In this video and article disability insurance attorneys answer the question: Do I Need a Lawyer For a Long Term Disability Claim? If you are considering hiring an attorney to represent you in your battle to receive disability income benefits, read this article or watch this video to get your questions answered. Topics covered include:

  • The Reasons a Disability Insurance Income Policy Holder Will Benefit From Attorney Representation
  • What is “Return To Work”?
  • When Should A Disability Insurance Policy Holder Hire an Attorney?

GREG DELL: Hi, I’m Greg Dell with attorneys Dell & Schaefer here with attorney Steven Jessup. And we’ve started this series of most frequently asked questions that we get with regard to disability insurance claims. And the question that we have today is, “Do I need a lawyer for a long-term disability claim?”

And Steve, that’s a question we get all the time, even though people call us and ask us that question. But let’s get into obviously that’s what we do for a living. So obviously, the answer to this is, yes, you should have a disability lawyer. But let’s talk about the reasons why and how a person will benefit from having a disability lawyer.

The Reasons a Disability Insurance Income Policy Holder Will Benefit From Attorney Representation

STEPHEN JESSUP: I think the biggest thing with it is going to be just the experience. Yes, claims get approved without attorneys. There are instances where that happen. Not everyone needs one.

But if you’re in an inclination that you might, it’s always good to call and go because you think, hey, I paid for this policy out of my own payroll or whatever the case may be. I’m entitled to these benefits. They told me I was going to get paid to the age of 65, all these things.

And yes, certain portions of these policies, that’s correct language. But it’s the application of the provisions of your policy that are going to get you the benefits. So having a lawyer puts you at a distinct advantage in being able to secure your benefits and in dealing with the insurance industry and your insurance carrier because this area of the law is unfortunately very one-sided if it gets to a litigation for an insurance company. So you really want at the ground level, get in and get an attorney involved if you can.

GREG DELL: Yeah. I think the simple answer to this is that it’s all about being prepared. And if you don’t have a disability lawyer, you really don’t know what to expect. And I think you get lulled into a false sense of security because the disability insurance claims people are trained to, I would say, be nice to you or act like they’re trying to help you.

I don’t want to say all of them are the devil in disguise because they’re not really. But look, they’re employed by the insurance company. And it’s in their kind of– there’s an inherent conflict of interest.

STEPHEN JESSUP: And then there’s that culture and the training. And they do– how they evaluate. And maybe they look at things with skepticism. And we’ve worked with claims people that we really like. We know who they are.

And there’s some that we go, they may be the devil-in-disguise-type. They’re really bad. And often, we hear from people who contact us. I should’ve gotten a lawyer involved earlier. They were sweet as can be to me.

Then next thing I know, my claim was being denied. They’re not returning my calls and stuff. So you’re right, it’s just one of those things. And in a way, it shows the insurance company you’re very serious about this claim.

That you got a lawyer involved because it’s a serious matter. And they do– unfortunately, it shouldn’t be this way– but they do treat an attorney differently than they will treat an insured. They make sure that they’re going to do everything by the book, cross their T’s and dot their I’s. And they don’t play loose and fast.

Like, some of the stories we hear from people who call us about, well, they told me this. They told me that. They threatened me with that. That doesn’t happen when you have a lawyer involved.

What is “Return to work”?

GREG DELL: I think it’s just it’s very easy to make a mistake in this area. And then one little mistake results in the claim denial. But what I really want people to understand here is that these disability claims people are trained for what’s called return to work. Can you explain what that is? And even talk about this return to work manual that’s out there and how that could affect a person’s claim.

STEPHEN JESSUP: Yeah. Well, generally, with the return to work, what happens with that, especially if you have any type of surgery especially, there’s kind of this information out there– there’s resources that they use to determine well, if you had this procedure done, it should take x amount of time to recover from it and return to work.

So once you file a claim based on your medical condition, they almost have a ticking time clock as to when they expect you to return. This will really become problematic for you if your short-term policy is administered by the same insurance company that does the long-term policy. So to make that a little clearer, a short term more often than not.

Say, for instance, you have a Hartford policy. Hartford is not going to insure the short-term disability. They administer it for your employer. And the funding comes from your employer’s pocket. Hartford just says, hey, pay the claim.

When it goes to long-term, it’s insured by Hartford, which means they’re paying you out of their pocket. So on these short-term claims, you file them. There’s a return to work plan in place, or this idea of when you should. More often than not, that’s during the short-term disability period, a.k.a. when the insurance company isn’t responsible for paying. So if you go beyond that point, there is a likelihood increased opportunity that they will deny your claim because they don’t want it to get to long term because they don’t want to have pay with their own money.

GREG DELL: Right. So you got that situation to deal with transitioning from short to long term. You got the disability claims person thinking, I got to get this person back to work because the manual says you should be back to work in x amount of time. And why haven’t your doctors gotten you better?

STEPHEN JESSUP: Yeah. And we get plenty of calls where people are short term– no problem. As soon as it goes to long-term– denied. And they’re denied by the same company using the exact same information that was used to approved the short-term claim. And it’s because, in my opinion, that’s the way the policy’s become funded at that time.

When should a disability insurance policy holder hire an attorney?

GREG DELL: And in terms of using a lawyer for long-term disability, at the application stage obviously is probably one of the best times. And you get the biggest bang for your buck because you get a lawyer involved early shaping the whole claim. But then obviously, if you have an appeal, another option to get a lawyer involved– you still don’t have to. But again, and you watch all of our appeal videos that we have out there.

STEPHEN JESSUP: That’s when it’s really smart.

GREG DELL: –and how we talk about appeals, a whole other gamut of situations. And then of course, if your appeal gets denied, then the only option is to file a lawsuit. And nobody really files their own lawsuit without a lawyer, even though, again– you could– you will not know what the hell you’re doing unless you are an attorney or trained in this area because the risk is highly complex.

So there’s endless reasons to end up having a lawyer to help you. The nice thing is for claimants who are watching this video and saying, OK, maybe I do need a lawyer. Maybe I don’t is that we’re going to offer a free initial phone consultation.

So what we suggest you do is go ahead and give us a call where we will review a copy of your disability policy. Whatever status your claim’s at, we’ll let you know immediately if we think we can help you. We have lots of information available on our website that you can look at to see if it helps you with your specific carrier.

Our clients are all over the country. We always do these videos that you see on YouTube. We have hundreds of them. And we encourage you to subscribe to our videos so that you can see all of our upcoming videos as well. And we really look forward to the opportunity to speak with you.

If you need assistance applying, appealing, or filing a lawsuit to receive your disability income benefits, contact any of our disability insurance lawyers for a FREE consultation to discuss how we can assist you.