We Help the Disabled Get the Individual and Group ERISA Disability Insurance Benefits they Deserve
If you were injured or developed an illness and are unable to work full or part-time your disability insurance policy is hopefully going to be there to help you, right? Not always.
Few beneficiaries realize how difficult it is to claim disability benefits in Illinois. Thousands of people in Illinois are currently disabled and unable to work. In many cases, these people thought their employer-sponsored group disability plans would cover their disabilities, but they are currently having trouble obtaining the benefits to which they are entitled.
Whether you are just beginning the claim application process, were wrongfully delayed or denied individual or group ERISA disability benefits, or need to appeal a bad-faith denial, the award-winning, experienced disability insurance attorneys at DarrasLaw work with clients throughout Illinois on claims and appeals.
Spearheaded by the nation’s top disability lawyer, our litigation and claim attorneys have spent more than 100 years collectively fighting for your right to individual and group disability insurance benefits. Frank N. Darras and his firms have recovered nearly $1 billion on behalf of clients whose insurance companies wrongfully delayed or denied their valid claims. We are passionate about protecting you from Illinois’s insurance conglomerates.
Help! My Valid Disability Insurance Claim Was Just Denied
The bad-faith delay or denial of a valid individual or group long-term disability claim is among the most common reasons that people call DarrasLaw looking for help.
Your disability insurance is supposed to help when you suffer a disabling illness or injury, but your policy is likely riddled with complicated coverage limitations. The most common exclusions involve:
- Self-inflicted injuries. A self-inflicted injury is one that you caused to yourself on purpose. Some people may injure or disable themselves by attempting suicide, or purposely inflict self-harm to take advantage of their disability insurance benefits. If you did not purposefully hurt yourself, don’t let the insurance company confuse you with questions about self-inflicted injuries.
- Pre-existing injuries or illnesses. If you got into a car accident and injured your back a few years ago but recovered, your back may still hurt from time to time. The other week, you slipped and reinjured your back so that you can’t work for a few months. Remember, disability insurance companies are looking for reasons to deny your valid claim and your company may ask about prior back accidents or injuries. If you state, without explaining, that your back was injured before, you may face a wrongful delay or denial of individual or group disability insurance benefits.
- Injuries sustained as the result of illegal or reckless activities. Although this exception differs based on the provisions and limitations of each policy, insurance companies don’t like to pay benefits for disabilities they think you could have avoided. If you were disabled because of injuries you sustained while driving under the influence, for example, your individual or group disability insurance company may deny you benefits for disability.
Our seasoned individual disability lawyers and ERISA insurance attorneys offer completely free policy analysis and claim consultations to protect you from falling into these and other traps your individual or group ERISA disability insurance company may set.
Long-Term Disability Insurance Benefits in Illinois
If you file a valid claim for your individual or group long-term disability benefits, you’re probably facing a complete or partial disability that will take a recovery time of longer than 90 days. Because a for-profit insurance corporation likely administers your individual or long-term disability policy, the insurance company is going to do everything it can to wrongfully delay, deny, reduce, or cut off your disability benefits.
Furthermore, a long-term disability does not protect your job like military deployment or maternity does. That may mean your only foreseeable source of future income is your individual or group long-term disability payments.
Conditions that most individual or group long-term disability insurance policies should cover include:
- Rehab after a motor vehicle crash
- Maternity complications
- Knee injuries and knee replacements
- Whiplash/neck problems
- Tennis elbow
- Surgery recovery
- Carpal tunnel syndrome and cubital tunnel problems
- Tendonitis, sprains, dislocations, and fractures
- Herniated disks, degenerative joint problems
- Heart disease, diabetes, and strokes
- Lyme disease
- Fibromyalgia, chronic fatigue, and migraines
- Sprains and strains
- Congestive heart failure
- Coronary artery disease
- Neck, thoracic, and back pain
- Scoliosis and problems with the spine
- Pneumonia, asthma, and lung conditions
- Lupus, rheumatoid arthritis, and sarcoidosis
This is not an exhaustive list, so you should always explore whether your injury or illness entitles you to individual or group long-term disability insurance benefits with a seasoned, top-rated disability attorney at DarrasLaw.
