If you have a long term disability policy and you need to make a claim, you should first look to see if your policy is covered by a federal law called ERISA. This stands for the Employee Retirement Income Security Act of 1974. If you got your coverage through your employer, your claim is probably covered by ERISA. There are some exceptions, such as for governmental employees and church employees. It may be difficult to determine if you have an ERISA plan or not. Your attorney can help you determine this. If you have an ERISA plan, your rights are limited. You can sue the plan for the benefits it owes you, but not for pain and suffering, emotional distress, or bad faith. You may be able to get some interest payments if the plan delayed paying you benefits. You also may be able to compel the plan to pay you your attorney fees if you go to court. This will help you to get an attorney take your case.
You may need to file one or two appeals to the plan before you can get to court. Be careful – in court, you may not be able to add any new evidence. You should try to submit all evidence to the plan before the plan denies you. Once it denies your appeal, it may be too late to submit anything new. This is why you should hire an attorney as soon as you think you might need to file a claim. Don’t wait until you need to go to court. A disability attorney will know what kind of documents you need to submit to the plan. This includes both medical records and non-medical records.
Be prepared for a long fight. While some companies will pay a valid claim right away, others will not. Once you are in court, it will take years for your case to be decided. These are difficult cases. Zimberlin Law LLC won a Connecticut case against Liberty Life in Spears v. Liberty Life Assurance Company of Boston, 3:11-cv-01807-VLB. After fighting the case for ten years, both out of court and in court, we achieved a substantial victory for the disabled employee.