What to know about disability claims

11:14 AM, Oct 30, 2018
1:08 PM, Dec 12, 2018

No one wants to worry about insurance they hope they’ll never use, but when you do need it, you’ll wish you understood it better. And while it’s easy to assume you’ll never suffer a disability, Social Security has a reality check for you: of 20-year-olds starting out their careers, 1 in 4 will be disabled before retirement. If that happens, you’ll likely wish you knew a bit more about your benefits.

Government assistance is difficult to come by

As a taxpaying worker, you’ve contributed to Social Security throughout your career. You might assume the government has your back if someday an injury or illness prevents you from working. Don’t count on it. Social Security Disability Insurance has strict criteria for claim approval.

According to the Center on Budget and Policy Priorities, you’ll need to prove you worked solidly for at least five of the last 10 years and have suffered a severe impairment. “Severe” means the impairment will last longer than 12 months or will result in death and must be proved through clinical facts and/or examinations.

Additionally, you will need to prove you are unable to perform not just your past or current job, but any Substantial Gainful Activity, currently defined by Social Security as any job making more than $1,220 per month — just $208 per month more than the federal poverty level for an individual.

Employer plans aren’t guaranteed either

If your employer offers disability insurance — which, according to the Insurance Information Institute, is about half of all large and midsize companies — you probably assume you’ll receive benefits if and when you suffer an illness or injury. Unfortunately, that’s not always the case. Insurance companies all have one thing in common: They don’t love paying out claims.

If you don’t know how to navigate the claims process or you’re unsure of the mandatory documentation or timing requirements — or simply say the wrong thing to an insurance adjuster — you could be disqualified from or denied benefits. In some cases, your employer may be able to offer guidance, but often that’s not the case, or you may feel uncomfortable because the claim is for a work-related injury. If you find yourself in this situation, you may need to retain an attorney experienced in disability insurance claims.

You don’t have to live with the decision

If your short- or long-term disability insurance claim has already been denied, don’t despair. Both Social Security Disability Insurance and employer disability insurance programs provide a process for appealing claim decisions. But if your income depends on disability insurance benefits, it’s in your best interest to get a good attorney on your side. Appeals have strict timing parameters and complex requirements, and your attorney will have insight into the process you may not.

For example, Goodman Acker, a Detroit-based law firm with a 99 percent success rate, says many insurance companies are known to wrongfully deny claims. And when your claims file is prepared by an experienced attorney, you’ll be better prepared to win if a lawsuit is inevitable. That’s because, according to Goodman Acker, you’re limited in court to the evidence that already exists in your claims file — you won’t be able to add more later.

“A lawyer can help add vocational, medical and other evidence to the administrative record to strengthen your claim,” the firm’s website says.

The right attorney can help you get the disability benefits you deserve. To schedule a free consultation, call Goodman Acker at 248-793-2010.

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