Fighting for Your Right to Obtain Disability Benefits in Oregon
According to the Oregon study on health and disability, more than 25 percent of adults in Oregon live with a disability. Many of Oregon’s disabled adults are between the ages of 18 and 59. These working-aged people may struggle to get by each day. Many beneficiaries may not take advantage of the individual or group disability insurance benefits to which they are entitled and other claimants may face the bad-faith delay or denial of disability benefits. Some people may not know how to timely file a proper disability claim. Maybe you are one of these people.
As you know, a disabling illness or injury can result in immediate financial distress for you and your family. Further, individual and long-term disability benefits don’t protect your job, just your occupation, so you may fear what the future holds.
No matter what stage of the disability insurance process you’re in, or where in Oregon you live, our award-winning individual disability attorneys and ERISA lawyers at DarrasLaw can explain your consumer rights. With more than 100 years of combined litigation and claim experience, we’ve fought—and beaten—every major disability insurance company in the country. Led for more than 30 years by our founding partner, America’s top disability attorney Frank N. Darras, our experienced, award-winning individual and long-term disability insurance lawyers share a passion for protecting the most vulnerable from Oregon’s insurance conglomerates.
If your disability insurance company has delayed or wrongfully delayed or denied your valid disability claim in Oregon, or you simply need advice about how to fill out your claim application, contact our seasoned individual disability attorneys and ERISA lawyers online or at (800) 458-4577.
What Is Disability Insurance, and When Is It Time to File a Disability Insurance Claim?
Disability insurance typically acts as an income replacement policy if you suffer from a disabling illness or injury that leaves you unable to work. Some workers may try to get by on sick time or working from home when they really need rest and recovery. Your personal private disability policy or employer-sponsored group disability insurance protects you if you are unable to work. You paid dearly for your disability benefits for just these situations.
Your individual or group employer-sponsored disability insurance policy may not require you to suffer a total disability to obtain benefits. These benefits are designed to replace a percentage of your income during your disability period. The exact income percentage and disability period will depend on the terms of your disability insurance plan, but a typical term is to normal retirement age.
Filing a successful individual or group long-term disability insurance claim is more difficult than it sounds, so always have an experienced federal disability lawyer on your side. Typical individual and group long-term disability insurance benefits include, but are not limited to:
- Total and partial income replacement
- Return to work assistance
While the award-winning, seasoned individual disability attorneys and ERISA lawyers at DarrasLaw can help you timely file your individual or group long-term disability benefit claim, the majority of our clients call us after their insurance companies have wrongfully delayed or denied their rightful benefits.
The federal laws that govern employer-sponsored and group disability benefits help to make disability law so complex. These laws, codified under the Employee Retirement Income Security Act (ERISA) are not beneficiary friendly, and you need an experienced disability insurance lawyer and ERISA attorney from DarrasLaw on your side as you timely file your valid group disability insurance claim or administrative appeal.
Medical Conditions That Qualify for Benefits Under Most Oregon Disability Insurance Plans
The first hurdle in claiming disability benefits is proving to your disability company that you have a qualifying “disability.” The specific definition of a disability will depend on the terms and limitations of your disability insurance plan, but it is generally defined as having an illness or injury that prevents you from performing the important duties of your occupation. As long as your illness or injury meets this definition, you may qualify for disability benefits through your individual or employer-sponsored disability group insurance plan. Common examples of qualifying disabilities in the United States include:
- Slipped discs and back pain
- Pregnancy complications
- Surgical recovery
- Broken bones, fractures and dislocation
- Car accident injuries
- Carpal and cubital tunnel syndrome
- Heart disease, COPD, diabetes and stroke
- Asthma, lung problems
- Depression, anxiety and PTSD
- Chronic fatigue, Lyme disease, fibromyalgia and migraines
Oregonians most commonly suffer from the following disabilities:
- Back, neck, and spinal injuries: Many injuries stem from a serious Oregon car accident or degenerative disc conditions. These injuries and sicknesses typically result in extreme difficulty walking, sitting, laying down, standing, or climbing stairs. Furthermore, even office workers may find sitting difficult for short periods of time. This is often the result of “sciatica,” a significant cause of lower back pain. If you suffer from sciatica, pain may radiate through the sciatic nerve in your lower back down to your hips and legs. This can result in such constant pain and discomfort that you can no longer tolerate to do your work functions.
- Traumatic brain injuries: The brain is such a complex organ, it is often hard to tell how a traumatic brain injury will affect you in the long term. A traumatic brain injury can result in a coma, difficulty concentrating, impaired problem-solving abilities, and debilitating migraines. Any of these symptoms can prevent you from working in nearly any occupation. Furthermore, it can take a long time to recover from traumatic brain injuries, and your treating doctors generally need years to determine their full effects. While many traumatic brain injuries result in total disabilities, some traumatic brain injuries may only prevent you from pursuing your current occupation, but you could do other work.
