The Disability Application

Those with a long-term disability (LTD) who’ve been plodding through the process of claiming a disability insurance benefit can tell you: it’s no walk in the park. It typically starts with an ERISA denial by the disability insurance company, followed by an ERISA appeal, and finally, the intimidating reality of an ERISA lawsuit.

When the world’s largest disability insurance company gets a claim from someone whose professional license has been suspended, what happens? Can the policyholder collect disability insurance benefits? The short answer is: That depends. Disability insurance attorney Greg Dell and fellow lawyer Cesar Gavidia explain how a similar situation played out in a 2018 case against Paul Revere, which is now Unum Disability Insurance Company.

You get one shot

So why is the appeal so important? Why should you get help with filing an appeal if you have a denied disability claim?

The most important reason why you need to put in a strong appeal is that with Hartford, you only get one shot. An ERISA denial can be beaten, but you’ll need a good disability attorney. The appeal essentially is your trial in front of a judge. If the appeal is denied then all the judge will see is the administrative record. So, they won’t get any new testimony. You can’t file anything new, and the judge won’t get to meet the claimant. So, everything you want to show the judge needs to be in the appeal itself. That’s why it’s crucial that you hire a disability insurance attorney. With that being said, there are a lot of important elements in an appeal against Hartford for long term disability insurance.

There’s a misconception among holders of long-term disability (LTD) insurance policies that the company issuing the coverage will simply “pay up” when workers say they are disabled and can no longer perform their job duties. However, as with most things in life, it’s just not that simple.

Disability insurance attorneys Greg Dell and Stephen Jessup shed some light on what really happens, specifically the importance of clarifying the claimant’s pre-disability occupation and the specific duties involved. There’s high potential for a disability claim denial and eventual ERISA lawsuit if the disabled policyholder doesn’t know exactly how to present the crucial issue of defining the occupation – and proving how his or her disability now makes it impossible to perform that particular job.

Many people receiving disability insurance claim denials believe they can file an ERISA lawsuit and receive well-deserved justice for denied benefits. While this is often true, especially if you work with a competent disability attorney, it’s not quite as cut-and-dried as one might imagine. There are several potential outcomes when taking a long-term disability (LTD) case to court.