Mistakes to Avoid When Claiming Disability Benefits
Employees who become disabled from work may apply for long-term disability benefits under the Employee Retirement Income Security Act (ERISA) or another employer-sponsored group disability insurance plan; however, correct completion of the application process can be all-important to success in NJ ERISA disability claims. The process can be complicated and challenging and mistakes can be costly. They can put the whole award in jeopardy. A disability insurance lawyer helps to build a solid disability claim so that you receive the benefits you’re entitled to.
Common Mistakes to Avoid
For fastest and best results, avoid six common mistakes many NJ ERISA disability claimaints make:
- They assume, if their employers say they are too sick or disabled to work, they have enough evidence to support their NJ ERISA disability claims for benefits. The insurer financing the plan, however, not the employer, pays the long-term disability benefits. Therefore, insurers decide at least initially whether a claim meets the legal standard or definition of disability under ERISA plan. For this reason, it is risky to assume that an employer’s opinion about the claim is or should be conclusive for the process. Smarter claimants submit all supporting evidence available, especially medical findings and conclusions, in addition to employer opinions.
- They rely solely on advice from their human resource offices. This mistake is similar to the first. For viability, they put all the metaphorical eggs of their claims into one basket. Human resources may mean to encourage claimants and make them feel good about their prospects but, even if trained in interpreting disability insurance terms and policies, they have no actual authority or official influence over the insurers, who make the initial decisions on the claims.
- They document their disability claims only on forms provided by the insurers. Professional health care providers must answer certain questions on these forms, but more information still may be necessary for favorable decisions on complicated claims that may need additional explanation or information to prove disability to the insurers’ satisfaction. Claimants should ask their examining physicians to explain any terms of their disability insurance policies unclear or difficult to comprehend. They should ask for medical reports that explain fully how their conditions prevent them from performing essential duties of their jobs. Any extra charge for additional detail is a good investment.
- They engage or participate in activities against medical advice. Insurers monitor claimant activities. If they engage in conduct in medical opinion too strenuous, unhealthy, or dangerous for their claimed disability, insurers might investigate for fraud, and at best investigations delay outcomes on their claims. For quickest and best outcomes, claimants should follow doctor orders or instructions faithfully.
- They use insurer personnel to help them file for benefits. Generally, recipients of long-term disability benefits must file for Social Security benefits as well. Sometimes an insurance company or an affiliate offers to help with the filing process. There is reason to hesitate before using such help. In some cases where insurance companies guide claimants in selecting disabilities on their Social Security applications, those claimants later had inordinate difficulty proving their long-term disability claims.
- They retain or work with lawyers inexperienced in ERISA practice. The ERISA law is complex with many rules governing the disability application process. Deadlines are strict, and not all arguably relevant evidence may be admissible during an appeal. A disability attorney in New Jersey assisting and representing ERISA claimants must have the knowledge, skills, abilities, and experience necessary in this area of law.
Contact Our Disability Insurance Lawyer in New Jersey
Uscher Quiat Uscher & Russo, PC (UQUR) is one of the most experienced and respected law firms for NJ ERISA disability claims against insurance companies. UQUR advises, represents, and advocates for clients whose insurers fail or refuse to pay disability, health, life, and long-term care insurance claims. UQUR has extensive experience with complex ERISA administrative appeals and federal court cases. For answers to questions about ERISA claims, call 800-797-5575 to arrange a consultation with a disability insurance lawyer in New Jersey.