Long Term Disability 101: Understanding the Claims Process

By | October 17, 2016

Most personal injury claims can be easily quantified. The property damage and physical injury involved in such claims are limited and hence, easier to calculate. For example, a car accident victim who has suffered a broken hand can incur specific damages such as medical expenses, property damages, out-of-pocket expenses, and lost wages.

Long-term disabilities, on the other hand, have ongoing medical treatment costs. These kind of costs can make it difficult to calculate settlements for such claims. In addition, estimating the psychological impact a long-term disability can have on a victim is almost impossible.

Unfortunately, long-term injury can seriously affect the quality of your life. In most cases, victims are unable to get back to their old jobs, limiting their options to earn a living. It is, therefore, necessary to maximize your compensation. Understanding how the long-term disability claims process works will help you strengthen your claim.

  • How the Claims Process Works

You can file a long-term disability claim with the insurance company, your employer or the defendant depending on the circumstances of your case. For example, you can file a claim with your employer if the workplace-related accident caused the long-term disability. In the case of a car accident, however, you can file a lawsuit against the negligent driver.

The insurance company or the defendant will then review your claim to decide whether or not you are eligible for the long-term disability benefits. In short, they will verify if the evidence you have produced in support of your claim is enough to prove that you are disabled. Naturally, permanent injury claims supported by strong evidence are more likely to be settled.

  • Key Elements of a Long-Term Disability Claim

There are usually two key elements in a long-term disability claim. First, you have to prove that the accident caused the injury that disabled you. Second, you have to prove that the injury has restricted or limited your ability to work. Proving theses key elements, however, is no cakewalk. You may have to collect a variety of medical documents to confirm the extent and effect of your injuries. Plus, you may have to submit evidence supporting your claims of incurring economic and non-economic damages.

  • Proving Need for Long-Term Treatment

In most cases, courts can rely heavily on medical evidence to determine the outcome of a long-term disability claim. You should, therefore, document all medical bills related to your treatment regardless of how small or big the amount. Make sure to document your medical records such as X-rays, CT scans, and MRIs, among others. You may also need to keep the receipts for therapies you are receiving at home or a rehabilitation center. Further, you can ask your one of your friends or family members to keep track of all out-of-pocket expenses.

The fate of most long-term disability lawsuits depends on the doctor’s or medical examiner’s opinion. Get everything your doctor and therapist say in writing. The doctor supporting your claim needs to be an expert in the field of your injury. He/she should be able to determine the extent of your injury and the time required for the treatment in detail. You can also hire expert witnesses to support your claim. If a dispute about your medical condition arises, the insurance company can ask you to undergo an independent medical examination (IME) to evaluate your injuries. You must comply with the independent examinations to avoid complications in your claim.

  • Awards for Long-Term Disability

According to a survey conducted by the Council for Disability Awareness, long-term disability payments by employers totaled around $9.8 billion in 2013. This represents a 1.6 percent increase in the payments made in 2012. Social Security Disability Insurance (SSDI) claims, on the other hand, witnessed a modest decline for the third year in a row following a rapid increase from 2008 till 2010.

You can recover economic as well as non-economic damages by filing a long-term disability claim. Tangible losses are considered economic damages, including medical expenses, physiotherapy treatment bills, lost wages, rehabilitation costs and additional expenses associated with your disability. Non-economic damages, on the other hand, compensate for non-monetary losses such as pain and suffering. As there is no clear cost associated with them, non-economic damages are often difficult to calculate.

There are several factors that can affect your compensation. These factors may include your age, the extent of your injuries, and the nature of your rehabilitation program. Your state’s personal injury laws can also limit the damages awarded in certain types of permanent injury cases. So, make sure to consult with a personal injury attorney to know how much your claim is worth.

  • You Need an Experienced Attorney

In most cases, insurance companies pay little or no compensation at all. In fact, they will try to settle the claim before the victim gets a chance to hire a lawyer. If you have suffered a permanent injury in an accident, hire a competent personal injury attorney as soon as you can. Hiring an experienced attorney will increase the chances of maximizing your claim. Besides, an attorney can make this arduous claim process a lot more tolerable.

In the United States, personal injury law is under the authority of individual states. Hence, it may vary significantly from state to state. Plus, court procedures may vary depending on your jurisdiction. It is always advisable to hire a local attorney who is familiar with your state’s personal injury law and local court procedures. For example, a leading personal injury lawyer in New Jersey can hardly handle a claim filed in California. A local attorney practicing personal injury law in San Francisco, on the other hand, can handle the same as it should be.

  • Conclusion

The long-term disability claims process is the most intricate legal process. Even the smallest mistake can result in the denial of your claim. Insurance companies often investigate a long-term disability claim thoroughly to save as much money as possible. It is not unusual, however, for the jury to award generous compensation in a claim supported by strong evidence. It is, therefore, necessary to familiarize yourself with the long-term disability law in your jurisdiction before filing a claim. Understanding the claims process can significantly increase your chances to get a fair compensation.

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