Often, when clients begin to apply for disability benefits they mistakenly believe the insurance representatives who answer the phones are really there to help them. Mostly, that is not the truth. The insurance company mantra, too often is, Deny, Deny, Deny. Yes, insurance carriers offer disability benefits – either through private policies or as a part of a benefits’ package through an employer – but they generally do not want to pay out benefits because that is not the key to success for their bottom lines. While very happy to accept premium payments, they are not nearly as happy to make good on them when you need them to do so.
Unfortunately, you must operate under the assumption that the insurance carrier exists to disprove your claim, regardless of how disabled you are or how much objective evidence you provide them with. They particularly will deny claims to individuals who apply for benefits on their own, without the assistance of a disability attorney who understands medical evidence, and knows the law. Individuals applying for disability benefits on their own generally are far more vulnerable than are those who have legal representation, and insurance carriers tend to tread much lighter when they know an attorney is managing a client’s claim.
And, It Doesn’t Matter . . .
It is because of this that my firm does so many administrative appeals. Most of the time, clients contact our firm after they have been denied, having applied on their own. And, the degree to which clients are disabled does not matter much. I have had clients with severe disabilities such as heart conditions that have affected their cognitive abilities; clients with late-stage cancer; clients who have been hit by vehicles and can no longer function; clients with serious chronic diseases – what they have in common is, they all were denied after applying for benefits without legal representation.
But, But, But, No One Told Me . . .
Please do not rely on a human resource professional from your office or even an agent who sold you the policy to give you this information. Likely, they won’t. First of all, it is not their job nor their area of expertise; and second of all, their focus is not on you. Once you become disabled and unable to work, chances are your employer will merely hire your replacement. While the agent who sold you the policy will no longer look forward to a percentage of those premium payments. You need to look out for you.
How Do I Find A Good Lawyer?
You find a good lawyer just like you would find a good doctor. Do your research including asking for recommendations from friends and associates. You also can call your local Bar Association. They will point you in the direction of an attorney who focuses on the type of disability lawyer you need to fight the carrier. Unlike, say, criminal law or personal injury law, disability law is more of a niche practice area.
Once you’ve obtained a name or some names of attorneys, the next step is interviewing them. Our firm requires you to first speak with a legal assistant and send us your paperwork (your carrier denial letter, some medical records, and a formal job description). After we’ve had the chance to review your material, an attorney will contact you and let you know whether your claim is a viable one. Then, you can make your hiring decision.
I usually advise potential clients against any one-to-one contact with the insurance carriers, whether they decide to retain our firm or not. Because remember, an insurance carrier definitely is not your friend, and an insurance carrier definitely does not have your best interests top of mind.