- Cancer: While you may work for a while after a cancer diagnosis, treatments tend to take you out of the labor force. The side effects of chemotherapy and radiation therapy can leave you fatigued, nauseated, confused, and susceptible to infections. Even if you don’t need chemotherapy, you may require time to recover from a surgical procedure. While many Oregonians with cancer may wish to keep working, your treating doctor may not be recommend it if treatments have compromised your immune system. It’s best in these situations to timely file a claim for the disability insurance benefits that can help you recover fully.
- Congestive heart failure: This condition occurs when the heart is too weak to pump blood like it should, resulting in a buildup of fluid around the heart. This condition generally gets worse with time, and results in shortness of breath, weakness, and dizziness.
Whatever illness or injury has left you disabled, don’t feel afraid to contact the experienced disability insurance lawyers at DarrasLaw.
Exceptions to Qualifying Disabilities
Even if you initially qualify for disability benefits, remember that your disability insurance carrier is looking for ways to save money. So before your disability insurance company wrongfully delays or denies your benefits, look for traps on your disability claim form that deal with:
- Injuries obtained from war or due to an act of war. If you were injured in a domestic attack, does this mean your disability insurance company can disqualify you for benefits?
- Injuries obtained during the commission of a crime, including as the result of a DUI. Be careful when answering questions about this subject on a claim application, especially with car accident related injuries. Talk to one of our top-rated disability insurance attorneys and ERISA lawyers to get a legal sense of what constitutes an intentional act.
- Injuries obtained during participation in “civil disturbance.” Before answering any of these questions, speak with an award-winning disability insurance lawyer or ERISA attorney at DarrasLaw.
- Injuries obtained “on the job.” Your individual or group disability insurance company may try to encourage you to apply for workers’ compensation insurance when you didn’t actually suffer an injury during the course of your employment. Don’t let them.
You may also face certain disability insurance exclusions and limitations for otherwise qualifying illnesses and injuries. For example, even though back pain is among the most common disabling injuries in Oregon, your disability insurance company may limit you to a few years of benefits with a musculoskeletal limitation. The same is true for certain emotional mental disabilities, such as depression or PTSD. In many cases, you can only claim disability benefits for these conditions for a few years.
Having one disability can lead to many others. For example, if you initially applied for disability benefits as a result of back pain, if your condition worsened and you are now struggling with a neurological disorder and ambulatory disability—that is, you can’t walk or climb stairs—you may qualify for additional disability benefits.
Consult a Top-Rated Individual Disability Lawyer and ERISA Attorney at DarrasLaw as Soon as Possible
If your employer or another organization, such as a union, sponsors your group long-term disability policy, it is likely considered an ERISA plan. ERISA is touted as a series of federal laws designed to help protect disability beneficiaries, but it has the opposite effect. Most beneficiaries in Oregon don’t see ERISA’s drawbacks until it’s too late.
Under ERISA, if your disability insurance company wrongfully delayed or denied your valid claim, you generally cannot take your case directly to court. Instead, you must first timely file a comprehensive administrative appeal with your group disability insurer.
While this seems simple enough, it’s a huge trap. When you file a group administrative appeal, you must submit certain medical documents and statements to your insurer proving you’re entitled to disability benefits. If you’re again wrongfully denied disability benefits, your entire federal ERISA lawsuit is limited to a review of the documents you submitted during your claim and group administrative appeal. You don’t have the right to call witnesses on your behalf, and you don’t have the right to a trial by jury. You can’t even submit additional medical records to the federal judge that weren’t apart of the claim or appeal.
The earlier you consult an experienced individual disability attorney or ERISA insurance lawyer from DarrasLaw, the more likely you are to protect your case and your benefits. We know what information you need to place in your ERISA administrative appeal, and we can help you make it as complete and hard to deny as possible.
Don’t Fall Into the Disability Insurance Trap. Call DarrasLaw Today
The prospect of applying for, maintaining, and potentially appealing a bad-faith delay or denial of group disability benefits can overwhelm anyone. But it doesn’t have to. The top-rated individual and group long-term disability and ERISA insurance litigation firm in the country, DarrasLaw, has taken on every major disability insurance company—and won.
Whether you live in Portland, Gresham, Salem, Hillsboro, Happy Valley, or anywhere else in Oregon, consult our award-winning ERISA lawyers and individual disability insurance attorneys. Call DarrasLaw now for your risk-free individual or group long-term disability policy analysis and free claim consultation at (800) 458-4577 or contact us online.