Long-Term Disability Lawyers Protecting Claimants in Boston
Award-Winning ERISA Group Attorneys and Top-Rated Disability Lawyers Fighting for Bostonians’ Disability Benefits
Having a disability is hard enough, especially in the harsh winters of Boston. Did you know that nearly 40 percent of disabled citizens in Massachusetts are working, and more than half of them work full-time, year-round? In Boston, about 9 percent of working-age individuals have a disability. Whether they were born with disabilities or suffered them from an injury or illness, their disabilities may make year-round, full-time work difficult.
A lack of sufficient time to treat your disabling illness or injury may hurt your ability to work in the future. Furthermore, not all employers can make accommodations for disabled workers. Some workers may mistakenly believe this leaves them without options, except to work through the pain. However, if you suffered from an injury or illness that prevents you from completing the important duties of your occupation, you may have a valid claim for individual or group insurance long-term disability benefits.
Led by award-winning ERISA attorney Frank N. Darras, America’s top-rated individual and group long-term disability lawyers at DarrasLaw have more than 100 years of combined litigation and claim experience protecting America’s disabled from insurance companies. Frank N. Darras and his firms have recovered nearly $1 billion in wrongfully delayed, denied, and terminated insurance benefits. To schedule a free, confidential long-term disability policy analysis or free claim consultation, call us at (800) 458-4577 or contact us online.
Qualifying for Long-Term Disability Insurance in Boston
Depending on your disability policy’s terms and limitations, long-term disability insurance replaces your income if:
- You suffered a qualifying injury or illness—that is, the injury cannot have been self-inflicted or pre-existing
- You cannot perform the important duties of your occupation as a result of the disabling injury or illness
- You can’t perform those duties for the period of time specified by your individual or group disability insurance policy
If you qualify for individual or group long-term disability benefits, you’ll receive a percentage of your monthly income that your policy specifies. Beware, however, of disability payment offsets. Your group long-term disability insurance company will use offsets, or other income, to reduce what it pays you. These offsets may include:
- Social Security benefits or SSA benefits
- Pension benefits
- Related wrongful termination settlements or other third party judgments
- Damages from personal injury lawsuits
- Workers’ compensation benefits
- A. benefits
A lot of disability insurance fraud occurs when claimants fail to report alternative sources of income. Sometimes these innocent mistakes are caused by intentionally vague or misleading questions on the disability claim application. Then, the individual or group long-term disability insurance company uses the mistaken answers to deny otherwise valid claims.
While the injury or illness may truly disable you, failure to report sources of income can result in the denial or termination of your individual or group long-term disability benefits. Before filling out your claim application, please contact DarrasLaw for claim assistance. Our nationally acclaimed individual disability lawyers and top-rated group ERISA attorneys can help you accurately answer application and claim questions without compromising your case.
Individual versus Group Long-Term Disability Insurance
If your employer offers a benefits package, it may include a long-term disability insurance policy among them. Group long-term disability policies cover you while you work for that employer. For example, if you’re a nurse, but you work weekends at Fenway Park, you can’t use your nursing disability insurance to cover your lost weekend income. Furthermore, when you leave your sponsoring job, you generally lose your long-term disability insurance.
With individual long-term disability insurance, you typically pay your premiums, but the policy travels with you between jobs and projects. These policies cover you, not just the income from one job and the disability benefits are paid tax-free.
Many self-employed people, independent contractors, or high-wage workers have individual long-term disability insurance policies. Furthermore, because most long-term disability policies only replace a percentage of your salary or hourly wage after a disabling injury or illness, some employees opt to buy an individual long-term disability insurance policy as well.
If you are totally disabled—that is, unable to work in any occupation for which you are trained, educated, or suited—you may receive coverage through Social Security Disability Insurance (SSDI). SSDI actually runs concurrent to your private individual or group disability insurance, so you may claim both. As mentioned above, however, your group disability insurance company will offset any benefits you or your dependents are granted through SSDI.
Understanding the type of disability insurance policy you have is actually very important. Different laws apply to each type of long-term disability insurance plan.
If you have group or employer-sponsored long-term disability benefits, the Employee Retirement Income Security Act (ERISA) generally governs your plan. This complex set of federal laws controls everything from insurance disclosures to wrongful denial litigation in federal court.
Individual policyholders are not generally subject to ERISA’s many restrictions, and you will have more consumer rights for wrongfully delayed, denied, or terminated benefits from an individual long-term disability insurance plan.
Injury and Illness Coverage in Boston
Provided that the injury or illness was not self-inflicted, suffered in combat, or caused due to your criminal actions, you may claim individual or group long-term insurance disability benefits. You must, however, suffer from a qualifying injury or illness.
