Long Term Disability (LTD) Lawyer in Virginia Beach, VA
A Lawyer Can Help
Do you have a claim under a long term disability plan (LTD) because of an injury or illness? Has your claim been denied?
Long Term Disability benefits offered through private employers are covered by ERISA (Employee Retirement Income Security Act). ERISA controls nearly everything about the procedure for appealing a denied claim.
With more than 35 years’ experience in injury and disability law, the Disability Law Center of David L. Horne, PLLC can help submit the initial application or file an appeal when benefits are denied.
Why Hire an Attorney
Federal law governs most private employer who provides any type of group insurance or retirement plan. The Federal ERISA (Employee Retirement Income Security Act) law controls nearly everything about group benefits including the appeal procedure.
Winning a long term disability (LTD) claim involves a complex process requiring knowledge of the law, and the presentation of medical evidence. This requires experience in legal and medical issues. We gather medical documentation and work closely with our client’s physicians in developing proof of disability.
Special Rules for ERISA Disability Appeals
Most ERISA disability plans provide for an appeal procedure that places the disability decision in the hands of the insurance company managing the plan. In most cases, after the second denial there is a right to file a suit in Federal Court.
No new evidence will be reviewed by the judge, and only the evidence in the record submitted to the company before the suit was filed will be considered by the court. The insurance company will win if there was some reasonable basis for its decision. The judge will not make a new independent decision.
It is critical to the success of the claim that all the proof of disability be presented early in the appeal process. An experienced attorney can do that. The attorney can also anticipate and try to preempt some of the insurance company’s tactics such as calling the client’s physician in an effort to manipulate the physician into answering questions in a way that will damage the claim.
We understand the financial stress disability from injury and illness place on our clients and their families, and consider this in the fees we charge. After applying for long term disability (LTD), it is usually required that a claim for Social Security Disability Insurance (SSDI) be filed. We usually represent our client in both claims. In the Social Security Disability Insurance (SSDI) claim no legal fee is paid unless benefits are awarded.
We will evaluate the SSDI and LTD claims and try to structure a fee in the long term disability (LTD) claim that considers our client’s circumstances and the likelihood of success. In many instances we are able to structure a fee where a substantial portion of the fee is paid only if benefits are awarded. Please call us for a fee quote.
We Maximize Overlapping Benefits from All Claims
We maximize benefits and compensation from all available sources. If there is a claim for a work injury or personal injury, and a claim for long term disability (LTD) or under another disability program or plan, applying the regulations and law is complicated. Disability programs and plans, and claims for personal injury and worker’s compensation frequently overlap.
We can represent you in your Social Security Disability (SSDI) claim, and other types of disability and injury claims such as claims for Virginia Retirement System (VRS) Disability, motor vehicle accidents and other personal injury (PI) and workers compensation.
Your Benefit Amount
The long term disability plan must be reviewed to determine the benefit amount and the definition of disability. Monthly benefits are usually a percentage of earnings, not including commissions or overtime. While most plans provide the potential for benefits through retirement age, except with the most severe disability, it is likely that there will be continuing frequent reviews.
Under many plans, a person can receive benefits for two (2) years if disabled from the material duties of her own occupation. After two (2) years it is often required that there is a disability from any occupation.
Some plans will limit the benefit period to two (2) years in the case of mental disorders such as depression, and with conditions whose symptoms cannot be proven with diagnostic testing such as migraine headaches and fibromyalgia.
Usually plans call for an offset or reduction for other income such as workers’ compensation, disability retirement payments, and Social Security Disability Insurance (SSDI). Often there is still a minimum payment, sometimes as little as $100 per month.