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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 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 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 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.Get a Free Case Review
Is Disability Insurance Specialists, LLC an Insurance Company?
Disability Insurance Specialists, LLC was founded in 1996. Disability Insurance Specialists, LLC is not an insurance company; 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 their company’s goals. Unfortunately, that often means denying disability benefits to claimants in need.
Insurance Companies and Third-Party Administrators
With that being said, you may be wondering what some key differences are regarding 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 who experience loss by helping them when they need it. Insurance can cover many different aspects and categories, disability being one of them.
Regarding third-party administrators, like Disability Insurance Specialists, LLC, their goal and work revolve around delivering administrative services for insurance plans and insurance companies. They are the organization that processes insurance claims. 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, multiple reasons 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 the insurer has contracted feels you can return to work.
Get Help with Your Disability Claim Denial
If Disability Insurance Specialists, LLC denies your initial disability claim, you may assume the denial is the end, and you can not proceed further. It is important to note that you still have options and 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 while only to have the benefits terminated before they can return to work. You can appeal the insurer’s decision to deny future benefits.
If you receive another denial in response to your appeal,, you can take further steps to recover your benefits by filing a lawsuit. While this may seem highly confusing or even impossible to some people, our team at Ortiz Law Firm can assist you through the claim process following a denial of benefits.
How Ortiz Law Firm Can Help
For individuals whose disability claims are denied, you need to take action immediately by contacting 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 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 supplement 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 countless 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 contact a disability lawyer at Ortiz Law Firm if your claim is 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 start, you can contact us at (888) 321-8131. We will schedule a free case evaluation with a long-term disability attorney.
If you prefer to contact our office online rather than by phone, we also have another option on our website. You can fill out a confidential contact form on our website to request a free case evaluation with a lawyer. After filling out this form, we will contact you to schedule a free consultation to discuss a possible attorney-client relationship and how the Ortiz Law Firm can help you get the compensation you deserve.
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. We handle both long-term disability and Social Security disability claims.