Helping Clients Throughout Fresno Obtain Long-Term Disability Benefits
Having long-term disability insurance is important to everyone since no one can predict whether he or she will be the victim of an illness or injury that results in prolonged, or even lifelong, incapacity. While we all know that medical and prescription costs run high, and can quickly decimate one’s life savings, few of us stop to think of the instability our loss of income could create. Unless your mishap is work-related, workers’ compensation will not be of help.
The purpose of purchasing long-term disability insurance is to protect you and your loved ones from the double catastrophe of lost wages and exorbitant medical costs. There are too many cases, however, in which even those who have purchased expensive long-term disability policies find themselves financially, as well as physically, disabled. Most of us are aware that insurance companies would much rather sell policies and collect premiums than make payments to deserving clients. Therefore, in California as elsewhere, a time may come when you need a knowledgeable disability attorney with strong negotiation and litigation skills to assist you in filing a lawsuit to get you the monies you deserve. This is the time to contact our dedicated disability law firm, Peña & Bromberg.
Doesn’t Social Security Take Care of Long-Term Disability Coverage?
The short answer is No. California does not have a long-term disability program. If you are 65 years or older, or blind or disabled at any age, and have little or no income and few resources, you may qualify for Social Security Income (SSI). If you have worked for many years before you became disabled, you may be able to collect Social Security Disability Income (SSDI) which gives you benefits based on your past earnings. Both SSI and SSDI, however are notoriously difficult to qualify for, and neither pays enough to actually support an individual or family. As an illustration, SSD pays an average of $1200 per month, while SSI, pays an average of $750 monthly.
It should be noted, however, that if you purchase private long-term disability insurance, you may be able to receive government benefits as well, although your government benefits may be deducted from your private benefits. It is wise to make certain how many years of disability the plan you purchase will cover.
Ways of Purchasing Long-Term Disability Insurance
There are two basic ways of acquiring long-term disability insurance, individually or as part of a group. You may be eligible for inclusion at a group rate (nearly always lower than an individual rate) through professional groups, organizations, or associations you belong to. In almost all cases, you have to be a member of the group for a certain period of time before you can buy the long-term insurance at the discounted price. In most cases, once your short-term benefits expire (generally after 3 to 6 months), long-term disability insurance will pay a percentage of your salary, usually 50 to 60 percent, depending on the policy.
What to Watch out for in Long-Term Disability Policies
Long-Term Disability Insurance is not the same as health coverage, meaning it will not pay for medical, surgical, rehabilitative, or pharmaceutical care. Long-term disability is intended to replace your income when you lose it because you have become disabled. In cases in which you have a pre-existing medical condition at the time of purchase, the policy may not start making payments until an exclusionary period (stipulated in the policy) has passed. On the other hand, it is possible that, if you are an employee whose hours have been reduced due to your disability, you may still be able to receive partial benefits to cover the lost portion of you income.The benefits typically last until you have sufficiently recovered to go back to work or for the number of years stated in the policy.
If you feel you are being dealt with unfairly by your long-term disability insurance company, make an appointment with Peña & Bromberg so that we can evaluate your case and determine whether you have cause for a lawsuit. If so, you can count on us to get you the compensation you deserve, including attorney fees and court costs, and, if there is intentional deception involved, punitive damages. The company may have breached its duty of “Good Faith and Fair Dealing,” misrepresented their coverage at the time of sale, tried to underpay your claim, told you to purchase less insurance than you actually needed, or tried to deny your claim on the grounds that you misrepresented yourself on your original application.
You should remember that the court will rule in your favor if there is any ambiguity in your policy and that our capable attorneys know all the tricks in the book of insurance company chicanery. We have known insurance companies to fixate on small mistakes in your original application, such as having forgotten to mention one doctor that you consulted 20 years ago, in order to try to invalidate your policy and your claim. At Peña & Bromberg, we will not let the insurance company get away with any misconduct. We will fight vigorously to protect your rights and to make sure that you get every dollar of the coverage you paid for.
The Most Common Causes of Long-Term Disability Claims
According to The Council for Disability Awareness, the most common reasons for long-term disability claims are these:
- Musculoskeletal/connective tissue disorders (back pain, osteoarthritis)
- Various types of cancer
- Injuries & other physical impairments (falls, car accidents, poisonings)
- Cardiovascular/circulatory disorders (heart attacks, strokes, coronary artery disease)
- Mental disorders (Bipolar disorder, schizophrenia, PTSD)
Whether you have become disabled for one of these reasons or for some other reason, Peña & Bromberg can make sure that your insurance company does not cheat you out of monies you are entitled to receive. Contact us to schedule a consultation.