Disability Insurance Attorneys Representing Individuals in Los Angeles, California
Helping People Obtain Wrongfully Delayed or Denied Benefits in L.A. and the Surrounding Areas
According to federal census statistics, about 6 percent of all Los Angeles residents younger than 65 live with some type of disability.
Other statistics tell a much different story. By Los Angeles County’s estimate, nearly 19 percent of L.A. area residents younger than 65 suffer from some type of disabling condition. An illness or injury prevents them from performing daily activities such as bathing, cooking, cleaning, sleeping, sitting, bending over, walking, or makes these tasks extremely difficult.
Unfortunately, many people who are part of L.A.’s disabled population do not receive disability benefits—even though the law may entitle them to. If you’re reading this page, there’s a good chance that you may be one of these people. Fortunately, you have help available.
Applying for, receiving, and maintaining your individual or group long-term disability benefits is more difficult than disability insurers would have you believe. Your individual or group long-term disability insurance company will look for ways to save money by delaying or denying your benefits. As a result, if you seek individual or group long-term disability benefits, you need a top-rated individual disability attorney or ERISA insurance lawyer on your side who knows the ins and outs of disability traps and pitfalls.
That attorney is Frank N. Darras. With more than 30 years of disability litigation and claims experience, he knows the denial strategy your insurance company will set for you. He and his firms have recovered more wrongfully delayed or denied individual and group disability insurance benefits than any other lawyer or law firm in the nation.
Don’t give in to a bad-faith delay or wrongful denial of benefits in L.A. Contact an award-winning individual or long-term disability insurance lawyer or ERISA attorney at DarrasLaw for a free policy analysis or claim consultation today. Write us online or call us at (800) 458-4577.
Am I Entitled to California Disability Benefits?
Although L.A. County reports that nearly 20 percent of working age citizens live with disabilities, not everyone has access to private disability benefits. Most people obtain disability insurance coverage through an employer, professional organization, or privately from an agent or broker. Typically, if you suffer from a disabling illness or injury that leaves you unable to perform the essential duties of your current occupation, you may qualify for benefits. These benefits can range anywhere from 50 percent to 66 2/3 percent of your salary or hourly wage, but this varies based on your individual or group disability insurance policy.
Employer-sponsored disability plans are generally offered at work as a part of an employee benefits package. If your job provides disability insurance, your employer will usually cover all or part of your disability premiums. A union or professional organization typically provides group-sponsored disability plans as well.
While employer-sponsored disability insurance generally only covers you while you’re employed at your current job, group-sponsored insurance may cover you if you move to another union-sponsored employer.
Individual disability insurance is completely private—you buy it for yourself, generally from an insurance agent, broker, or online. If you pay the premiums personally, the disability benefits generally flow tax-free to you.
Some people actually have multiple policies—an employer-sponsored policy and a supplemental private individual policy. For example, if, in the event of a disability, you know you need all of your take-home income but your employer-sponsored policy only covers 50 percent of your salary, you can buy a supplemental individual policy to fill in the gap. As you will see, the different laws that apply to group and individual disability plans make this an extremely important distinction.
Long-term disabilities are generally defined as illnesses or injuries expected to last 60 days or more. A cancer diagnosis or traumatic brain injury may immediately qualify you to claim individual or long-term disability benefits. Benefits may include:
- Total and partial income replacement
- Rehabilitation and occupational therapy
- Back to work assistance
Depending on the terms of your plan, benefits may last for a few months or until you reach normal retirement age. Watch out, however, for the fine print exceptions, exclusions, and cut-offs contained in your individual or group long-term disability policy. Most importantly, watch out for the appeals traps set by employer and group-sponsored ERISA plans.
The Employee Retirement Income Security Act (ERISA) generally governs any employer or group-sponsored disability plan that insures you. ERISA is a complex, ever-evolving set of federal laws that the Ninth Circuit Court of Appeals has interpreted in specific ways.
If you are denied benefits under an individual disability policy, then you generally don’t have to appeal—you can go straight to court and sue for your valid benefits along with emotional distress, punishment damages, and attorney fees.
Under an ERISA-governed plan, you do not have the same rights as an individual policyholder facing a wrongful delay or denial of benefits. Under ERISA, you are not entitled to a trial by jury, cannot call witnesses on your behalf, and cannot introduce evidence outside of the “administrative record.” Your administrative record consists of the documents supporting your disability claim that you submit during your administrative appeal after the initial denial of benefits. The insurance company may play down the importance of these appeal documents. This could result in you failing to submit all of the relevant medical, occupational, and vocational evidence—and making a fatal ERISA appeal mistakes.
In most cases, ERISA is not beneficiary friendly. Consulting an experienced ERISA attorney or individual disability insurance lawyer from DarrasLaw early in the claim process can help protect your legal rights.
Common Conditions Covered by Disability Insurance
Some disabled Californians suffer from ambulatory or cognitive disabilities.
An ambulatory disability prevents you from walking and climbing stairs or makes it extremely difficult to perform those tasks. Ambulatory disabilities include back pain, sciatica, nerve damage, herniated discs, and broken legs.
