Get Help From The Disability Specialists
The Disability Specialists focus on representing people who have been denied disability benefits by:
- Insurance companies
- A claim administrator
- Or both
Our clients are individuals pursuing claims for short-term disability or long-term disability claims under employer-sponsored group plans governed by the Employee Retirement Income Security Act of 1974 (ERISA), or claims made under an individual disability policy.
In addition to handling disability claims, we also represent people who have been denied benefits under long-term care insurance policies.
When you work with us, our attorneys will be personally working on your case. We never hand off cases to associates.
With over 20 years of experience, our attorneys can be trusted to help protect your rights.
Specialized Practice Areas
We specialize in three practice areas, allowing us to stay up to date and provide personalized representation to every client.
Meet with our attorneys for a free initial consultation about your case.
Group Disability Insurance Claims Governed BY ERISA
The Disability Specialists focus on helping people who have been denied Short-Term Disability and/or Long-Term Disability benefits by an insurance company or third-party administrator. Most employers sponsor group disability plans that are funded through an insurance policy.
Other employers have self-insured group disability plans which results in the employer hiring a third-party administrator (i.e., Sedgwick, Broadspire, etc.) to manage claims made under the plan.
There is almost no underwriting with group disability claims, so it is easier for people to get.
If you have the opportunity to obtain disability insurance through a group plan sponsored by your employer, you will not be required to go through the underwriting process that insurance companies use to assess the risk that you pose (i.e., the risk that you will become disabled triggering the payment of benefits).
Whether the employer self-insures the group disability plan, or purchases an insurance policy to fund the plan, the denied claim will most likely be governed by ERISA.
Individual Disability Claims (Not Governed By ERISA)
The Disability Specialists also focuses on assisting people who have been denied disability benefits under individual policies purchased outside the group setting with their employer. Individual policies are underwritten based upon your specific medical history and your personal needs.
While individual policies generally offer better coverage, this type of insurance is more expensive, and coverage can be subject to exclusions based upon your pre-existing medical history.
A person can be insured by both a group disability plan obtained through their employer, and an individual policy. It is possible to make a claim for disability on both policies as a result of the same disability.
Long-Term Care Claims
Another focal point of The Disability Specialists’ practice involves helping people who have been denied Long-Term Care (LTC) insurance benefits. LTC insurance covers the costs of nursing home and/or assisted living services.
Under most long-term care policies, a person is eligible for benefits when they are not able to perform at least two out of six “activities of daily living” without the assistance of a home-health professional, or they suffer from dementia or other cognitive impairment.
The activities of daily living assessed under these policies are:
- Caring for incontinence
- And transferring in and out of a chair or bed
Insurance companies aggressively pushed LTC coverage and have profited for years telling people that they would provide coverage if they ever needed:
- To go into a nursing home
- To go into an assisted living facility
- Or needed in-home health care
There has been an increase in the denial of LTC claims due to the unprofitability of the policies. Insurance companies are bound by the terms of the LTC policies regardless of profit.
Now that a large wave of baby boomers are starting to require long term care, the costs are increasing and insurers have been delaying the payment of these benefits to people in need of their benefits.
The Disability Specialists seek to ensure that LTC insurance carriers do not unfairly take advantage of our clients and their caregivers.
If you are having a problem with an insurance company delaying or denying a claim for LTC benefits, contact The Disability Specialists now for a free consultation.