Many years ago, before 1995, a professional could file a long-term disability claim on their own and likely get paid. After 1995, the industry changed dramatically. Many companies went out of business in the long-term disability space, claims were being denied and terminated like wildfire, and litigation spawned all over the country on a massive basis; a huge industry shakeup happened.
About ten years later, long-term disability insurers started selling these policies again, but they changed their claims management model. Rather than just cutting people off and litigating, they have and continue to spend a significant amount of time scrutinizing and evaluating the claims made by the insureds, before acknowledging they are liable to pay long-term disability benefits.
This scrutiny is the reason it is important to have a strategic game plan and understand what you may face when dealing with a long-term disability insurance company on your claim, particularly if you are a business owner, or a professional such as a lawyer, doctor, or dentist. If you are in the financial services industry, you may also have an enormous amount of monthly benefits at stake, and not having a plan can be costly, and potentially fatal, to your ability to get paid.
Complicated factual and legal issues often abound in long-term disability claims, with the level of complexity dependent on the situation:
•If a diagnosis is inaccurate or difficult to support,
•The health care provider or physician is unable, unwilling, or does not know how to support a long-term disability claim, or
•There is more than one disabling condition, with one being more significant than the others.
Long-term disability companies examine someone’s finances for purposes of determining if they have a motive to file a claim, as well as for a whole host of other reasons. Understanding what’s going on in your financial world and how it could affect your claim typically requires a level of analysis and complexity well beyond the skill of a lawyer without experience in this area.
Knowing when to stop working and file your claim, or when to change the way you work and file your claim, typically requires a complex analysis of your financial circumstances, the deterioration of your medical condition or conditions, as well as what is happening within your occupation itself.
Legal and Personal Issues
If you are separating from a private practice, a practice with partners, or a large company, there are always going to be issues involving the details of the separation for which you’ll need sophisticated legal advice.
If you are having or expecting to have health difficulties and think you may need to access your long-term disability policies, contact an experienced lawyer as soon as you can. My firm and I are here to assist you in evaluating any potential issues you may have and to help you make the right decisions for you.
Evan S. Schwartz
Founder of Schwartz, Conroy & Hack