According to the New York State Department of Health, more than three million New Yorkers experience some type of disability during their work lives. Citizens with household incomes of less than $25,000 a year and those without high school educations suffer from disabilities at higher rates than others. This means that the poorest, most vulnerable New York workers are the ones going up against the disability insurance giants.
They don’t have to do it alone. The nationally renowned disability attorneys and ERISA lawyers at DarrasLaw have more than 100 years of combined experience fighting insurance companies. Whether you’re suffering from a psychological, physical, or a combination of disabling problems, the long-term disability lawyers at DarrasLaw understand it all. We evaluate claims from all over the country, including New York.
New York Disability Categories
When you hear that a coworker has suffered from a “disability,” you may think of a physical injury, such as a broken back. However, you are entitled to disability benefits in New York for so much more. New York State recognizes the following disability categories:
- Pregnancy: Yes, this is considered a disability. You are entitled to take advantage of your short and long-term disability insurance benefits both during and after your pregnancy.
- Impairment to body structure: This encompasses typical physical injuries, such as broken legs. However, it could also include internal injuries, such as a ruptured appendix.
- Impairment to mental functioning: This can include disabilities that develop as the result of traumatic brain injuries, illnesses, or degenerative brain disorders.
- Activity limitation: This includes functional disabilities, such as the loss of your hearing or sight.
- Daily activity limitations: These disabilities occur because you cannot perform your normal daily functions, including going to work. If you struggle to bathe, drive, sleep, eat, walk, or engage in normal social activities, then you have a disability. Daily activity limitations can result from conditions such as diabetes, heart disease, or other illnesses or injuries.
Even if you suffer from a non-traditional disability, you may still be able to take advantage of your long-term disability benefits. If you’re unable to perform the important duties of your occupation due to a disabling injury or illness, speak with a top-rated, experienced disability lawyer at DarrasLaw today. During your completely free consultation with one of our disability insurance attorneys, we will analyze your policy and the facts of your case to see if you have valid disability benefits claim.
Common New York Disabilities and Coverage Options
No two disabilities are exactly the same. The human body is incredibly complex, and an illness that leaves a coworker out of work for a day could leave you out of work for a month. In New York, the following illnesses and injuries most commonly result in disabilities:
- Mobility disability, when you either cannot or are unable to easily walk or climb stairs.
- Cognition disability, when due to a physical, mental, or emotional injury or illness, you have serious difficulty concentrating, remembering, or making decisions.
- Self-care disability, when you have difficulty performing normal activities of daily life such as bathing, dressing, or cooking.
- Vision disability, when your disability results from legal blindness or serious difficulty seeing, even with prescription glasses or contacts. Blindness, however, does not cause all vision disabilities. A brain or ocular nerve tumor can also result in vision impairment.
- Independent living disability, which is similar to a self-care disability, but where you are typically able to perform daily bodily functions such as using the bathroom. Instead, this type of disability is defined by an inability to work, run errands, shop, or go to the doctor on your own. You can suffer from this type of disability as the result of a mental, emotional, or physical illness or injury.
New York State has an insurance fund that covers certain off-the-job injuries or illnesses that result in disabilities. However, it still functions as a private disability insurer would. In fact, it actually competes in the disability insurance market. If you have New York State Insurance Fund (NYSIF) you still have to file disability claims, and apply for disability benefits as you would with a private insurer. Overall, whether you have an individual disability plan, an employer-sponsored group plan, or short-term coverage through NYSIF, your first hurdle is proving that you suffer from a disability.
The best way to do that is to consult one of the seasoned disability attorneys at DarrasLaw. By bringing in a top-rated disability insurance attorney, you improve your chances of making your initial application as bulletproof as possible. This may reduce the need to appeal to get the benefits you deserve for your valid claim, and result in the quicker receipt of disability benefits.
Filing a Claim for New York Disability Benefits
Before filing a claim for disability benefits in New York, you must distinguish between “off the job” and “on the job” injuries! Your disability insurance carrier may look for ways to deny you coverage by tricking you into claiming that you sustained a workplace injury. Look out for these types of questions on your application or from an insurance adjuster. One of the seasoned, top-rated disability insurance lawyers at DarrasLaw can protect you from this tactic.
