Trusted Disability Lawyers Serving San Francisco Families
Helping People Obtain Wrongfully Delayed or Denied Benefits in San Francisco and the Bay Area
A common misconception in the United States is that people who are “disabled” can do little for themselves. We may picture citizens in wheelchairs, hospital beds, or confined to homes. These stereotypes may convince many San Franciscans suffering from a disabling illness or injury that they don’t qualify for disability benefits or that they need assistance. A San Francisco disability lawyer can help you right off the bat.
What actually constitutes a disability differs significantly from that perception, as nearly one in five Americans will develop a disability at some point in their lives. About 6 percent of all working-age San Franciscans suffer from disabling illnesses or injuries.
Disabilities may involve serious difficulty sitting, walking, carrying, hearing, seeing, or understanding. These disabilities may affect your ability to perform the essential duties of your occupation, and even activities of daily living like cooking, cleaning, bathing, dressing, shopping, and driving. If so, you may qualify for benefits under your individual or group long-term disability insurance policy.
For example, if you injured your back and have difficulty walking or sitting and you are in so much pain that you can’t, stand, sleep, or drive as a result, you may have a valid claim for individual or group long-term disability insurance benefits.
Think about what this disability might cost you and your family in time and expenses. What if you can’t work and also have to hire someone to clean your house? What if you can’t drive and have to pay someone to take you to every doctor appointment? A disability that prevents you from working and takes away your income can create a huge financial burden for you and your family.
You don’t have to suffer from a total disability to claim individual or group long-term disability benefits. The experienced, individual and long-term disability insurance attorneys at DarrasLaw can help you understand your claim and your right to benefits. Our founding partner, Frank N. Darras, and his firms have recovered nearly $1 billion in wrongfully delayed and denied benefits from America’s insurance conglomerates.
Mr. Darras, has spent more than 30 years fighting to win benefits for disabled people, and his experienced individual disability attorneys offer completely free disability policy analysis and claim consultations. If you’re curious about your disability insurance benefits, want to file a disability claim, or were wrongfully delayed or denied benefits, call a San Francisco disability lawyer today at (800) 458-4577 or contact us online.
What Is Disability Insurance, and Who Qualifies for Benefits?
Contrary to popular belief, your private disability benefits are not provided through federal Social Security Disability Insurance (SSDI). Although most working Americans pay into SSDI, you can’t claim these benefits unless you are totally disabled. Unfortunately, you only have a total disability under SSDI if you are completely unable to perform any work that you have performed in the past and are completely unable to adjust to other available work considering your abilities and education.
Private individual and group long-term disability insurance policies generally don’t require a total disability to qualify for benefits. Instead, if your injury or illness prevents you from performing some of the important duties of your current occupation, or any other occupation, you may qualify for benefits.
There are three types of disability insurance plans: employer-sponsored, group-sponsored, and individual. This distinction is critical, because the laws that apply to your valid disability claim depend on the type of policy you have.
An individual policy that you purchase from an agent or broker stays with you, not your job if you quit or move on to a new employer. The benefits flow tax-free if you paid the premiums, and you have superior consumer rights and remedies.
An employer may offer employer-sponsored disability insurance to employees, typically as part of an employee benefit package. These policies cover you where you are currently employed and do not generally come with you if you leave your job.
If you suffer from a disabling illness or injury that prevents you from working, you may claim disability benefits to cover a percentage of your salary or hourly wage as stated in your employer-sponsored disability insurance certificate.
Disability Benefits and Bad-Faith Delays and Denials
Generally, disability insurance serves as an income replacement if you suffer a disabling injury or illness. Depending on your plan, you may receive a percentage of your income or hourly wages for a total or partial disability claim.
The catch is that your private disability insurer is a for-profit corporation. Your insurance company is in the business of making money, not distributing it. It will interpret your right to benefits narrowly and will wrongfully deny you benefits if possible.
If you have individual disability insurance, you may generally take your bad-faith denial straight to the courts in most cases without filing an appeal. There, you may submit evidence, use discovery to get insurance company documents, call witnesses on your behalf, cross-examine the insurance company’s witnesses, and try your case before a jury. In addition, you may seek emotional distress and punishment damages along with attorney fees with your trial before a judge and jury of your peers.
Employer-sponsored and group-disability insurance policies are generally governed by a complex, constantly evolving set of federal laws called the Employee Retirement Income Security Act (ERISA). If you are wrongfully denied benefits under an ERISA policy, you must first file an administrative appeal with your insurer. If the insurance company upholds the initial denial, you must base your entire federal ERISA lawsuit on the record you submitted during the claim and what was submitted during your administrative appeal. Your case will be decided and judged by ERISA holdings from the Ninth Circuit. Finally, if you don’t timely file your administrative appeal, the court will dismiss your case, no matter how valid your claim.
For most people, this means you need an award-winning disability insurance attorney from DarrasLaw to help protect your right to group disability benefits. Our top-rated San Francisco disability lawyer can tell you what needs to go into a timely, comprehensive, legally sufficient administrative appeal.
