Helping Chicago’s Disabled Fight for Their Long-Term Disability Benefits
Born and raised in the Chicago land area, founding partner Frank N. Darras holds billion dollar insurance companies accountable for his friends and neighbors of Illinois. According to the Centers for Disease Control (CDC), nearly 22 percent of adult Americans live with a disability. In Illinois, only 9 percent of working-age individuals report having a disability. Though the statistics increase exponentially as the population ages, Illinois has one of the lowest reported disability rates in the United States. However, is this because Illinois has fewer disabled residents or because residents don’t realize they may qualify for long-term disability insurance benefits?
When you think of a disability, what comes to mind? A genetic condition, someone in a wheelchair, a traumatic brain injury? Many Americans don’t realize that, while federal Social Security disability benefits require a total disability, you don’t need to suffer from a total disability to qualify for most private individual or group long-term disability benefits. If you have individual or group long-term disability insurance, you may qualify for disability benefits if an injury or illness leaves you unable to perform some of the important duties of your occupation.
Every individual or group disability insurance policy will contain a multitude of exclusions and exceptions to coverage. If an injury or illness leaves you unable to perform the important duties of your occupation, you may have a valid total disability claim for individual or group long-term benefits.
The experienced individual and nationally renowned group ERISA long-term disability lawyers at DarrasLaw have more than 100 years of combined insurance and litigation experience helping America’s disabled fight for their long-term disability benefits. Award-winning disability attorney Frank N. Darras and his litigation firms have recovered nearly $1 billion in wrongfully delayed, denied, and terminated insurance benefits. To schedule a free, confidential disability claim consultation or free policy analysis, call us at (800) 458-4577 or contact us online.
What Is Long-Term Disability Insurance?
You’re driving down the Dan Ryan Expressway one day when a drunk driver slams into you. At the peak of your career, you’ve found yourself suffering from a traumatic brain injury. You wake up with severe migraines each morning, can’t focus on work-related tasks, and find yourself irritable. You can’t work for a least a year. So if you haven’t built up savings, what do you do?
This kind of scenario is what long-term disability insurance is for. Whether provided through your employer, the government, or a personal individual plan, long-term disability insurance exists to replace a percentage of your lost income if you’re too sick or injured and unable to work. If you qualify, your individual or group long-term disability insurer will replace a portion of your income specified in your policy during your eligible disability benefit period.
Your disability benefits will differ depending on your plan. Some employees may purchase a feature rich individual disability insurance plan if their employer-sponsored policy offers only minimum benefits. It’s important to calculate what you’ll receive after qualifying for long-term disability benefits before you suffer a disabling illness or injury. If 60 percent of your income won’t cover your basic expenses, consider purchasing an individual disability plan. The experienced individual and group long-term disability attorneys at DarrasLaw can guide you through this process with our free policy analysis. Know what you are buying and how to use your disability policy before paying for rich premiums.
Do I Have Long-Term Individual or Group Disability Insurance?
This is a more complicated question than you might think. There are generally three types of long-term disability insurance:
- Group disability insurance – This is the most common type of long-term disability insurance. Your employer or an organization, such as a union of which you may be a member, typically offers group policies. These policies generally cover you as long as you maintain your employment or membership, so if you leave your job or union, you’ll lose your coverage. Your employer will typically cover the premiums for these group policies.
- Individual disability insurance – If you’re self-employed, an independent contractor, or bought a personal policy from an agent or broker, these policies follow you, not your job, and the benefits are paid tax-free if you paid the premiums.
- Social Security Disability Insurance (SSDI) – Working Americans who have paid into SSDI through their taxes for a qualifying period can apply for SSDI. SSDI, however, requires a total disability to qualify. This means you cannot engage in any occupation by which you are trained, educated, or suited. In addition, long-term disability insurance policies will deduct, or offset, any SSDI benefits you and your dependents receive from what the insurance companies must pay you.
Understanding the type of disability insurance you have is important because the applicable laws and qualification standards vary according to whether you have individual or group long-term disability insurance.
A complex set of federal laws called the Employee Retirement Income Security Act (ERISA) governs employer-sponsored and group disability insurance plans. ERISA policyholders do not have the same legal rights or consumer protections as individual policyholders, and the ERISA litigation process is more limited than litigation involving individual policies.
If you experienced a wrongful delay, denial, or termination of long-term disability insurance benefits, consult our experienced ERISA group attorneys or seasoned individual disability lawyers today at (800) 458-4577 or online.
What Conditions Do Individual or Group Long-Term Disability Insurance Usually Cover?
You don’t generally need to suffer from a total disability to claim individual or group long-term disability insurance benefits. You need only prove that an injury or illness prevents you from some work after your elimination period (the time you have to wait to claim individual or group long-term disability benefits is exhausted). This period will differ depending on your long-term disability policy language.
