Fighting for Disability Insurance Benefits in Kings County and the Surrounding Areas
It’s home to some of the world’s most prominent corporations—Amazon, Microsoft, Starbucks, Boeing, and Costco. These companies are also some of Seattle’s largest employers. As with most major corporations, these employers may offer at least some of their employees disability insurance.
Some might ask, what is individual or group disability insurance, and when should you make a valid claim for the disability benefits it should provide?
If you’re struggling with an illness or injury that makes performing the important duties of your occupation extremely difficult, you may qualify for individual or group long-term disability insurance.
The University of Washington reports that about 14 percent of Washington State’s population suffers from a disability. In Seattle, about 6 percent of residents live with legal disabilities.
However, a legal disability is different from the disabling illnesses and injuries affecting many of Seattle’s citizens. If you’ve come across this page, there’s a good chance that you have a disability that is preventing you from working, but does not qualify you for benefits under the Social Security Disability Insurance (SSDI) program.
This is why private individual and employer-sponsored disability insurance exists, but it’s not as easy to claim as your disability insurance company makes it seem.
The nationally renowned individual and long-term disability attorneys at DarrasLaw know the tricks your disability insurance company will play when you claim your disability insurance benefits. We can help you understand your rights as a claimant. Spearheaded by award-winning disability lawyer Frank N. Darras, his firms have recovered nearly $1 billion in wrongfully delayed and denied insurance benefits. With more than 100 years of combined litigation and claim experience, practicing disability insurance and long-term care law exclusively, we’re the litigation firm to call for help. To schedule a free policy analysis or claim consultation, contact us today online or at 800-898-7299.
What Is Individual and Group Disability Insurance?
Individual and group disability insurance is really income replacement insurance that takes effect if you’re disabled and can’t work. Depending on the terms of your disability insurance plan, you will receive a percentage of your monthly income while disabled. Individual and employer-sponsored disability insurance is typically classified as either “short-term” or “long-term,” depending on the nature of your illness or injury. “Short-term” disability insurance is meant to cover temporary injuries and illnesses, including:
- Minor fractures
- Sprains and strains
- Pneumonia and bronchitis
You typically have to use your sick time before taking advantage of your short-term disability insurance benefits.
Long-term individual or group disability insurance benefits are designed to cover injuries or illnesses expected to last more than 30 days, depending on your disability insurance policy. You may qualify for long-term disability insurance benefits in one of the two ways:
- You’re still suffering from the injury or illness for which you’re receiving short-term disability insurance benefits.
- Your injury or illness is expected to last beyond your policy’s waiting period before benefits kick in.
Your private individual or long-term disability insurance is different than federal Social Security Disability Insurance (SSDI). To qualify for SSDI, your disability must prevent you from engaging in any occupation to which you are suited by education, training, or physical ability. With your private individual or group sponsored disability insurance plan, however, you may claim disability insurance benefits if you’re disabled from your regular occupation or in some cases any occupation, due to an off or on the job injury or illness. You’re not generally expected to look for work outside of your field if you’re claiming long-term disability insurance benefits under a private individual or employer-sponsored disability insurance policy during the “own occupation” period.
Types of Disability Insurance Policies Offered to Seattle Residents
Individual and long-term disability plans generally fall into three categories:
- Employer-sponsored disability insurance: This is the most common type of disability insurance. Your employer, who may pay some or all of your premiums, provides these plans. Employer-sponsored disability insurance plans do not generally travel with you between jobs. However, they do provide disability insurance benefits if you’re unable to perform the important tasks of your occupation or in some policies the duties of any occupation, due to a disabling illness or injury. You don’t have to suffer from a total disability to claim these disability insurance benefits.
- Group disability insurance: An organization or professional association you joined, such as a union, typically provides these disability insurance plans. Union members may share the costs of disability insurance premiums, or unions may include them in their dues. If you lose your job, you may generally still keep your disability insurance coverage if you maintain your membership in the union, pay the premium and the same disability insurance plan may follow you between union-sponsored jobs.
- Individual disability insurance: You purchase these disability insurance plans yourself from a broker or agent, the same way you purchase private auto or life insurance. You typically pay the premiums for such disability plans, so they follow you, not your job, and the benefits should flow tax-free. Independent contractors, self-employed individuals, and many other non-professionals and professionals may have purchased private disability insurance policies. Individual disability insurance typically provides income replacement benefits the way an employer-sponsored or group plan would, but generally it’s tax-free. As long as you are disabled from your occupation, or in some policies, from any occupation by which you are trained, educated, or suited, you may qualify for individual disability insurance benefits.
Your legal rights differ significantly under each type of disability insurance policy. A complex set of federal laws called the Employee Retirement Income Security Act (ERISA) generally governs employer and group disability insurance plans. If your ERISA-governed group disability insurance company arbitrarily and capriciously delayed or wrongfully denied your disability insurance, you don’t have the same legal rights or consumer protections as an individual policyholder.
