FAQ – How do I file a claim for disability benefits? | Clearwater Long Term Disability Lawyer

Well, that depends on what the summary plan description or disability policy says about when and how you file a claim for disability benefits.

I think that as soon as your physician says that you are disabled, and you agree you’re unable to work, you should file a claim for disability benefits. When should you file the claim?

There is no easy answer to that question, because, again, a summary plan description or policy may tell you when you have to file for disability benefits. If you don’t file your claim for disability benefits at the right time, the disability carrier may say that they don’t owe you any disability benefits, because you screwed up.

I always suggest that the claim for disability benefits be filed in writing on the day you last worked. Get the disability forms from your employer or the disability carrier, complete them, keep a copy and give one to your employer, and send the other copy to the disability carrier certified mail, return receipt requested.

If you don’t have the forms, write out a note that says you are claiming disability benefits, and the date on which you claim you become disabled. Attach to your disability note any supporting medical documentation of your inability to work. Give your material to your employer and asked for a receipt. Send it to the disability carrier certified mail.

The ERISA regulations require that your request for disability benefits comply with the disability plans procedures and rules set forth in the summary plan description for policy. Even if these procedures are burdensome or unreasonable!! You need to try to comply with the rules.

And, by all means keep a copy!

Now start counting the days until you get a response!

If you have any questions, please give us a call at 727.894.3188 or contact us online by clicking here.

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FAQ – Okay, I got the plan. Now what does it say? | Clearwater Long Term Disability Attorney

Congratulations! You’ve gotten the summary plan description which is just what it says – a summary of the plan. Let’s hope you got the policy.

Sometimes we find that there is a difference between what’s in the plan and what’s in the policy. For the sake of this posting, I will just talk about what’s in the disability policy.

Remember when I said there was no uniform disability policy in the United States. There are, however, some basic things I look for when I review a disability policy.

1. Is there a provision that requires you to have a policy for certain length of time before you can claim entitlement to disability benefits? If so, how long is it?

2. Is there a provision that excludes certain physical or mental conditions from coverage? If so, what’s excluded?

3. Is there a provision that limits coverage for certain physical or mental conditions? If so, what are those provisions, and how long is the coverage?

4. What is the definition of disability? Does the definition require objective proof of your disability?

5. What is the elimination period or the time you must be disabled before you are entitled to receive benefits?

6. How does your plan define occupation? Is it your occupation? Your occupation as performed for your employer? Your occupation as performed in the national economy? The Dictionary of Occupational Title definition of your job?

7. What is the claims process? When do you have to put the disability carrier on notice of your claim? How many appeals can you file? How long does the disability carrier have in which to make a decision?

8. How much are your benefits? Is there a set off against your disability benefits that will reduce your long-term disability benefits? Does that set off include Social Security benefits, your children’s Social Security benefits? Workers’ compensation or pension benefits?

9. Is there a limitation in the policy on when you must file suit?

10. What is the track record for this disability insurance carrier denying claims? Settling claims? Litigating claims?

Without knowing the answers to these questions, you are setting yourself up for a denial of your disability claim.

Nancy Cavey’s book, “Robbed Of Your Peace of Mind“, is a must read if you’re going to have any chance to avoid making mistakes, even before you file a disability claim.

If you have any questions, please give us a call at 727.894.3188 or contact us online by clicking here.

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FAQ – What if I asked for my plan or other documents and I can’t get them? | Tampa Long Term Disability Lawyer

You really do want to have a copy of the summary plan description (SPD) and your disability insurance policy before you even think about filing a disability claim.

So how do you get it? You should have been given a summary plan description when you signed up for your benefits. It may even be online.

Look at the summary plan description and see if it has the name of the plan administrator. If the plan administrator is identified, send a letter certified mail return receipt requested, asking for a copy of your policy and any amendments or changes made to the policy since you signed up.

If you can’t figure out who the plan administrator is, ask your human resources department. If they can’t give you an answer, send a written request to your employer certified mail, return receipt requested, asking for the name of the plan administrator, disability insurance company and a copy of any policy they might have.

Under the ERISA statute, the failure to provide a summary plan descriptions in a timely manner can result in a fine, under ERISA, of $110.00 per day. Unfortunately, that penalties is only awarded under certain circumstances, and by a judge.

If you can’t get a copy of a summary plan description or policy that is your first warning sign that problems lie ahead. You should obtain the assistance of an attorney to get the summary plan description and policy. Your attorney can file a lawsuit asking for enforcement of ERISA and the imposition of penalties.

Disability insurance companies who don’t play nice when asked to provide basic information aren’t going to play nice when it comes to deciding if you’re entitled to disability benefits. Take warning!

If you have any questions, please give us a call at 727.894.3188 or contact us online by clicking here.

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