Quite often we get calls from people who have become disabled and can’t work, and they can’t get their disability insurance company to pay them their disability benefits. What is disability insurance you ask? Some folks have disability insurance as part of their group benefits that their company provides. Others, such as doctors and accountants, have individual disability insurance policies. These policies pay a certain percentage of their normal income if they become disabled and can’t work.
For example, Michelle was an accountant for her company with over 25 years of experience. As part of her benefits package, her company provided each of its employees with a disability insurance policy in the event they became disabled and could not work. Michelle began to suffer from a crippling bout of rheumatoid arthritis along with a diagnosis of fibromyalgia. For years she fought through the pain and the restriction on her mobility to try to do her job, but she finally could not continue.
How in the world would she continue to pay her monthly bills without income? Michelle filed a claim with her insurance company and submitted her medical records. Her insurance company did what they usually do and quickly denied her claim asserting that they believe she could still perform her job duties. When Michelle came to us she was desperate. She had not worked in almost a year. She’d used almost all her savings to pay her monthly bills. Her insurance company—the company she had been paying premiums to for year—was refusing to pay her the disability benefits she deserved. We were able to prepare an appeal for Michelle which included additional reports from her doctors along with functional capacity evaluations. These records gave specific details about Michelle’s physical limitations and provided objective evidence supporting the reasons she could not perform the duties of her job.
Many times when we submit objective medical evidence and evaluations along with our legal arguments, insurance companies will approve or reinstate our client’s disability benefits—but sometimes they don’t.
Sometimes they have their doctors and nurses review our client’s medical records and determine from the records reviewed that our clients can work. And they make this determination having never seen nor evaluated our client.
In Michelle’s case, this is exactly what they did. After the insurance company’s final denial, we filed suit in federal court on Michelle’s behalf. After several months of litigation we were able to get the insurance company to agree to pay Michelle her back benefits along with a portion of her future benefits which totaled just over $150,000. Because Michelle placed her trust in us to handle her disability insurance claim, she was able to focus totally on getting medical treatment she needed to deal with her physical condition. If you need help with your disability claim, call us today!
