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Long-Term Disability Insurance Lawyers in Raleigh, NC 

Making Sure You are Covered With Your LTD Claim 

Are you having difficulty understanding what your disability policy means and what you’re entitled to? Have you become disabled and need help filing a long-term disability (LTD) claim? Are you dealing with an LTD insurance policy either through your job or purchased on your own?

You have been paying into your long-term disability (LTD) insurance policy for years, and you have never needed to use it. But now, due to an unexpected illness or injury, you find yourself unable to work and in need of the income protection your LTD policy provides.

Unfortunately, getting the LTD benefits you are entitled to is not always easy. Insurance companies are in the business of making money, not paying out claims. They will often try to find any reason they can to deny or delay a legitimate claim.

This is where having an experienced LTD attorney on your side can make all the difference. The lawyers at O’Malley Tunstall, PC, have helped many people in Raleigh, NC, get the LTD benefits they are entitled to. We know the strategies insurance companies use to try to avoid paying claims, and we will fight hard to make sure you get the income protection you need and deserve.

What is Long-Term Disability Insurance?

Long-term disability insurance is a type of policy that provides income protection if you are unable to work due to an illness or injury. The coverage can be purchased as an individual policy or as part of a group policy through your employer.

LTD policies typically replace 50 to 60 percent of your income, up to a maximum monthly benefit amount. Most policies have a “waiting period” of three to six months after you become disabled before benefits begin to kick in.

Long-term disability claims may arise from a variety of incidents, including:

  • Work-related accidents and illnesses
  • Accidents and injuries caused by another’s negligence
  • Illnesses that are not work-related
  • Other causes

LTD insurance companies are not on your side. It may feel like the insurance carrier wants to wear you down. Some tactics they use include:

  • Requiring you to send and resend documents it says it never received
  • Claiming you sent the wrong documents
  • Making little to no effort to properly evaluate your disability claim
  • Making a few attempts to obtain your medical documentation
  • Unreasonably denying your claim
  • Delaying or refusing to help you process or manage your claim

Many long-term disability insurance companies require improper examinations by hired-gun doctors who only agree with the companies’ decisions. Carriers are also known to push ambiguous and unclear policies in an effort to dissuade insured individuals from recovering what they have already paid for.

Unfortunately, many LTD insurance carriers give policyholders the runaround. Often an experienced attorney who has handled disability claims for years can do for you what you are unable to do for yourself. If you are having difficulty getting a response to your questions or being paid benefits that you are owed, the attorneys at O’Malley Tunstall, PC in Raleigh, North Carolina, will help you.

What Types of Long-Term Disability Cases Do We Handle? 

The lawyers at O’Malley Tunstall, P.C. have experience handling a wide variety of long-term disability cases. The many types of long-term disability cases we handle include:

Workers’ Compensation

If you have been injured at work, you may be entitled to workers’ compensation benefits. Workers’ compensation is a state-mandated insurance program that provides income and medical benefits to employees who are injured or become ill as a result of their job.

In North Carolina, most employers are required to carry workers’ compensation insurance. If your employer does not have workers’ compensation insurance, you may still be able to recover benefits under the North Carolina Workers’ Compensation Act.

Private LTD Policies

If you have a private long-term disability insurance policy, you may be entitled to benefits if you are unable to work due to an illness or injury. These policies are typically purchased by individuals or as part of a group policy through an employer.

Most private LTD policies will replace 50 to 60 percent of your income up to a maximum monthly benefit amount. Most policies also have a “ waiting period” of three to six months after you become disabled before benefits begin to kick in.

ERISA Policies 

If you have a long-term disability policy that is governed by the Employee Retirement Income Security Act (ERISA), you may be entitled to benefits if you are unable to work due to an illness or injury. ERISA is a federal law that governs the administration of private pensions and health plans.

ERISA policies are typically offered by employers as part of a group insurance plan. If you have an ERISA policy, you may be required to exhaust your sick leave and vacation time before you can begin receiving long-term disability benefits.

Social Security Disability Insurance (SSDI)

If you have paid into Social Security, you may be entitled to Social Security Disability Insurance (SSDI) benefits if you are unable to work due to an illness or injury. To qualify for SSDI benefits, you must have worked five out of the last ten years and paid Social Security taxes.

