Long-Term Disability Claims and Insurance
Kevin Milliken has had substantial success representing clients on long-term disability insurance and disability claims and appeals. He has a great deal of experience in representing people whose rights are denied by insurers and disability plan administrators.
Kevin also has won appeals for people denied benefits or terminated from employer-sponsored long-term disability plans. Kevin has won significant settlements and awards for people on individual disability income-continuation policies and insurance contracts.
Frequently Asked Questions about Long-Term Disability Claims
How can an attorney help me appeal the denial of benefits under an employer-sponsored disability plan?
Most employer-sponsored long-term disability plans are governed by ERISA, which is a federal law. Under ERISA, an individual who has been denied benefits has 180 days after receipt of the written denial letter to submit information in support of the claim. After the 180 days, a court reviewing a denial of an appeal of an ERISA claim usually will not accept or consider new evidence. So, all relevant evidence and arguments in support of the disability claim should be submitted to the insurer or disability plan administrator for the initial administrative appeal.
As your attorney on an administrative appeal, we will obtain the complete claim file and evaluate all medical, factual and vocational evidence considered by the insurance company. But we will go farther by seeking medical and vocational opinions in support of your claim, as well as providing additional factual information to support the claim. We prepare a detailed appeal brochure critiquing the insurer’s analysis of the claim and documenting the evidence that supports a favorable disability determination, based on the insurance policy or group disability plan document.
What kinds of medical conditions result in favorable disability findings?
Each client’s job requirements and medical conditions are unique, so we evaluate disability claims based on your particular medical condition and work requirements. Most disability insurance policies and plans provide benefits for being disabled from your own occupation for a certain period of time, typically 2 or 3 years. After that, benefits are granted only if you are unable to work in any occupation for which you are reasonably qualified, based on your education, training and experience. We have successfully represented individuals by fully exploring the extent of their injuries and future ability to work, based on orthopedic injuries, neurological conditions, fibromyalgia, chronic fatigue, mental health conditions such as depression and post-traumatic stress disorder, back injuries, injuries or medical conditions affecting the use of arms, hands or legs, chemical dependency, and numerous other physical and mental health conditions.
How do I pay for legal services when I am not employed and my benefits have been denied?
We represent individuals both under hourly-fee arrangements and under contingent-fee arrangements. Under a contingent-fee arrangement, our attorney fee is a percentage of the benefit that we achieve for our client; our client does not pay a fee if we do not recover benefits for them. Clients who have limited financial assets usually prefer a contingent fee.
And we also work on an hourly-fee basis if our client prefers. An hourly-fee arrangement is usually preferred by a client with a strong claim and who has sufficient financial assets or other income to enable the client to pay for attorney services as the case progresses.
When should I contact a lawyer?
If the insurance company or plan administrator has denied your claim or terminated your benefits, you should contact a lawyer promptly. Most disability plans have deadlines for submitting appeal information; the earlier you get us involved, the more time we will have to assemble medical, vocational and other factual information to support your claim. We will consult with a potential client at no charge concerning the circumstances of their claim. Once we have obtained enough information to determine how strong your claim is, you can decide if you want to hire us to represent you.