benefits
Once you are unable to work, you may find that, depending on your plan, you may receive different benefits from long-term and short-term disability insurance.
A short-term disability policy is typically meant to handle a few months of disability coverage. You may receive the full amount of your paycheck for the first few months, covering your time off or your time as you transition into long-term disability, if you have both types of coverage.
While it sometimes doesn’t cover the full amount of your paycheck, long-term disability is designed to cover your needs for longer. Most insurance companies will review your pre-tax income and give you a percentage of that. This is typically 60 to 70 percent of your original income before your accident.
The benefits for a private disability insurance plan generally cover most of your wages that would be lost during your disability leave. While these policies generally do not cover healthcare or other care services for your disability, they can provide the peace of mind you need when you’re hurt and in need of help.
What Does a Los Angeles Disability Claim Attorney Really Do for You?
Many people believe that filing a claim on their own will be easy and they can’t possibly imagine that their claim would be denied—that only happens to frauds and cheats, right? Unfortunately, a claim denial can happen to anyone, and you may find yourself angry and frustrated when it happens to you.
If you hire an attorney before you even begin the claim process, you have a better chance of avoiding a denial entirely. However, even if you hire a lawyer after your claim has been denied, we can still help you. Your attorney will do the following and more to ensure that you receive the disability benefits you need to provide for your future:
- Help You Understand Your Policy – Disability insurance policies can be confusing, and a lawyer can help you decipher the legal jargon so that you will understand what benefits you’re entitled to and how to go about filing your claim.
- Assist You with Filing All Paperwork to Ensure It’s Accurate and Complete – Filing the paperwork is an important part of the claim process. If you make errors or omissions, your claim will surely be denied. Partnering with an attorney will mean the paperwork will be done correctly, and you’ll be taking away one of the common reasons insurers deny disability claims.
- Gather Medical Evidence and Documentation to Prove Your Disability – You will need a lot of medical evidence of your disability. Your attorney will walk you through this process of evidence collection. We will also work with your doctor to confirm that your injury is properly documented in a way the insurance companies will accept.
- Help You Fight a Claim Denial – We aren’t afraid to fight for you. We will review your case, including all the paperwork and evidence you’ve submitted thus far, and we’ll determine what else the insurance company will need. If negotiations completely break down, we won’t hesitate to head to court.
Contact a Los Angeles Disability Attorney
When you’re injured and unable to work, disability insurance can help you get back on track or sustain you during a permanent illness or injury. Disability insurance is there to help you, and when you need that coverage, getting help with your claim is for the best.
Understanding disability insurance laws can be difficult—first applications for disability coverage are often rejected. When this happens, you will likely need someone who understands the appeals process and who can make sure you get the compensation you need to maintain your quality of life.
If you are having trouble with your disability claim or believe you have a case we can help with, give us a call. A Los Angeles disability lawyer with Haffner Law can walk you through the appeals process and help you get your benefits. For a free, no-obligation consultation, fill out our online contact form below or give us a call at 1-844-HAFFNER (423-3637).
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