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

While Capitan Law is not licensed to practice in Oregon courts, our long-term disability lawyers assist disabled Oregon 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 Oregon 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 Oregon 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 Oregon

With regard to the long-term disability laws in Oregon, the federal Employee Retirement Income Security Act (ERISA) plays a pivotal role. Why? Because ERISA has the authority to preempt state laws on these disability benefits. In layman’s terms, “pre-emption” means that federal law takes precedence over state law. Even if Oregon has specific rules, everyone must adhere to ERISA standards.

This uniformity ensures clarity and fairness across the board. Whether you’re an employee seeking benefits or an employer offering them, ERISA’s guidelines provide a clear path to follow.

Eligibility Requirements for Long-Term Disability in Oregon

Private companies and public agencies choose their own insurance companies, and policies vary widely among insurers. This means that eligibility criteria can differ from one policy to another. That’s because in Oregon, as in many other states, the insurance companies typically set the eligibility requirements for long-term disability policies.

But there’s good news for the Oregon workforce: If you’re a full-time employee and your employer offers long-term disability coverage, chances are you qualify to purchase coverage. It’s one of the perks often extended to full-time staff members.

Oregon’s Definition of Long-Term Disability

Generally, a disability must have lasted or be expected to last at least six months before an insurer will consider it “long-term” under the restrictions of their policy. However, this can differ, as some insurance providers require a disability to last a full year before they pay any benefits.

While this timeframe provides a helpful guideline, there are always exceptions. Insurance companies might make allowances for terminal or extremely severe health conditions that may not have a prolonged duration but are undeniably serious. It’s also essential to note what conditions long-term disability policies might exclude, such as:

Substance abuse and related conditions
Disabilities stemming from self-inflicted injuries
Disabilities from certain criminal activities or incarceration
Conditions that developed during foreign residency or travel to certain high-risk regions

Long-Term Disability Benefits in Oregon

Long-term disability benefits in Oregon are as diverse as the employers and insurance providers offering them. With a wide range of policies available on the market, the benefits each policy offers can vary considerably. Even with the variety of offerings from policy to policy, there are a few common benefits that many long-term disability policies typically provide:

Waiver of Premium: If you’re on long-term disability, some policies will waive the requirement to pay premiums while you’re receiving benefits.
Income Replacement: This is the purpose for which policies are purchased, and most policies provide a percentage (often 50% to 70%) of the insured’s pre-disability salary.
Cost of Living Adjustment (COLA): Some policies increase benefits annually based on the Consumer Price Index or another measure to keep pace with inflation.

While these are the most common benefits, always remember that the specifics can vary. It’s vital to thoroughly review your policy or consult an attorney. Capitan Law can help you understand the breadth of benefits available and ensure you’re equipped to make informed decisions.

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 Oregon, call us at (267) 419-7888 for assistance with filing for benefits.