If your disability insurance company wrongfully denies your valid claim, this will delay the benefits you desperately need to support yourself and your family.
Confusing, vague, and deliberately tricky disability claim form questions are among the main reasons you should consult a disability attorney at DarrasLaw right away. Our experienced insurance disability lawyers offer free policy and claim form reviews to ensure you don’t fall into insurance company traps.
Long-Term Disability Insurance in New York
Long-term disability insurance is designed to protect people who suffer a disabling illness or injury expected to last 90 days or longer. The definition of a long- versus short-term disability will differ based on the terms and limitations of your policy, so always review it with an experienced long-term disability lawyer at DarrasLaw. Take it from seasoned disability lawyers with more than 100 years of combined experience fighting insurance companies-for-profit corporations will find any way to wrongfully deny you long-term disability benefits. Even not-for-profit disability providers will look for ways to save money.
Your insurance company’s goal is not to help you receive long-term disability benefits because your valid disability claim reduces that business’s bottom line.
When you file a valid claim for long-term disability benefits, your disability insurance carrier may require you to attend “independent” medical examinations, often with doctors who lack the proper training or specialization to accurately diagnose and determine your disability. Your long-term disability insurance company may also require you to show that you are receiving appropriate medical treatments for your conditions causing disability, and have a doctor certify you as disabled on a regular basis. If you don’t have great health insurance benefits, these requirements may eat into your already reduced income.
Sometimes, if your disability appears permanent, your long-term disability insurance company may offer you a “lump sum” settlement. While the large amount of a lump sum payment may tempt you if you and your family struggle financially, you should not accept a settlement until a long-term disability lawyer at DarrasLaw reviews it. You do not want the money from a lump-sum settlement to run out, while bills from your disability continue to mount up.
Individual vs. Group Disability Insurance Policies
After a wrongful denial of disability benefits, your legal options differ based on the type of disability insurance policy you carry. If you bought individual disability insurance, you generally can take your case directly to court. In this instance, you can call your treating doctors, friends, and family as witnesses to testify about your disabling conditions. You may also introduce evidence, request evidence from the insurance company, and have your disability attorney cross-examine the insurance witnesses in a real trial before a judge and jury.
Employer-sponsored group disability insurance policies are covered by a complex set of federal laws called the Employee Retirement Income Security Act (ERISA).
New York ERISA Insurance Policies
ERISA law is complicated by itself, and court decisions that interpret it may vary from state to state, further complicating the matter. Accordingly, you need an attorney from DarrasLaw versed in U.S. Second Circuit ERISA case law, as well as the federal ERISA statutes, to represent you during your group short- or long-term disability insurance case.
Before you can file an ERISA federal lawsuit, ERISA requires that you file a timely administrative appeal. The record in the administrative appeal must contain everything you need to win your disability benefits. You must ensure that you submit all of the evidence that could potentially result in a favorable ruling and not omit any medical, vocational, and occupational evidence that could possibly lead to a denial of your valid claim.
After you exhaust all of your administrative remedies, you may file an ERISA federal lawsuit to try to win your disability benefits. Unlike with individual policies, you are not entitled to a trial in an ERISA federal lawsuit. The court is limited to a review of the evidence you submitted during the claim and on appeal. You don’t have the option of any discovery or testimony, nor can you cross-examine witnesses for the insurance company, because there is no trial.
When it comes to an ERISA case, you need a nationally renowned ERISA attorney and disability lawyer with the experience of Frank N. Darras. With more than 30 years focusing on individual and ERISA federal disability lawsuits, he can fight the insurance companies for your benefits no matter the policy type. DarrasLaw can help craft a comprehensive, occupational, medical, and vocational case and greatly improve your chances of winning your needed group insurance disability benefits.
Wrongfully Denied Disability Benefits in New York? Call DarrasLaw for a Free Case Review
When it comes to applying for disability benefits, interpreting your policy, or appealing a wrongful denial of benefits, Frank N. Darras is the top disability attorney in the United States. His firms have recovered almost $1 billion for insurance clients—more than any other individual or long-term disability firm in the nation.
Our policy is analysis is free. Our consultation is free. Our case review is free. We are committed to helping the most vulnerable, and we will fight to ensure your right to disability benefits. Email us or call (800) 458-4577 today to schedule your free meeting with one of our disability attorneys.