Until they are needed, most Americans don’t give a second thought about their short and long-term disability policies. When a disabling illness or injury leaves you unable to work, what is intended to act as the safety net for you and your family, are actually policies riddled with loopholes. Rather than your disability policy being your life savior, your insurance companies hopes you will make fatal application or claim form mistakes.
Maybe the insurance company’s improperly credentialed doctor reports you’ve miraculously recovered from your injury after a 15-minute “independent” medical examination. Or, your insurance company says you were dishonest on the intentionally confusing individual or group application forms. Perhaps an insurance investigator claims to have caught you lifting a grocery bag into your car. Regardless, your disability insurance carrier is looking for ways to delay and wrongfully deny the disability benefits you may have spent years paying for.
Don’t let your disability insurance company take advantage of you. Protect yourself and other families like yours by contacting the seasoned and experienced California disability attorneys at DarrasLaw. As the nation’s top-rated disability law firm, DarrasLaw leaves no stone unturned when it comes to fighting disability insurance companies for your wrongfully delayed or denied disability benefits. In California and around the country, our award-winning disability insurance attorneys and ERISA lawyers have recovered nearly $1 billion in wrongfully delayed or denied insurance benefits.
Understanding Employer Sponsored Short and Long-Term Group Disability Insurance in California
You work for your paycheck—every penny of it. When each month, a lot of your hard-earned money goes toward your disability insurance premium, you accept it. You hope you never need disability benefits, but they’re there if you need them.
Don’t forget that group disability plans provided by your employer are not public service benefit plans such as Medicare and Social Security. Instead, the majority of these disability insurance companies are privately owned, for-profit enterprises. Their goal is to make money, not distribute it. Their teams of lawyers will fight you for every dollar you need to support your family after a disabling illness or injury.
In California, major insurance companies market long-term disability policies as emergency income to help cover expenses during extended illnesses or injuries. Group long-term disability benefits can assist with living expenses to help pay for food, clothing, rent or mortgage, car payments, co-pays, and utilities.
Short-term disability insurance provides between 50 and 60 percent of your salary replacement benefits. Overtime hours, bonuses and commission are items that the policy may or may not cover. Remember, short-term disability generally pays six days to six months, which incentivizes a quick transition back into the workforce.
Some employers choose to offer short or long-term group disability insurance benefits to their employees. Insurance companies, however, seldom hurry to help after a catastrophic injury or serious illness changes your life.
Fortunately for you, when DarrasLaw steps into a case, insurance companies take notice. Our team of California disability lawyers is led by nationally renowned attorney Frank N. Darras. For over three decades, he has understood the complexities of California bad faith insurance law, as well as the federal Employee Retirement Income Security Act (ERISA). No California disability insurance lawyer or firm has greater experience or recovered more for their clients than Frank N. Darras and his firms.
Applying for California Disability Benefits
Insurance companies make applying for disability benefits seem easy, don’t they? “Apply for disability benefits online with one click!” It’s so simple—until you get a denial letter.
Many individual and group disability insurance claims forms are intentionally vague and misleading. If you are unfamiliar with the tricky legal terms of your policy and misunderstand the nature of questions, you may certainly face a wrongful delay or denial of your claim.
Major disability insurance carriers in California may deny your individual or group disability claim if you suffered an “intentionally self-inflicted injury.” What does that mean? If you misinterpret a question about your responsibility for an accident, you may face an immediate denial of disability benefits and not know why.
Most California workers are simply trying to get by after suffering from a disabling illness or injury. Disabled workers are often too overwhelmed and are unable to effectively challenge a denial of their disability benefits. In fact, insurance companies may even trick applicants into believing they are not entitled to disability benefits. Accordingly, be cautious of claim application questions trying to get you to admit to any of the following:
- That the injuries were “intentional” or “self-inflicted”
- That you participated in illegal, negligent, or reckless activity when you suffered your injury or took ill
- That you had a preexisting injury or illness
- That you served in the military
Applicants may admit that they had injured the same area before, even though it was completely healed. Or, the carrier may write that the current accident significantly aggravated the previous injury. Insurance companies look for every possible excuse to deny you, hoping you won’t have the stamina to fight.
Instead, before filling out your claim application, take advantage of DarrasLaw’s free offer. We can assist with confusing questions or claim form ambiguities. That way, you may improve your chances of receiving timely disability benefits in the first place, and head off the need for an appeal or a lawsuit. If you are already in the appeal stage, bring in the premier California disability insurance attorneys and ERISA lawyers at DarrasLaw to challenge your disability insurance company. Engaging the top disability litigation firm in the country should significantly improve your chances of overturning your wrongful denial of disability benefits.
DarrasLaw is different than other disability law firms. Our experienced California disability insurance lawyers will complete a free case analysis—even on the complicated group disability claims governed by ERISA. This includes your short and long-term insurance policy and claims forms. Why hesitate? Get America’s most experienced disability lawyers and ERISA attorneys on your side today.
Fighting for Your California Disability Benefits
If you received an initial grant of disability benefits, don’t get comfortable. This is only the beginning of your disability insurance battle. Under California law, and pursuant to the terms of many disability policies, the insurer has the right to send you to “independent” medical examinations with physicians of their choosing. These insurance-hired doctors often lack the proper training or specialization. Carriers aren’t bashful and demand “independent examinations” to determine whether you truly suffer from a disability as your insurance policy defines it. Often, insurance company exams may not last more than 30 minutes. Insurance companies use hasty, shoddy “independent” medical examination to terminate your legitimate claim.
