Ohio Long-Term Disability Insurance Claims

Evidence for Your ERISA Insurance Claim

Simply telling an insurance company that your health problems are making it impossible to work isn’t enough.

When you make an ERISA claim, you need to back it up with significant evidence.

Some items that help include:

• Results of medical tests
• Your doctor’s assessment of your capabilities
• Records relating to treatments you’ve tried and evidence you’ve stuck to those treatments
• A list of medications you’re taking and their effects
• Vocational assessments that show how you can’t meet physical or mental demands work requires
• Statements from friends, family members, and coworkers who have seen your health struggles firsthand

The more evidence you can gather, the better. One of the most common reasons insurers use to justify denials is a “lack of objective evidence.” 

This is also where a long-term disability lawyer can help. 

Your lawyer can: review your policy, make sense of the legal language, help gather medical records confirming the seriousness of your health problems, handle communication with the insurance company, keep you ahead of important deadlines, and advise you on what to do about settlement offers.

When you get a denial from the insurance company, you generally have 180 days to appeal, so don’t delay.

Contact us well before your appeal window closes.

How to Talk to Your Doctor for an ERISA Insurance Claim

It’s critical to have a plan for how to talk to your doctor about your long-term disability claim. Your doctor’s reports need to make it clear why and how you can’t work.

One impediment to your claim is that your doctor and the administrator of your ERISA insurance plan work off of different definitions of the word “disability.” 

Your doctor may not think of your health condition as “disabling” because they think you’re still capable of doing some things on your own, even if you struggle with work tasks.

If your doctor isn’t clear about your everyday, skill-based limitations in your medical records, the insurance company may believe you don’t need benefits because you can work. 

Insurance companies often look for ways to deny benefits and save themselves money.

Talking in detail about your specific symptoms is important. But what can really strengthen your ERISA disability claim are comprehensive statements from medical professionals about the ways your health problems interfere with your chances at functioning in a work setting.

Your insurance company is likely to use “file reviewers” who will look at your medical records and say you are capable of functioning. 

These are doctors, so there’s an air of expertise, but this is truly just a distraction from the main issue—do you qualify for disability benefits or not?

Ohio long-term disability lawyer Joseph McDonald at HNB has extensive experience with ERISA claims. He’s helped hundreds of people across multiple states.

If you haven’t filed your ERISA disability claim yet, schedule your one-hour pre-claim consultation with our team and get the process of receiving financial relief started right. 

Contact an ERISA Lawyer Today.

Frequently Asked Questions: How Do ERISA Claims Work

Long-term disability insurance is one of those things you don’t think about, or want to think about, until you need it. Here are some basics about workplace-based long-term disability policies.

What Is ERISA Insurance?

ERISA long-term disability insurance plans are policies provided as employee benefits. They provide income support when health problems rob you of the ability to work.

The plans follow rules set by a federal law called the Employee Retirement Income Security Act, or ERISA.

You can also buy long-term disability insurance on your own, under an individual contract, which is not ERISA. ERISA plans are often less expensive than individual plans, but their benefits and rules are more restrictive.

Individual plans fall under state laws that differ from place to place instead of one federal law, like workplace plans. 

You, your employer or both of you pay the premiums for an ERISA policy. It is meant to protect you from economic distress when you face life-altering medical issues.

What Do Long-Term Disability ERISA Policies Pay?

When you get long-term disability benefits, you generally receive about 60 percent of your pay from before health problems interfered with work. It’s a crucial piece of maintaining financial security.

How Long Do ERISA Benefits Last?

Most ERISA policies begin with a two-year period when you qualify for benefits as long as your medical conditions prevent you from being able to continue in your past work.

After two years you need to demonstrate that your health problems are severe enough to keep you from any kind of work you might otherwise be qualified to perform.

Many people lose benefits at the two-year point. But benefits can last as long as your health limitations continue to qualify you, up to retirement age.