Conditions That Most Individual and Group Long-Term Disability Insurance Plans Cover
Physical injuries aren’t the only conditions that keep people out of work. Mental health and self-reported conditions such as post-traumatic stress disorder and chronic fatigue syndrome may all interfere with your ability to reliably work. These are among the most common conditions for which claimants may receive disability insurance, but the many others include:
- Depression, anxiety, and other mental and emotional health issues – Anxiety disorders are the most common mental health conditions in the United States, and depression often accompanies them. Only about one-third of Americans suffering from these disabling mental health conditions receive the professional help they need. Many of these people may not realize that, with the help of an experienced individual or long-term disability lawyer from DarrasLaw, they might claim and receive long-term disability insurance benefits for these conditions. The issue with claiming disability insurance benefits for mental health conditions, such as anxiety, is that these conditions are “self-reported” illnesses. While severe conditions may manifest in your disposition or even blood work, you may face a wrongful delay or bad-faith denial of disability insurance benefits due to lack of objective medical evidence. However, the top-rated individual and long-term disability attorneys at DarrasLaw can guide you through the disability insurance claims process. Our award-winning ERISA attorneys and long-term individual disability lawyers know what evidence you can submit to support self-reported mental health and other physical conditions.
- Sciatica, lower back pain, and scoliosis – Back pain is among the most common physical injuries suffered by Americans. While an MRI may show a herniated disc, lower back pain has many causes. This injury is often self-reported when it comes to how the pain hinders your ability to work. While objective medical evidence can prove you have sciatica, for example, you also must show that it’s too painful to reliably engage in your normal occupation. Back pain can make sitting, standing, climbing stairs, or lying down painful. This can damage your work-life in many ways. You may feel so uncomfortable that you can’t pay attention to your work tasks. Our experienced, long-term individual disability lawyers and ERISA attorneys at DarrasLaw understand how back conditions affect your work life. We can help you and your treating doctors with questions about the tricky claim forms and proper medical evidence you need to provide to your disability insurance carrier.
- Knee injuries and replacements – If you’ve ever torn an ACL, meniscus, or MCL, you know the excruciating pain a knee injury can cause. Many claimants are unable to return to work after a serious knee injury, even though they don’t work in a physically demanding occupation. Even if, intellectually, you can perform the important tasks of your occupation, working encompasses so much more. The inability to walk without assistance can leave a huge impact on your daily life, including your occupation. What if you can’t drive to work or use the restroom without help? Knee dislocations are also common after a car accident. Even a minor accident can cause your knee to hit the dashboard, dislocating the patella. The seasoned individual disability insurance and ERISA lawyers at DarrasLaw know how an unexpected knee injury or surgery can impact your work life, and they can help you secure disability insurance your benefits.
- Coronary artery disease, strokes, and heart attacks – High cholesterol often leads to coronary artery disease, which occurs when your heart is not getting the nutrients it needs due to artery blockages. As your arteries begin to narrow, you may become fatigued, experience shortness of breath, or suffer from chest pain. You will most likely suffer from these symptoms before you experience a heart attack, and you should address them immediately. The award-winning individual disability attorneys and ERISA lawyers at DarrasLaw know that coronary artery disease is a life-threating condition that may immediately qualify you for individual and long-term disability insurance benefits. If you’re diagnosed with this condition, our experienced individual disability lawyers and ERISA attorneys can advise you about the medical evidence you need to make an immediate claim for disability insurance benefits. This may give you time to get the help you need to prevent a heart attack.
Whether your injury is physical, mental, emotional, cognitive, or a combination thereof, a top-rated individual disability lawyer or ERISA attorney at DarrasLaw can help. Our skillful individual and long-term disability lawyers provide free policy analysis and free claim consultation for people with many disabling illness or injury, such as:
- Fractures, broken bones, and dislocations
- Arthritis, lupus, and other autoimmune disorders
- Pregnancy complications
- Neck pain and whiplash
- Tennis elbow
- Bunion removal
- Carpal and cubital tunnel syndrome
- Lyme disease and tick-borne illnesses
- Fibromyalgia, fatigue, and migraines
Consult an ERISA Attorney or Individual Disability Lawyer From DarrasLaw Immediately
If you have a valid claim for long-term disability insurance benefits, consulting an ERISA attorney or individual disability lawyer from DarrasLaw as early as possible can make all the difference in your case.
If you receive coverage under a group or employer-sponsored disability insurance plan, you do not have the same litigation rights as individual disability insurance policyholders. Instead, if you experienced a wrongful delay or denial of benefits by an ERISA governed group disability insurance plan, you must file a timely, comprehensive administrative appeal with your insurance company before filing federal ERISA litigation.
Under ERISA, your group administrative appeal is directly linked to any future litigation, which your disability insurance company won’t tell you. Unlike with individual disability insurance policyholders, ERISA cases are limited to an evaluation of the administrative record. This means the only evidence you can introduce during litigation are the documents you submitted to the disability insurance company during your initial claim and administrative appeal. You are not entitled to a trial by jury like individual policyholders are, nor are you entitled to discovery, to call or cross-examine witnesses, or to submit additional evidence or documentation. You cannot seek emotional distress, punishment damages, or extra damages for your stained credit or foreclosure.
Consult an experienced group ERISA attorney or long-term disability lawyer from DarrasLaw who deals exclusively with these extremely complicated disability issues. We can help you understand and fully protect your legal rights, as well as tell you want you need to present a comprehensive, legally sufficient, timely administrative appeal. This will give you the best possible chance should you need to file a subsequent federal disability ERISA lawsuit.
Call DarrasLaw Today to Schedule Your Free Disability Insurance Case Review
At DarrasLaw, our goal is to help protect the rights of the disabled, in Seattle and the rest of the nation. DarrasLaw charges no upfront fees or costs—we only get paid if we win your individual or group long-term disability insurance claim. Take advantage of our free case and free insurance policy analysis to see if we can help. Call our top-rated ERISA attorneys and individual disability lawyers today at 800-898-7299 or contact us online.