Sapiro Law Office

Long Term Disability

• A Dade County school teacher suffering from depression.
• A bank loan officer with herniated cervical discs.
• A retail store manager with a rare liver disease.
• A radiologist with diabetes and lumbar disc disease.
• An insurance claims adjustor with a herniated disc and depression.

All of these South Florida residents were forced to stop working, or drastically change their work routine, due to serious injury or illness. They were group members, or individual policy holders of long term disability insurance. They all applied for disability benefits, and each of their benefits applications was denied. By six different insurance companies or benefits administrators.

I have been a member of the Florida Bar for over twenty years. Throughout my career I have concentrated on claims of individuals with serious injury or illness. Over the past ten years, as a sole practitioner, I have represented an increasing number of individuals whose long term disability claims have been denied.

Long term disability claims can arise in a number of different ways. You may be an employee covered under a plan of group disability benefits. You may have purchased an individual plan of disability insurance. You may be a teacher, or state employee, with the right to apply for State retirement disability benefits. You may have experienced a benefits denial following an initial claims review. Your claim may have been initially approved and paid, and then subsequently denied or suspended. You may be considering a settlement of future benefits.

When making a disability benefits claim, keep this in mind. Benefits claims are reviewed under strict guidelines contained in the group or individual benefits policy. Disability is always defined in the policy. There may be time limits for the presentation of claims. Many policies also contain limits on the payment of benefits for certain kinds of disabling conditions. The amount of benefits paid may also be effected by the receipt of other benefits, such as Social Security Disability benefits.

Dozens of questions will arise during the course of an application for disability benefits. Does the insurance company or claims administrator have the right to have you examined by a physician of their choosing? What happens if you obtain long term disability benefits, and then obtain past due Social Security Disability benefits some time later? Are your disability benefits taxable income? Can you obtain a settlement of future benefits? Can you attempt to return to work?

For these reasons, experience has shown me that an individual attempting to obtain disability benefits should consult with an attorney at an early stage of the benefits review process. Understanding the claims process, receiving advise on legal issues, and getting a clear explanation of policy terms, conditions, and limitations, increases the odds that your claim for benefits will be approved. A thorough and proper initial application for benefits will increase the odds of eventual success in the event that your claim is initially denied.

If I can be of assistance to you, or a family member, please send me an email or call my disability law practice at (786) 242-4146.