Qualifying injuries or illnesses can include any of the following and more, provided they prevent you from performing the important duties of your occupation:
- Bunion surgery
- Tennis elbow
- Knee and hip injuries and replacements
- Carpal and cubital tunnel syndrome
- Broken bones
- Anxiety, depression, and other mental and emotional disorders
- Fibromyalgia, chronic pain, migraines, and other self-reported conditions
- Multiple sclerosis
- Crohn’s disease, irritable bowel syndrome, and bowel dysfunction
- Spinal cord, neck, and thoracic problems, including sciatica, herniated discs, and back pain
Working adults in need of individual or group long-term disability benefits in Boston commonly suffer from these injuries or illnesses:
- Cancer – In the most general sense, cancer is a disease caused by the rapid divisions of abnormal cells within the body. Some types of cancer cause tumors or abnormal growths, while other types disrupt normal cell functions. Breast and prostate cancer are among the most common cancers in the United States. If you need a malignant tumor removed and the cancer has not spread or metastasized, you may be able to return to work in a few weeks. Sometimes, however, the cancer doesn’t disable you so much as the treatments, including chemotherapy, radiation, and fatigue.
- Neck pain – Also called a cervical spine or c-spine injury or sickness. Neck pain is one of the most common disabilities in the United States. While many of us work with neck pain, it can become unbearable if you’re required to drive or work on a computer all day. When a truck driver can’t turn his head left due to neck pain, he can’t drive. Accordingly, he’d qualify for individual or group disability benefits.
- Post-traumatic stress disorder (PTSD) – While PTSD is commonly associated with combat injuries, it can manifest after any type of serious trauma. A physical or sexual assault, car accident, or traumatic injury can trigger PTSD. It’s common to experience symptoms, such as nightmares, social anxiety, and paranoia, for a few weeks after a traumatic event. If these symptoms persist, however, you may suffer from PTSD.
- Traumatic brain injuries (TBI) – Traumatic brain injuries commonly result from car accidents and sports-related concussions. Even if you don’t lose consciousness, you may still sustain a traumatic brain injury that damages your ability to concentrate, learn, focus, problem solve, or think critically at work. These are skills necessary for most occupations, and it’s difficult for employers to accommodate them.
- Heart attacks, strokes, coronary artery disease, diabetes, COPD, and aneurism – Heart conditions are the number one killer in America. This is true for men and woman of all races. Sometimes a heart attack or an aortic aneurysm is caused by an underlying genetic condition, while other times it’s caused by poor lifestyle choices. If your blood pressure and cholesterol are high, you may experience an increased risk of a heart attack. A heart attack actually occurs when one or more of the vessels that pump blood in and out of your heart become clogged with plaque. If the blood flow to your heart is cut off for even a few minutes, the loss of oxygen can cause a traumatic brain injury. Warning signs of a heart attack include trouble breathing, sweating, jaw pain, and chest pain. If you experience these symptoms, you may save yourself from a heart attack by seeing your treating doctor. Your treating doctor may also certify you as disabled because you need immediate treatment from the grave danger of suffering a major heart attack.
While you may assume it’s enough to say you have cancer or multiple sclerosis on your individual or group long-term disability claim application, it’s not usually the case. The severity of your illness or injury isn’t always the measure for your individual or group long-term disability company. Instead, it’s exactly how that injury or illness limits or prevents your ability to perform the important duties of your occupation.
Preventing a Wrongful Delay, Denial, or Termination of Individual or Group Long-Term Disability Benefits
ERISA generally covers long-term group disability insurance policies. ERISA requires your group or employer-sponsored long-term disability insurance carrier to provide you with certain legal disclosures and set forth the specific reasons for why they denied you disability benefits. If you were denied long-term group disability benefits for medical reasons, the insurance-company paid doctors (who may lack the proper training or specialization to properly evaluate your claim) need to set forth the specific reasons that they disagreed with your treating doctor’s restrictions.
In terms of consumer protections and legal rights, ERISA also has serious shortcomings.
If your group long-term disability insurance company wrongfully delays, denies, or terminates your benefits, you must timely file an administrative appeal with your disability insurance carrier before you can file a federal ERISA lawsuit.
If your group disability benefits aren’t reinstated after your administrative appeal, your entire federal ERISA lawsuit is limited to the evidence submitted during your underlying claim and your group administrative appeal. If you didn’t submit legally sufficient medical reports or produce witness testimony during the underlying claim or administrative appeal, you generally can’t introduce new evidence during the litigation.
An individual policy that you purchase from an agent or broker grants you many more consumer and legal rights. You generally may take your bad-faith denial straight to court without filing an administrative appeal. You may submit evidence, gather critical claim evidence through the use of discovery, call witnesses on your behalf, cross-examine the insurance company’s witnesses, and try your case before a jury. You may also seek emotional distress and punishment damages along with attorney fees in an individual disability insurance lawsuit.
Contact a top-rated ERISA lawyer or award-winning individual disability attorney at DarrasLaw at the onset of your individual or group disability case. We will know which laws apply to your situation and can guide your case in the best possible direction.
Call Our Nationally Renowned Individual and Award-Winning Group Long-Term Disability Attorneys at DarrasLaw for Help in Boston
DarrasLaw is here for Boston’s disabled. We have spent more than 60 years litigating, fighting and defeating every major long-term disability insurance company in the nation.
Whether your individual or group disability benefits were wrongfully delayed, denied, reduced, or terminated, schedule your completely free disability claim consultation and free policy analysis with us today by calling (800) 458-4577 or contacting us online.