Capitan Law is happy to evaluate your need for claim management regarding your long term disability claim before a denial or termination of your benefits has occurred. We will engage in long term disability claim management if the insurance company has begun to show signs of threatening your payment of benefits. We can never guarantee the future payment of your LTD benefits when we get involved, but we can work with you and your medical providers to possibly avoid a wrongful denial or termination of your benefits. We engage in long term disability claim management on a contingent fee basis. We do not require any money up front. We do not charge hourly fees. We do not receive payment of our fee unless your benefits continue.
While most of our law firm’s work focuses on the development of appeals and the filing of lawsuits regarding disputed claims, there are certainly times when disabled workers require legal representation before a claim is denied or terminated. The goal of getting an experienced long term disability attorney at Capitan Law involved when the claim administrator (usually an insurance company) first begins to hint or suggest that you are no longer disabled according to the group LTD policy is to try and avoid a denial or termination of benefits. The benefits of claim management to our disabled client includes continuation of benefits without interruption, easing the burdens and stress of interacting with an insurance company that has began to threaten your and your family’s financial livelihood, avoiding a negative ripple effect that could end health insurance coverage or other essential benefits, and lower attorney fees by comparison to fees associated with legal work on appeals and lawsuits.
Our clients are good, hard-working people that had great jobs and lengthy careers prior to their disability. Our clients are savvy and educated. They know when the insurance company has shifted its tone or posture in a way that threatens your payment of long term disability benefits. Situations where Capitan Law Law can become involved to help a client possibly avoid a denial or termination can include one or more of the following “red flags”:
- The insurance company’s claim representative explains to you that an “any occupation” review of your long term disability claim is beginning and suggests that you can likely perform less demanding types of employment.
- The insurance company is requesting that you attend an in-person medical exam, or a functional capacity evaluation.
- The insurance company is conducting video surveillance of you.
- The insurance company is requesting that you meet with a “field investigator” to undergo an in-person claimant interview.
- The insurance company requests forms, medical records, and medical opinions in a non-stop cycle alleging that your medical records “lack objective proof” or that your functional restrictions or limitations are “unclear.”
- The insurance company’s claim representative explains that the medical review of your claim is being “escalated” to a physician based on the suggestion of a nurse case manager.
- Your long term disability claim has been transitioned to a new claim representative that treats you very differently and seems to have a different personal opinion regarding the nature and severity of your medical impairments.
- The insurance company is requesting that you work with a vocational rehabilitation counselor for retraining or to assist you in a job search.
- The insurance company approves your long term disability claim but denies or terminates your life insurance waiver of premium claim alleging that, while you may be unable to perform your own occupation, you are able to perform other types of work.
The above is a sampling of the common “red flags” that let the disabled worker know that something is wrong, or possibly about to go wrong. You do not need to endure these challenges alone. It is possible that the experienced disability attorneys at Capitan Law Law can climb in to your corner to help fend off or mitigate these looming threats to the payment of your long term disability benefits.
Please contact us for a free legal consultation if you would like to learn more about the long term disability claim management services of Capitan Law Law.
Claim Management Following Reinstatement of Your Long Term Disability Benefits
In almost all cases, Capitan Law continues our legal representation of our clients whose term disability benefit claims have been reinstated after a long and trying administrative appeals process. We have won the battle, but not the war.
Following a hard-fought reinstatement of LTD benefits the insurance company will continue to periodically review your claim. If an appeal is successful, your LTD claim is typically returned to the same claim representative that denied your claim in the first place – to the very same person who previously alleged that you are not disabled. The person we just proved wrong will now be reviewing your claim moving forward. We have seen claim reviews occur as quickly as three to four months after an exhaustive nine-month appeal review process. The definition of disability may soon transition to an “any occupation” standard of disability. Your continued medical care requires consideration. Point being – we may have been successful, but our client’s continued payment of benefits can again be threatened. Our goal is to minimize those risks and work to keep our clients being paid LTD benefits for as long as they remain disabled per the terms of the specific long term disability policy.
Contact a LTD Claim Management Lawyer
Capitan Law Law prides itself on continuing to help our clients after we have already obtained significant measures of success in their claims. We stay in our clients’ corners and work to keep future threats at bay. Contact Capitan Law today at (267) 419-7888.