The complex nature of disability insurance law can confuse any beneficiary, and even most attorneys. The experienced long-term disability lawyers and ERISA insurance attorneys at DarrasLaw can help prevent a wrongful delay or denial of individual or group benefits if you consult us before you file your claim forms. If you anticipate a long period without work due to your injury or illness, our compassionate, award-winning disability insurance attorneys or ERISA lawyers have the claim and litigation experience you need.
Group Disability Benefit Offsets
The primary goal of your disability carrier is to make money and they will do whatever they can to limit the amount it has to pay you each month. For this reason, most policies contain a clause stating that your disability insurance company can offset your group disability benefits if you have another source of income. Common examples of income that will offset your disability benefits include:
- Social Security Disability Insurance
- Supplemental Security Income
- Personal injury settlements
- Supplemental income if you are able to work part-time
In other words, if you receive $4,000 in long-term disability benefits for 10 months, and your policy pays you $40,000. Most insurance carries reserve the right to be “reimbursed” for money if you receive compensation for your lost wages from another source, such as a lawsuit. If a car accident caused your injuries, and you recovered $100,000 in a personal injury lawsuit, you will likely have to pay the $40,000 back to your disability insurance company so you don’t receive a double recovery.
You should also prepare for your disability carrier’s requirement that you apply for Social Security Disability and perfect all appeals. Even if you don’t qualify, your long-term disability carrier may cut off your group benefits if you refuse to apply or appeal.
Some group policies actually obligate you to seek an offset to help reduce your own disability payout. The nationally renowned disability insurance attorneys at DarrasLaw may also help prevent your disability carrier from wrongfully offsetting your individual or group benefits when it is not entitled to do so.
Appealing an Individual Bad-Faith Denial or Group Benefit Denial in Illinois
Remember when we told you the type of disability insurance policy you had was important? This is why.
If you have an individual disability insurance policy, which is common if you bought it from an agent or broker or if you are self-employed, you are entitled to many consumer rights and remedies. This means that if your individual disability insurance company wrongfully delayed or denied your benefits, you can generally go straight to the courts to file suit, without an appeal.
During individual disability litigation, DarrasLaw’s award-winning, experienced litigation attorneys can call witnesses on your behalf, cross-examine insurance company witnesses, request claim and underwriting information from your insurance company, and introduce evidence and testimony about your case from your treating physician, pharmacy records, physical therapists, and even friends and family.
This is not true if an employer-sponsored or group disability policy through a labor union or similar organization covers you.
If you have a group or employer-sponsored policy, the process for appealing your wrongful denial is much more limited and complex. Your case will generally fall under a set of complicated, ever changing federal laws called the Employee Retirement Income Security Act (ERISA).
Furthermore, the interpretation of ERISA’s extremely complicated statutes can change based on the federal court circuit in which you live. In Illinois, the case law handed down by the courts in the Seventh Circuit applies.
Under ERISA, before taking your case to federal court, you must first go through a timely administrative appeal with your insurer. During any subsequent litigation, you can only use the medical records, statements, and documentation you and your carrier used in the underlying claim and your group administrative appeal.
Many people have no idea that in a federal ERISA lawsuit, the court can only rule on what was submitted in the administrative appeal. To win your federal ERISA lawsuit, you need to lay out how ERISA supports your valid group disability insurance claim. You must then document the objective medical issues and subjective medical determinations in the chart notes, including medical tests, pharmacy records, and adverse medication side effects along with vocational support.
The award-winning ERISA lawyers and individual bad-faith disability insurance attorneys at DarrasLaw understand how to protect your rights.
Wrongfully Denied Individual or Group Disability Benefits in Illinois? Call DarrasLaw Today
Frank N. Darras and his firms have recovered nearly $1 billion in wrongfully delayed or denied insurance benefits for our clients. Led by award-winning disability attorney Frank N. Darras, no other disability lawyer or long-term disability litigation firm has greater experience or recovered more wrongfully delayed or denied individual or group disability benefits than DarrasLaw.
Our disability insurance policy analysis and insurance claim consultation is completely free. If you’re struggling in your fight with your disability insurance carrier in Illinois, call us today at (800) 458-4577 to schedule your free consultation or contact us online.