Conditions That Individual and Group Disability Insurance Should Cover
You don’t have to suffer from a catastrophic injury or total disability to claim disability insurance benefits. Your individual or group disability insurance policy may limit your benefits for certain illnesses and injuries, especially musculoskeletal and mental/nervous claims.
The following common injuries or illnesses can generally qualify you for the initial benefits if you can’t do the material and substantial duties of your regular occupation:
- Fibromyalgia and chronic fatigue
- Lyme disease and other tick-borne diseases
- Broken bones, dislocations, and fractures
- Surgical recovery
- Pregnancy and pregnancy complications
- Pneumonia, asthma, and lung issues
- Multiple sclerosis
- Carpel tunnel and cubital tunnel issues
- ACL tears, knee injuries and replacements
- Cancer, chemotherapy, and radiation
- Sciatica, herniated discs, neck and thoracic problems
- Lupus and other autoimmune diseases
- HIV/AIDS complications
The following common disabling conditions are especially hard to claim benefits for
Depression/anxiety: More than 16 million Americans suffer from a major depressive episode each year, whether from major depression, bipolar disorder, or persistent depressive disorder. Furthermore, post-partum depression is a serious condition, and you may need additional time to recover after giving birth. If your depression interferes with your ability to perform the important duties of your occupation or concentrate at work, you may qualify for benefits.
It is harder to prove you have an emotional/mental condition than a physical injury, so you will need to submit psychological records and reports to claim these benefits. Individual and group long-term disability insurance companies may also limit the length of time you can claim benefits for mental and nervous problems.
Substance abuse: Opioid addiction is quickly becoming one of America’s newest killers, and it’s leaving many others with permanent, disabling brain damage. While your individual or group long-term disability carrier may grant you long-term disability benefits to treat opioid addiction, recent lawsuits have highlighted the drug companies’ deception. Some insurers may claim your drug addiction was “self-inflicted” to wrongfully deny you benefits, but studies have shown that many major pharmaceutical companies misled customers about the addictiveness of their pain medications.
If your individual or group long-term disability insurance company delayed or denied your valid claim for an addiction to a prescription drug about which you were misled, contact a San Francisco ERISA attorney. Our experienced individual disability lawyers understand how the ongoing opioid litigation can affect your valid disability insurance claim. We can help you fight for your right to individual or long-term disability benefits while you work hard to get well.
Cardiac conditions and heart disease: America’s number one killer is heart disease. Heart disease and heart attacks are responsible for one of every four deaths in America. It is the leading cause of death for both men and women, though it is more commonly associated with men. If you have any precursors to heart disease, such as shortness of breath, fatigue, arm pain, jaw pain, chest pain, nausea, or cold sweats, seek medical help immediately.
If you do develop heart disease, filing a claim for cardiovascular individual or group disability benefits can be tricky. An award-winning San Francisco disability lawyer or at DarrasLaw can help you prepare your valid claim application so you can get well and avoid further stress. If you just suffered a cardiac episode, don’t put more strain on your heart by worrying about finances. Let our top-rated individual or group long-term disability attorneys help you take care of the paperwork so you can focus on your recovery.
Cancer: America’s number two killer is still cancer. Despite recent advances in treatment options and efficacy, cancer remains a reality for many in San Francisco. If you received a cancer diagnosis, you may immediately qualify for individual or group long-term disability benefits. Whether you need some recovery time after a mastectomy, have a clouded mind due to chemotherapy, or are bedridden, let the compassionate individual disability attorneys help you obtain benefits. You and your family should concentrate on your treatment and recovery. While you fight cancer, let us help you fight your disability insurance company.
No matter your disability, the seasoned disability insurance attorneys at DarrasLaw are here to help you.
Call an Individual Disability Lawyer at DarrasLaw Before It’s Too Late
ERISA limits your group’s administrative appeal and federal ERISA lawsuit in many ways. Insurance companies may even downplay what evidence you need to submit for a successful group administrative appeal, leading you to make a fatal claim mistake. You also must meet its strict and unforgiving deadlines, or the court will dismiss your federal lawsuit, despite the validity of your claim.
Call an experienced individual disability attorney at DarrasLaw today. We know the traps and tricks, and those that your individual or group disability insurance company will set for you.
At DarrasLaw, our disability claim consultation and policy analysis are always free. Furthermore, we don’t get paid unless you do. Remember—your insurance company is generally not on your side, but we are.
Make Your Appointment With an Award-Winning San Francisco disability lawyer at DarrasLaw Today
With more than 100 years of combined experience fighting America’s disability companies—and beating them—we know how to protect you from a bad-faith delay or denial of your disability benefits. Even if you’ve already filed your valid disability claim, our top-rated individual disability insurance attorneys understand how to help you win disability benefits in San Francisco. Contact us online or at (800) 458-4577 today.