Whether your individual or group long-term disability insurance policy considers your injury or illness disabling will vary according to your occupation and its’ important duties. A thumb injury may disable a surgeon but not an accountant. Any of the following injuries or illnesses can result in a disability if you’re unable to perform the important duties of your occupation:
- Herniated discs, sciatica, whiplash, and other soft-tissue damage or back pain
- Tennis elbow
- Carpal and cubital tunnel syndrome
- Depression, post-traumatic stress disorder (PTSD), anxiety and other mental and emotional disorders
- Bunion removal
- Pregnancy complications
- Heart disease
While you should never ignore an injury or illness that prevents you from performing the important duties of your occupation, the following conditions are among the most common disabling illnesses and injuries in Chicago:
- Scoliosis – This degenerative condition is marked by a sideways curvature of your spine, resulting in an S While it most commonly occurs during growth spurts, it’s also a symptom of cerebral palsy and muscular dystrophy. Some people diagnosed with scoliosis may have such severe curvature of the spine that it compresses the chest, making breathing difficult. There is no cure for scoliosis, and many patients have to wear a full back brace. If the curvature is sufficiently disabling, you’ll need surgery to straighten your spine, which normally requires insertion of metal rods. This limits your movement and can result in partial or total disability.
- Fibromyalgia – While this is a self-reported condition, it’s also a serious one. Medical professionals define fibromyalgia as a condition where you experience whole body pain, especially in your joints. As a result, most patients suffer from pain, brain processing disorders, and extreme fatigue. Fibromyalgia is also a symptom of many common injuries and illnesses. Lyme disease, traumatic brain injuries, surgeries, infections, or other physical and medical trauma can trigger fibromyalgia. Accordingly, you may have a valid claim for individual or group long-term disability benefits for multiple conditions.
- Fractures – This is a broad category of injuries that may or may not cause a disability. Small stress fractures may resolve with time, while major compound fractures may require surgery. Certain fractures are so bad they lead to amputations. How a fracture damages your ability to work makes all the difference. If you work from home in an information technology profession, a fractured rib may not prevent you from working. The same rib, however, may prevent a mechanic from performing the important duties of that occupation due to the bending and lifting.
- Bunion removal – The name of this procedure is misleading because bunion surgery is more than just bunion removal. It’s a complex foot surgery. A bunion is a growth within the bone joint where your big toe meets your foot, and it can cause extreme pain. As the bunion grows, it pushes your big toe into your other toes such that it deforms the bone. This means your big toe is no longer able to bear your weight or help you balance, straining the rest of your foot. If you need bunion surgery, it will require the realignment of your bones and tendons. This often means breaking the bones in your foot to reset them.
- Car accident injuries – A severe car accident can injure multiple areas of your body. When the force of the collision transfers through your body, it can damage your back, neck, legs, shoulders, knees, and head. Traumatic brain injuries are some of the most serious injuries you can sustain in car accidents. If an airbag doesn’t deploy fast enough or deploys too fast, it can also cause traumatic brain injuries.
Individual and group long-term disability policies don’t generally exclude, exempt, or limit many injuries or illness from disability coverage. The provisions, exclusions, exceptions, and limitations to coverage generally involve the circumstances of the injury itself. For example, an individual or group long-term disability insurance policy may exclude self-inflicted injuries, on the job injuries, or injuries resulting from driving under the influence or while attempting to commit a felony. If you suffer from a disabling illness or injury in the Chicago area and aren’t sure if you’re entitled to disability coverage, schedule a free disability policy review and free case analysis with one of DarrasLaw’s award-winning individual disability lawyers or nationally acclaimed group ERISA attorneys today.
Why Hire a Top-Rated Individual or Group Long-Term Disability Lawyer?
Most workers suffering from a disabling illness or injury wait to contact an individual long-term disability lawyer or ERISA attorney until after they’re denied disability benefits. Waiting to contact a long-term disability attorney or group ERISA lawyer until after your denial can hurt your case, especially if you have a group long-term disability insurance plan.
If you purchased an individual disability policy, you may face a more traditional litigation process after denial, which generally does not require an appeal. You may submit evidence, get insurance company documents through the discovery process, call and cross-examine witnesses, and try your case before a jury. In addition, you may seek emotional distress and punishment damages along with attorney fees. If you paid the premiums yourself, the disability benefits should flow tax-free.
A complex set of federal laws generally applies to most group disability cases. In accordance with the Employee Retirement Income Security Act (ERISA), you can only litigate wrongful group disability insurance delays, denials, and terminations after you have submitted a timely administrative appeal.
What your group long-term disability insurer won’t tell you is that the evidence you submit during your administrative appeal is the only evidence allowed if you later must file a federal ERISA lawsuit for wrongful denial of group benefits. You cannot introduce new evidence or call and cross-examine witnesses. A jury will not hear your case and the federal judge reviews the case generally without argument and the standard to win, is arbitrary and capricious.
The judge can only rule on what you submitted to your insurance company in the underlying group disability insurance claim and your group administrative appeal.
Having a top-rated long-term group disability attorney from DarrasLaw on your side early in the ERISA claims process can help protect your legal rights. We can help you timely file a legally sufficient administrative appeal and position your case for its best chance of success if you need to file an ERISA federal lawsuit to claim your rightful group disability benefits.
If You’re Disabled in Chicago, Call Our Nationally Renowned Long-Term Individual Disability Attorneys and Award-Winning ERISA Lawyers at DarrasLaw Today
Frank N. Darras, America’s top-rated disability lawyer, and his litigation firms have recovered nearly $1 billion in wrongfully delayed, denied, and terminated insurance benefits. DarrasLaw’s award-winning individual disability lawyers and experienced group ERISA attorneys know the disability insurance companies’ tricks and how to navigate the laws that govern them. Whether your individual or group disability benefits were wrongfully delayed, denied, reduced, or terminated, consult DarrasLaw as soon as you can. Schedule your completely free disability consultation and free policy analysis today by calling (800) 458-4577 or contacting us online.