Have you recently tried to get disability benefits from Disability Insurance Specialists, LLC, for yourself or a close family member only to find that the claim was denied? Getting a long term disability claim approved by any insurance company or third-party administrator can be much more difficult than most people assume.
In this article, we will discuss several topics that you should learn about in order to build your best case, including:
- Why long term disability claims with Disability Insurance Specialists, LLC are often denied.
- Is Disability Insurance Specialists, LLC an insurance company?
- The difference between insurance companies and third-party administrators.
- Getting help with your disability claim denial; and
- How Ortiz Law Firm can help if your long term disability claim has been denied.
Long Term Disability Claim Denied by Disability Insurance Specialists? You’re Not Alone
Disabled individuals often find themselves looking for assistance with their long term disability claims after they file an application for benefits and the carrier has decided to deny the claim. You may be suffering from a variety of possible conditions, such as depression, chronic back pain disorder, or some other major physical or mental medical condition that hinders your ability to work and to perform your usual daily activities. Being disabled is difficult enough, and things only get harder when your insurer and its administrators try to use the rules and regulations against you to deny your claim.
At Ortiz Law Firm, our team focuses primarily on long term disability insurance benefit claims that have been wrongfully denied or terminated. We are familiar with the common reasons that insurers deny claims, and we know how to fight back. We help with many different situations, including long term disability appeals, lawsuits, and lump sum buyout offers. If you have become disabled and are unable to work as a result then you deserve disability benefits, and our team wants to ensure that you receive them. We will
Is Disability Insurance Specialists, LLC an Insurance Company?
Disability Insurance Specialists, LLC was founded in the year 1996 by two individuals that have experience in the management of the industry of insurance. Disability Insurance Specialists, LLC is not an insurance company themselves, but instead, they administer insurance claims and consult with insurance companies, reinsurance companies, and self-insured employers. Disability Insurance Specialists, LLC is known to be an independent third-party administrator. They are looking to help these companies implement solutions that will fit the goals of their company. Unfortunately, that often means denying disability benefits to claimants in need.
Insurance Companies and Third-Party Administrators
What that being said, you may be wondering what some key differences are when it comes to insurance companies and third-party administrators and how they are connected. An insurance company is an institution of finance that provides insurance policies that are designed to protect you from financial loss in certain situations, such as disability. With their policies, they can help those people stay protected that experience loss by helping them in times where they need it. Insurance can cover many different aspects and categories with disability being one of them.
When it comes to third-party administrators, like Disability Insurance Specialists, LLC, their goal and work revolve around delivering administrative services on behalf of insurance plans and insurance companies. They are the organization that processes the insurance claims as well as some other services. Insurance companies typically use these third-party administrators for their customer service as they act as the mediator. They are used as the intermediary between you and the insurance company.
Why Was I Denied Disability Benefits by Disability Insurance Specialists?
There are a variety of reasons why you could be denied disability. Depending on your situation and type of disability policy, there are multiple reasons that could result in your claim being denied. Some of the most common reasons that people typically run into problems with their claim include:
- The insurance carrier or administrator finds there is not enough medical evidence,
- The medical evidence indicates that you can go back to work doing your regular job duties,
- There is a change in the definition of disability from your current occupation, or
- A job expert that the insurer has contracted feels that you are capable of returning to work.
Get Help with Your Disability Claim Denial
If your initial disability claim is denied by Disability Insurance Specialists, LLC, you may assume that the denial is the end and you can not proceed any further. It is important to note that you still have options and you should not give up. You have the right to gather additional medical records and any other evidence to support your claim that your medical condition prevents you from working. You can then submit this evidence to the insurer or third-party administrator as part of the appeals process.
The same goes for those who received benefits for a period of time only to have the benefits terminated before they are able to return to work. You have the option of appealing the insurer’s decision to deny future benefits.
If you receive another denial in response to your appeal then you can then take further steps to recover your benefits by filing a lawsuit. While this may seem highly confusing to some people or even impossible, our team at Ortiz Law Firm can assist you through the claim process following a denial of benefits.
How Ortiz Law Firm Can Help If Your Long Term Disability Claim Has Been Denied
For individuals whose disability claims are denied, you need to take action immediately by getting in touch with a law firm that you can trust that specializes in this area, as you only have a limited amount of time to file an appeal. As you begin the appeals process, you will want to hire an experienced attorney who knows what they are doing and knows the ins and outs of the laws that apply to denied long term disability insurance claims. Here at Ortiz Law Firm, our team of professionals is ready to assist claimants in preparing and filing an appeal if their claims are denied.
Our firm will ensure that we have all of the appropriate information and medical evidence to support your claim for long term disability benefits so that you won’t have to spend hours tracking down medical records and treatment notes. The insurance company must provide a reasonable amount of time to make an appeal after disability claims are denied, with most policies allowing 180 days. The sooner you contact an attorney for help, the sooner you can appeal the denial of your claim.
We also try to generate additional medical evidence by preparing custom Residual Functional Capacity forms or Medical Source Statements for your doctors to fill out. These forms are specific to your disabling conditions and are a supplement to your other medical records and treatment notes. The forms are brief and will only take a few minutes for your doctors to complete, but they are designed in such a way that they clearly indicate your various symptoms and limitations to the claim administrator evaluating your claim for benefits.
Here at Ortiz Law Firm, we are ready to take on your claim and to help make the best appeal possible to ensure that you get the benefits for your disability that you deserve. Even if you have exhausted all of your appeals with the insurance company, an attorney may still be able to help by filing a lawsuit against the insurance company for denying your claim.
We have helped a countless number of people recover millions of dollars in wrongfully denied disability benefits. We have gone against many different popular insurance companies when it comes to these claim denials. Some of the insurance companies that we have litigated claims against include Prudential, Cigna, Hartford, Unum, Lincoln, MetLife, and Guardian, as well as third-party claims administrators like Disability Insurance Specialists, LLC. If you are ready to fight back and make an appeal for your denied claim, our lawyers are ready to fight for the compensation you deserve.
Request a Free Case Evaluation
You will not want to wait too long to get in touch with a disability lawyer at Ortiz Law Firm if your claim was denied. You will want to take an appropriate amount of time to execute your appeal properly, and we will also need time to collect proper medical evidence and other documents to support your claim, review the documents, and build a strong legal case for you. If you’re ready to get started you can get in touch with an attorney by giving us a call at (888) 321-8131 to request a free case evaluation with one of our lawyers.
Most disability policies will require that a claimant file for Social Security Disability benefits, so you can also let us know if you need help with a Social Security case too. We handle both long term disability and Social Security disability claims.
If you would prefer to get in touch with our office online rather than by phone, we also have another option for you on our website. On our website, you can fill out a confidential contact form to request a free case evaluation with a lawyer. In our form, we ask for a small list of information so that we can contact you. At the bottom of the form, we provide a box where we ask you to give us a small description of your long term disability claim, including where you currently are in the appeal process.
After filling out this form, we will contact you to schedule a free consultation to discuss a possible attorney-client relationship and how the lawyers and legal team at Ortiz Law Firm can help you get the compensation you deserve.