Do you need to be honestly thinking about whether or not you can’t perform your professional responsibilities due to injury or illness? Just asking that question is hard, much less answer. We try and show up and do our jobs under all circumstances, so we might not even wonder about this until we’ve been through a lot of different levels of personal struggle. That’s why many workers are typically not all that familiar with the provisions of their disability coverage, be it private, public, or employer sponsored, much less how such benefit claims are decided. So, when a potential disability situation turns into an urgent one, there are complicated issues at play that must be both recognized and dealt with in an expedient fashion. Sadly, this is complicated by the fact that it happens in a time period of distractions, stress, complication, and urgency. You should know that a better way exists.
Contemplate this hypothetical situation:
Joe spent the last quarter century working his way up the career ladder. His job responsibilities grew over time, but so did his stress. Family matters piled on to all this and he got emotionally depressed. He started getting poor sleep and turned to heavy drinking. As a result, his job performance declined, as did his income. He was relieved of many management duties, and eventually he was demoted. His personal depression was never actually observed. The symptoms of his alcohol abuse were something that was observed, but there was no conversation about it. He did go to AA meetings, but several relapses happened. Eventually, he got laid off on the premise that the position he held was getting eliminated, even though others that were not impaired like was got to keep their jobs. He filed a disability claim, but it got denied. The insurance company deemed that his incapacitation in terms of work was due to causes that were not injury or sickness, that being his position being eliminated. That’s a very thorny issue to untangle, and to do so, you need both time and the assistance of experts to get it done.
Disability is something that happens in two ways. One is suddenly, and the other is gradual, where the ability to perform your professional obligations withers over some period of time. As such, disability insurance claims bring about a set of ‘moving targets’ or benchmarks that the insurance company must consider. The following is a brief list of a few, but not all of them:
-Was there a loss of duties or time due to something health-related?
-If yes, did this period start while insurance was already in effect?
-Just how specifically stated and defined are occupational duties in the policy, particularly for professions like attorneys and physicians?
-How does state law layout or interpret things?
-What occupational duties apply to your claim if they were altered over time?
-Can you properly document your income loss either partially or totally due to your disability?
-Just how do certain activities specifically reflect a performance ability?
-If you are still working, does that prove ability is intact or you are just looking to work while impaired?
Both state law and policy are quite variable when it comes to defining a person’s individual ability to discern that they are disabled either partially or totally that is why during claims you need to get best ERISA disability Litigator to help you out. Many folks try to power through their adversity by themselves. It’s often later, when things get truly consequential, even disastrous, that they submit a claim. That seriously complicates the ‘moving target’ benchmarks and facets of a case.
An insurance company is likely to view a claim in a simple fashion as it can. In fact, the insurance company is likely to make a number of assumptions about many issues since they lack what they perceive to be conclusive documentation. They’ll have financial, medical, and even vocational professionals weigh in, but they’re not likely to differ from the presumed perception about the claim. This presumed perception is likely to be a generally defensive stance by the insurance company. Keep in mind that they see many claims and find it best to be skeptical. That creates an avalanche effect where each reviewing professional rubs off on the next one.
The presumption effect an insurance company is not overstated. It happens in casual conversations among reviewers, it seeps into their notes and files, and even body language can reinforce this feeling among the workers. On the other hand, you can combat this atmosphere by filing your action in a timely manner that is appropriate as well as effective. Supporting documentation can help you make your case and pierce the general perceptions insurance workers are likely to have. We’re here to help you do this so that your claim is more likely to get approved.
Regardless of whether or not your impairment is totally debilitating or only partially, or whether or not it hit you gradually or suddenly, there’s nothing stopping you from asking yourself if your impairment is costing you the power to perform at work due to injury or illness. It’s unfortunate that trying to just ‘tough things out’ actually hurts your chances at getting a good claim towards disability benefits. Knowing when to file and even if you should means having a lot of knowledge about the particular process. You need to make an informed decision so that you can properly fight for yourself against the general perceptions of the insurance company. Lack of knowledge, fear, concerns about privacy, and even pride all complicate things and lead to delays, leaving messy situations, like the one Joe had.