How Idaho Long Term Disability Attorneys Can Help You

Many employers provide employer-sponsored disability insurance coverage. This may be offered free of charge to employees or an employee may have to buy in by paying part or all of the monthly premium. Having this safety net is important, especially if you work in a job that requires you to do physical labor or exposes you to chemicals or other hazards. Disability insurance is also important if your occupation requires you to obtain a professional license in order to work in the field. At Dabdoub Law Firm, our long-term disability lawyers can help you obtain disability benefits when you are in a time of need. We can handle your case at any level from initial claim, to appeal, to lawsuit.

The Insurance Company Won’t Pay or Stopped Paying

With few exceptions, most group disability insurance policies are governed by a federal law known as the Employee Retirement Income Security Act of 1974. This law is commonly referred to as ERISA. ERISA has specific rules that govern a person seeking disability benefits as well as the disability insurance company. ERISA gives you a right to appeal a denial or termination of disability benefits. You cannot go straight to court. Instead, this appeal must be sent directly to the insurance company.

The appeal of a denial or termination of disability benefits is vital to your case. Important medical and non-medical information must be given to the insurance company to support your claim. You typically have 180 days to submit your appeal, in writing. The appeal is often the last time to provide evidence supporting your case because once the final decision is made your file is closed if it is a denial. If your appeal is rejected, the next step is to file a lawsuit in federal court. If you have not hired a long-term disability attorney by this point, now is the time to hire one. Because the rules that govern ERISA cases are many and complicated, even one small mistake could ruin your case.

Idaho Disability Cases

Some states across the country -- including California, Illinois, and Texas -- have passed a discretionary clause ban. This means insurance companies are not allowed to have language in their insurance policies that give the insurance company the sole authority, or discretion, to decide who is entitled to benefits. The Idaho Department of Insurance issued Rule 18.01.29 in May of 2009, restricting health insurers from putting discretionary clauses in insurance policies. Rule 18.01.29 applies to all insurance contracts issued or renewed after May 1, 2009. While the draft of the rule specifically stated this ban did not apply to ERISA plans, that language did not make it to the final rule. This means that, at least for now, disability insurance policies that have discretionary clauses will not be able to use that clause to give the insurance company sole authority to make decisions. This gives a person seeking disability benefits a more even playing field in court. This is because when a discretionary clause exists in an insurance policy, and it is not voided by law, a judge will only reverse the insurance company’s decision if he or she finds it completely unreasonable. This is a difficult standard to overcome.

Not all disability insurance policies contain discretionary clauses. Idaho law, however, voids discretionary clauses in those policies that were issued or renewed after May 1, 2009.

How We Can Help

The long-term disability attorneys at Dabdoub Law Firm know the applicable laws. They also know what to look out for when reviewing disability insurance policies. Our firm also constantly challenges disability insurance policies that may not have the right language to actually grant discretion under the law. If your disability insurance policy has a discretionary clause and there is no law banning the language, our attorneys know how to work within the harder standard.

Our firm solely focuses on disability insurance and ERISA cases. We handle cases at every stage from claim initiation to presuit appeal to litigation in court. We can work together to make sure you are taking full advantage of the law in your case.

Contact us today to schedule your free case evaluation!


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