No one knows the insurance companies’ delay and denial tactics like the seasoned California disability attorneys and ERISA lawyers at DarrasLaw. California disability lawyer Frank N. Darras has more than 30 years of experience fighting on behalf of people who were wrongly denied the benefits they richly paid for. DarrasLaw knows how to successfully and quickly challenge a delay, denial, or cessation of benefits after an independent medical examination.
Employer-Sponsored Group Disability Plans—ERISA in California
Disability law is complicated, especially when your short or long-term group policy falls under the Employee Retirement Income Security Act (“ERISA”). Dealing with an ERISA case means understanding more than the federal statutes. California’s Federal District Courts and the United States Court of Appeals for the Ninth Circuit have issued specific rulings on this complex, ever-changing body of federal law. DarrasLaw’s nationally renowned disability attorneys know ERISA regulations and the case law that interprets it. Our firm has more individual and group disability litigation experience than any other firm in the country.
ERISA is often touted as a series of federal statutes passed to protect beneficiaries of employer-sponsored group insurance plans. Unfortunately, ERISA has the opposite effect. ERISA legislation contains a set of minimum requirements that group disability insurance providers and plan administrators must follow, including but not limited to:
- Providing you with access to certain plan and trust documents
- Setting minimum standards for participation to measure your wrongful denial
- Explaining how group plan benefits accrue and are funded
- Establishing an administrative appeals process
- Giving you the right to sue for benefits in federal court, with very limited consumer safeguards
Your group disability insurance company may have denied benefits outright. Perhaps your carrier delayed your benefits with repeated requests for duplicative claim documentation. In addition, are you sure you are receiving the right dollar benefit you are entitled to?
Unfortunately, the disability claim process is designed to be difficult and unforgiving. Contact an experienced California disability attorney or ERISA lawyer at DarrasLaw who is dedicated to litigating federal disability matters in the Ninth Circuit. We will ensure your plan provider and administrator operate in accordance with all the slim protections afforded you under ERISA. Don’t delay, because ERISA contains strict, exacting deadlines for filing group disability insurance claims.
Many disability carriers will arbitrarily deny you benefits based on a quick review of the medical evidence before them. Insurance companies are counting on the insured to fail to make a timely challenge of the wrongful denial. The disability insurance lawyers and ERISA attorneys at DarrasLaw understand the complexities of ERISA litigation and how California’s federal courts handle and interpret these cases. The top-ranked California ERISA lawyers and disability insurance attorneys at DarrasLaw know how to take on the insurance industry—and win.
Litigating Your Wrongful Denial of Disability Benefits in California
If you have an individual disability policy, you are entitled to take your case directly to Federal District Court in California after a wrongful denial of benefits. However, if you carry employer or group-sponsored short or long-term disability insurance, your case probably falls under ERISA.
After your group disability insurance has been denied and a comprehensive administrative appeal has been timely filed and denied, an ERISA federal lawsuit can be filed.
The California ERISA attorneys and disability lawyers at DarrasLaw can determine whether ERISA law applies and whether an administrative appeal is necessary. If your claim is subject to ERISA, the ERISA counsel at DarrasLaw can do your administrative appeal so you can concentrate on getting better.
Properly evaluating the ERISA landscape is crucial because, in the majority of circumstances, if California governs the jurisdiction of your group disability claim, a de novo review standards applies. The legal standard in your administrative appeal is de novo review, which is like “preponderance of the evidence.”
Crafting a comprehensive, occupational, medical, and vocational case for your administrative appeal entails providing the court with all of the relevant information in your case. The judge will not consider anything that was not part of your administrative appeal. If you receive a wrongful denial of your disability benefits under a group ERISA plan, you don’t have the option of any discovery or calling your treating doctors, friends, and family to testify to the validity of your disability. You are not entitled to a trial by jury or any court trial to determine your ERISA preempted claim.
The award-winning disability attorneys at DarrasLaw can analyze your group ERISA terms and benefit opportunities. In your administrative appeal, we show how the disability insurance denial violated ERISA and other similar rulings in the Ninth Circuit. DarrasLaw can lay out the objective medical issues and subjective medical determinations in the chart notes (including medical tests, pharmacy records, adverse medication side effects). Documenting how your disability prevents you from performing the important duties of your occupation is no easy task.
Insurance companies know the disability claim road is tremendously complicated. The California ERISA lawyers and disability attorneys of DarrasLaw know what evidence needs to go into a successful, ironclad administrative appeal.
DarrasLaw—Your California Individual and Long Term Disability Lawyers at Every Stage
Why has attorney Frank N. Darras been the go-to California disability lawyer for more than thirty years? He has been referred to as the David against Goliath, the Robin Hood of saving the disabled. Taking on billion dollar disability insurance companies isn’t for the faint of heart, and DarrasLaw has no peer.
Turn the tables on your insurance provider after a wrongful denial of benefits by contacting California’s leading disability lawyers at DarrasLaw. The top-rated, seasoned attorneys at the disability insurance law firm DarrasLaw have recovered millions on behalf of disabled individuals who were wrongfully denied their disability benefits.
Our disability insurance policy analysis and claim consultation is free. We are passionate about fighting for your disability rights and protecting you from the wrongful delayed or denial of benefits. Email us or call (800) 458-4577 today.
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