SSDI benefits are not automatic–you must apply for them and be approved by the Social Security Administration. The approval process can be lengthy, and it is not uncommon for applicants to be denied benefits on their first try. If you are denied benefits, you have the right to appeal the decision.

Appealing a Denial of Benefits 

If your long-term disability claim has been denied, you have the right to appeal the decision. The appeals process will vary depending on the type of policy you have.

If you have a workers’ compensation policy, you will need to file a claim with the North Carolina Industrial Commission. If you have a private LTD policy, you will need to file an appeal with your insurance company. If you have an ERISA policy, you will need to file an appeal with the Department of Labor.

The appeals process can be confusing and overwhelming, but an experienced long-term disability attorney can help guide you through it.

Navigating the Claims Process Without an Attorney

If you are trying to navigate the long-term disability claims process without an attorney, you may want to consider hiring one. An attorney can help make sure that your rights are protected and that you are getting the benefits you are entitled to.

An attorney can also help if you have been denied benefits and need to file an appeal. The appeals process can be confusing and overwhelming, but an experienced long-term disability attorney can help guide you through it.

Is Hiring a Lawyer for My LTD Claim Worth it? 

When you are unable to work due to a disability, the last thing you want to worry about is whether or not you will have enough money to support yourself and your family. Unfortunately, for many people, this is a very real concern. If you have been denied long-term disability benefits, or if your benefits have been cut off, you may be wondering if hiring a lawyer is worth it.

The answer is that it depends on your individual situation. If you are struggling with a complex legal issue, or if you are up against a large insurance company, then hiring an experienced long-term disability attorney may be your best option. An attorney can help you navigate the complicated claims process, gather evidence to support your claim, and negotiate with the insurance company on your behalf.

On the other hand, if you have a straightforward claim and you are confident in your ability to represent yourself, then you may not need to hire an attorney. Keep in mind, however, that even if you do not hire an attorney, you will still be responsible for meeting all of the deadlines and requirements set forth by the insurance company.

If you are unsure whether or not hiring an attorney is right for you, we encourage you to contact our office for a free consultation. We will review your case and let you know if we think hiring an attorney would be beneficial.

How can a Lawyer Give me an Advantage in My Long-Term Disability Claim?

When you’re unable to work because of a disabling illness or injury, you may be entitled to long-term disability (LTD) benefits from your employer’s group disability insurance policy. However, getting the LTD benefits you’re entitled to can be a challenge. Many insurance companies will deny legitimate claims or try to limit the payments they have to make.

An experienced long-term disability attorney can help you navigate the claims process and give you the best chance of getting the full amount of benefits you’re entitled to. Here’s how an attorney can help:

Help You Gather Evidence 

One of the most important things an attorney can do is help you gather the evidence you need to support your long-term disability claim. This may include getting copies of your medical records, gathering statements from witnesses, and helping you get in touch with experts who can testify about your condition.

An attorney can also help you obtain a copy of the insurance policy so you know what benefits you’re entitled to and what the insurer will require in order to approve your claim.

Prepare and Submit Your Claim

Once you have gathered all the necessary evidence, an attorney can help you prepare and submit your long-term disability claim. The claim must be submitted in accordance with the requirements of the insurance policy, and it must include all the required information and documentation.

If the insurance company denies your claim, an attorney can help you appeal the decision. The appeals process can be complex, and an experienced attorney will know how to present your case in the best light and give you the best chance of getting your claim approved.

Negotiate a Settlement 

If your long-term disability claim is approved, the insurance company will begin making monthly benefit payments. However, in some cases, the insurance company may try to limit the amount of these payments or stop them altogether.

An experienced long-term disability attorney can negotiate with the insurance company on your behalf to make sure you’re getting the full amount of benefits you’re entitled to. If necessary, an attorney can also file a lawsuit on your behalf to get the benefits you’re owed.

Do not try to fight the insurance company on your own. Insurance companies have lots of lawyers and money on their side. It may seem that winning is almost impossible. In some cases, a lawsuit may be necessary to obtain the benefits you are owed. In others, the advice of an attorney when the disability tactics become unfair is all that is needed.

Hiring a lawyer early on in the process can prevent the long-term disability insurance carrier from stacking the deck against you. At O’Malley Tunstall, PC, our attorneys have years of experience representing and defending those with disabilities, including social security claims. Contact us today to learn about your options and how we can help you. Call us at (919) 277-0150.