ERISA

Four tips that you should remember in the long term disability claims application process:

Almost all ERISA long term disability plans will offset (decrease) your LTD benefit by any amount you receive from Social Security for your disability. If you win your Social Security claim and the LTD insurance company has to pay you less money per month, they have a smaller financial incentive to deny LTD claim. In addition, Social Security Disability requires the tougher "total disability" from any job. Most LTD plans only require you to be disabled from your "own occupation" initially. Winning SSDI benefits will strengthen your claim for LTD benefits.

If your LTD benefits are stopped by the LTD carrier, you will still have income coming in from Social Security. Also, at some point you should be entitled to collect Medicare.  Regardless of your age, 24 months after your date of entitlement to SSDI benefits, you are eligible for Medicare benefits, which includes Part A (hospital benefits) and Part B (medical benefits). A variety of Medicare Advantage plans also are available to you.

Clients who I represent in ERISA cases who are able to win their benefits often ask if taxes will be taken out. It depends on who was paying the premiums. If you pay your own premiums, the benefit will not be taxable if it is ever paid out. If your employer pays the premiums, the benefits will be considered ordinary income. If you split the costs, you will pay taxes on a proportion equal to the proportion of the premiums that your employer paid.

A lot of people call and say – what am I supposed to do, sit home all day? I can’t live a life, I can’t do any activities because they will put me on video. Can I go to the gym, can I go grocery shopping? And there is a quote here from a recent case, the California Federal court, and it says – "the court has repeatedly asserted that the mere fact that a claimant has carried on certain daily activities does not detract in any way her credibility as to her overall disability. One does not need to be utterly incapacitated in order to be disabled." So I think it is really important for people to understand that you can go about living your life, do somewhat normal things, you don’t have to be bed ridden in order to collect disability. You should not live in fear that disability carriers will see you on video because just because they see you outside does not mean benefits are going to be cut off.

At Allan W. Ben P.C., we believe that we are among the very best ERISA lawyers and disability lawyers in the nation. Allan Ben has been voted in Michigan to be a top ERISA Lawyer by Dbusiness Magazine. Our ERISA law firm wants to help victims of abusive insurance company tactics get their benefit payments they are rightfully owed, no matter where they live in the United States.

In the past, before the Internet and e-mail and fax, you were limited to hiring local ERISA lawyers. Very few lawyers practice in the area of ERISA so it was difficult to find the best ERISA lawyers.

The Law Offices of Allan W. Ben P.C. has experienced attorneys who do both Social Security Disability and ERISA cases. Often when you are applying or receiving Long-Term Disability Benefits you are asked by the Plan administrator to apply for Social Security Disability. In fact the LTD Plan administrator will hire you a free attorney to help you apply of Social Security Disability and appeal your SSD case if necessary.

Why do you need a private Social Security Disability lawyer while your ERISA long term disability claim is pending? Most ERISA Long Term Disability plans require you to file for Social Security Disability (SSDI) benefits. This is because they can usually "offset" (subtract) any benefits you receive from Social Security from the amount of long term disability (LTD) benefits they must pay you dollar for dollar. This offset can often times significantly reduce, and in some cases wipe-out, all the LTD benefits they may owe you.

ERISA plans often require claimants to undergo examination by doctors selected by the plans. Even when a claimant’s treating physicians concur that he or she is totally disabled, the plans commonly seek opinions from an examining physicians regarding the claimant’s condition, prognosis, and impairment. Many claims are denied based largely, if not exclusively, on the opinions of examining physicians. It is common for claimants to challenge reliance on "independent medical evaluations" by plans and insurance carriers. After all, examining physicians often spend very little time with a claimant, have not seen the affects of the claimant’s condition over time, and arguably have less ability to assess the claimant’s credibility. What’s more, there are often allegations that the examining physician may be biased in favor of plans and carriers, which typically pay the examining physician’s bill. I have seen some independent medical examinations take less than 10 minutes.

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Among the many reasons that insurers give for denying benefits, the following are fairly common.

Your Medical Records Do Not Support Your Disability:

The excuse that your medical records do not support your inability to work in your job may be given because the insurance company or Plan has misinterpreted your medical records, or because your medical records don’t adequately document your limitations because of your medical condition. Physicians are trained to diagnose and treat medical conditions. They are not necessarily the best at documenting physical or mental limitations associated with a physical injury or illness. In these situations, the experience Long-Term Disability lawyers at Allan W. Ben P.C. will need to assist the doctor to document your condition or refer client to other professionals who can objectively document their disability.