Cognitive disabilities are marked by an inability to concentrate, remember, or make decisions as the result of physical, mental, emotional impairments or medications.
One injury or illness can lead to a series of others. Extreme back pain, for example, may constitute both a cognitive and a physical disability. While the back injury itself prevents you from walking, sitting, laying down, or standing for extended periods of time, the pain or pain medication may prevent you from focusing and concentrating at work.
Some disability plans only provide limited benefits for common musculoskeletal conditions such as back injuries. However, if you work with a top-rated individual disability insurance attorney or ERISA lawyer at DarrasLaw, you may learn that you also qualify for all of your co-morbid conditions.
Common injuries and illnesses that may qualify for benefits include:
- Substance abuse: Some disability policies may provide benefits if you seek treatment for substance abuse. A 12-month rehabilitation program may qualify you for short- or long-term individual or group disability benefits, but this depends on your specific plan. If your disability insurance doesn’t cover illegal drug abuse, it may cover addictions to prescription medication. You may need additional time to find effective, alternative methods of pain management for your underlying injury or illness. An experienced long-term individual or group disability insurance lawyer or ERISA attorney at DarrasLaw can help you file a strong claim application without falling into a “self-inflicted” exclusion.
- Pregnancy complications: If you’ve ever had a child, you know a multitude of complications can occur during pregnancy. Your treating doctor may put you on bed rest early in your pregnancy, or you may develop a post-surgical site infection after a C-section or post-partum depression. Even the healthiest people can suffer complications during and after giving birth. Tennis star Serena Williams suffered from life-threatening blood clots after giving birth to her daughter, and women are at a higher risk for clots during pregnancy.
- Multiple sclerosis: This immune system disorder attacks the nerves, interfering with communication between the brain and the rest of the body. Physical symptoms vary widely, from numbness or tingling sensations to loss of coordination, vision, and even the inability to walk. Patients may also lose the ability to concentrate, think, or control their emotions. Expensive treatments are available (ranging to $6,000 a month), but no known cure exists. M.S. potentially precludes patients from working in any occupation while saddling them with enormous medical bills.
- Traumatic brain injuries: Athletes, particularly in football, get a lot of press these days for chronic traumatic encephalopathy (CTE). Though it is not yet well-understood, CTE may result from repeated concussions and other more serious forms of traumatic brain injury (TBI). A single TBI, however—particularly TBIs caused by accidents involving cars, trucks, and motorcycles—can result in a long-term or even permanent disability.
The seriousness of your condition isn’t always the determining factor in whether you receive disability insurance benefits. How your illness or injury affects your ability to perform the important tasks of your current occupation, or any occupation you are trained or suited to do, is another consideration in a successful disability claim application.
Below is a list of additional disabling illnesses and injuries that may qualify you for individual or group disability benefits:
- Cancer, chemotherapy, and radiation
- Car accident injuries
- Spinal cord, neck, and thoracic problems
- Surgical recovery
- Heart attacks, strokes, diabetes, COPD, and aneurism
- Knee injuries and replacements
- Fibromyalgia, migraines, chronic fatigue, and other self-reported conditions
- Rheumatoid arthritis, lupus
- Crohn’s disease, IBS, and bowel dysfunction
Remember, if you suffer from an injury or illness that leaves you unable to work, consult an award-winning individual disability insurance lawyer or ERISA attorney at DarrasLaw to see if you can take advantage of your individual or group long-term disability benefits.
Consult a Top-Rated individual Disability Insurance Lawyer or ERISA Attorney From DarrasLaw at the Onset
After you suffer a potentially disabling illness or injury, contact a top-rated individual disability lawyer or ERISA attorney at DarrasLaw immediately. Individual and group disability insurance claim applications are intentionally vague and may present you with trick questions designed to wrongfully deny you benefits.
If your individual or group long-term disability insurance company has already wrongfully delayed or denied you benefits, getting a seasoned ERISA attorney or individual disability lawyer from DarrasLaw involved before you file an administrative appeal can help save your case. The insurance company may play down the importance of your administrative appeal documentation, then sustain its initial bad-faith delay or denial. By falling into this trap, you can limit the judge’s ability to later rule in your favor.
Consulting an award-winning individual disability insurance lawyer or ERISA insurance attorney from DarrasLaw can help you file a comprehensive administrative appeal. That way, you are in a better position should you need to file a federal ERISA lawsuit in support of your valid disability claim.
Don’t Delay. Speak With an ERISA Lawyer or individual Disability Attorney at DarrasLaw Today.
While many attorneys charge a consultation fee, DarrasLaw operates under a different model. Our passion is helping you fight the disability insurance companies while you’re fighting to get well. We charge no fee to meet with one of our award-winning ERISA lawyers or individual disability attorneys, including when we evaluate complicated individual or group ERISA matters.
Our case analysis is free. Our policy review is free, and you don’t pay unless we recover disability benefits for you! With more than 100 years of combined experience fighting for your right to benefits, Frank N. Darras and his firms have recovered nearly $1 billion back from the insurance conglomerates. Contact us online or call us at (800) 458-4577.