New Mexico Residents – Get Assistance from Expert Long-Term Disability Insurance Lawyers

While Capitan Law is not licensed to practice in New Mexico courts, our long-term disability lawyers assist disabled New Mexico citizens with ERISA-governed disability insurance claims. As discussed in more detail below, ERISA is federal law. If you have a claim that is governed by New Mexico law, please contact a local attorney licensed to practice law in your state to assist you with that matter.

Facing a non-work-related injury or illness can threaten your financial stability. Let Capitan Law, your experienced long-term disability insurance lawyers, guide you through the application process of disability insurance via your employer’s ERISA-governed policy. Be aware that this process is complex, with insurance companies often attempting to minimize or deny benefits owed.

Our long-term disability attorneys will defend your rights, collate necessary evidence, and strive for the benefits you deserve. We offer free consultations, so call us at (267) 419-7888 today.

About ERISA and Long-Term Disability Insurance

The Employee Retirement Income Security Act of 1974 (ERISA) typically governs long-term disability insurance plans provided by employers. That means if your employer pays for part or all of your disability coverage, you must follow the rules and procedures set forth by ERISA. The benefits that are provided by your LTD insurance policy will replace a portion of your income for an extended period, which is generally determined by your plan and the nature of your disability. As mentioned above, these claims can get complex. An ERISA benefits claim attorney will provide knowledge and experience to guide you through the process.

Each policy varies slightly in its definition of disability, but in general, to be eligible for benefits, the injured individual must be unable to perform the duties of their own job. After some time, eligibility for benefits may change and may stipulate that the individual cannot complete any work at any job due to their disability.

Differences between LTD Insurance and Workers’ Compensation

The main difference between long-term disability and workers’ compensation is that LTD benefits provide a partial-wage replacement for someone who becomes injured while doing something unrelated to their work, while workers’ comp is for job-related injuries and illnesses. If you are injured at work, you may still be able to apply for disability insurance benefits depending on the specific language contained in your policy. However, if you are eligible for both types of benefits, LTD benefits are usually offset by any benefits received through the workers’ comp claim.

Both insurance policies can come from your employer; however, not all businesses in New Mexico have a legal obligation to provide long-term disability to their employees. If your employer does not offer LTD insurance, you may have purchased your own individual disability plan and paid the monthly premium. It is also possible to have a policy you purchased yourself and one provided through your employment relationship. If you sustain an injury or get sick, you’ll be able to collect benefits based on your policy type. The attorneys at Capitan Law can help you understand the options available to you and are well-equipped to help you navigate these complex issues.

Disabilities Qualifying for LTD Benefits

LTD policies typically cover severe medical conditions that prevent you from maintaining your previous work schedule. These disabling conditions can include autoimmune diseases, back and spine injuries, mental health disorders, and many others.

Filing a Long-Term Disability Insurance Claim

Immediately file a claim when an injury or illness impedes your work. First, file a short-term disability claim; when these benefits end and your disability persists, your LTD benefits can commence. Start the process early to resolve any claim denials or delays promptly. We are happy to assist you in the long-term disability application process.

Common Reasons for Claim Denial

LTD claim filing is complicated, with any errors potentially leading to denials. Common reasons for denial include discrepancies in the definition of disability, missing medical records, procedural errors, inconsistent information, bad faith by insurance, and lack of understanding of rare medical conditions.

Appealing a Denied Claim

You can appeal a denied long-term disability claim. Under ERISA, you must file the appeal within 180 days from the denial notification date. At Capitan Law, we understand the appeals process and will help you through each necessary step.

Long-Term Disability Laws in New Mexico

Long-term disability laws may vary from state to state, but one unifying force governs them all: the federal Employee Retirement Income Security Act, commonly called ERISA. While New Mexico has its unique rules designed to protect and support those with long-term disabilities, it’s crucial to understand that these state-specific laws operate within the framework of ERISA.

Why does this matter? ERISA is a federal law, which means its guidelines and regulations have overarching authority. So, even as each state crafts its provisions and stipulations tailored to its residents, every state law must comply with ERISA standards.

For those dealing with long-term disability, this dual layer of protection—both state and federal—can be beneficial. It ensures consistency and fairness across the board. The experienced team at Capitan Law can help you understand the intricate balance between New Mexico’s regulations and ERISA’s overarching mandates, ensuring you are well-prepared to assert your rights.

Eligibility for Long-Term Disability in New Mexico

In New Mexico, if you want to understand the eligibility criteria for long-term disability, the answer often lies with your employer and their chosen insurance company. They are the primary entities that determine eligibility guidelines, which means standards can differ from one organization to another.

For many workers in New Mexico, there’s good news. If you’re a full-time employee and your employer includes a long-term disability plan in their benefits package, you’re likely eligible to obtain an LTD policy. However, there are a few details to know. Many plans stipulate that you must be disabled for a year or even longer before you can claim any benefits. This means it’s essential to understand the specifics of your policy and keep a keen eye on the eligibility timeframe.

Long-Term Disability Plan Exclusions in New Mexico

Furthermore, it’s not uncommon for plans to exclude certain conditions from coverage, such as:

Pre-existing conditions: If you had a health issue before your coverage began, your long-term disability insurance policy may not cover it.
Mental health disorders: Some plans might limit coverage for mental health disorders or even exclude certain conditions entirely.
Conditions related to substance abuse: If a disability arises due to drug or alcohol misuse, many plans won’t offer coverage.

Long-Term Disability Benefits in New Mexico

While specific benefits can vary depending on the policy and the insurer, these are the most common benefits under long-term disability insurance plans in New Mexico:

Monthly Income Replacement: Typically, this is a percentage of your regular wage, often ranging from 50 percent to 70 percent.
Waiver of Premium: Should you become disabled and start receiving benefits, some policies will waive the requirement to continue paying premiums.
Cost-of-Living Adjustments (COLA): Some policies come with COLA provisions to ensure that benefits remain in line with inflation and rising living costs. This means that your benefits may increase over time to account for these economic shifts.
Extended Benefits: Some policies offer extended benefits for conditions that might last longer than the standard coverage period, ensuring you’re adequately protected if your illness or injury requires prolonged treatment.

Contact our ERISA Benefits Claims Experts

At Capitan Law, we comprehend the urgency of receiving LTD benefits. We work tirelessly to protect your rights and ensure fair treatment during the claims process. If you’re unable to work in New Mexico, call us at (267) 419-7888 for assistance with filing for benefits.