Neurological Disorders & Long-Term Disability
Long-term disability is intended as protection against serious illnesses that prevent you from working long-term, such as six months or longer. In some cases, it may mean never going back to work, and your policy will be paying you as long as permitted under your policy (often until age 65).
Whether you purchased your disability policy through your employer or on your own, the purpose was to provide for you if you became disabled. But with a neurological disorder, it can be difficult to get your long term disability claim approved and to receive the benefits you deserve.
Our long-term disability attorney helps claimants get the benefits they paid for whether in the initial application or through an appeal or lawsuit after a wrongful denial. If you have questions about your long-term disability policy or have been denied benefits, call our long-term disability law firm in Kansas City, Missouri at 816-203-0143. We will review your denial letter for free and provide a strategy on how to fight back.
Neurological Conditions Qualifying for Long Term Disability
Neurological disorders originate in the brain, central nervous system and spinal cord. They can range from mild to severe. Some neurological disorders may be manageable with medications, diet, physical therapy and other means.
The term “neurological” encompasses a large number of different disorders, including:
- Cerebral Palsy
- Epilepsy or other seizure-related disorders
- Parkinson’s Disease
- Alzheimer’s Disease
- Multiple Sclerosis
- Strokes that become disabling
- Muscular Dystrophy
- Traumatic Brain Injuries (TBI)
- Brain tumors
- Post-polio syndrome
- Transient Ischemia Attacks (TIA)
- Spinal Cord Injury and Paralysis
- Peripheral Neuropathy
This is not a complete list of the neurological conditions that may cause you to be disabled. Whatever illness you have, it’s important to keep track of everything that you’ve done, such as doctor visits, medications prescribed, and testing.
Another helpful document is a journal of your associated symptoms. Include the duration of your illness, the severity, and how the illness affects your everyday life and your ability to work.
Opinion statements from your physician also go a long way in documenting as well as proving your condition.
Claiming Long Term Disability Due to a Neurological Disorder
The first thing to do is to read your policy and learn what the insurer considers and defines as a “disability.” Once you understand what they require, you need to make sure you have sufficient objective medical evidence to show you meet the policy definition.
Insurers are interested in any evidence you can provide to them, including medical, test and prescription records, and anything else that supports your claim of the condition.
The question they want answered is how the condition impacts you as well as impairs you and your activities at work. Additionally, they are interested in how it affects your ability to do work activity, with things such as sitting, standing, walking, lifting, and other types of movement.
The more test results and other medical evidence you have that can demonstrate the existence of your condition, the better. Also helpful is a physician’s opinion on how your condition directly impacts your daily life.
It’s important to include as much information as you can in the filing stage for the possibility of denial. Should you need to appeal, you won’t be able to submit additional evidence to support your claim.
Some neurological disorders involve episodes, such as epilepsy, so having a description of a seizure may be difficult unless your doctor happens to witness one. Statements from family, friends, or other third parties that describe and document episodes and/or symptoms are also helpful.
If the forms and evidence gathering seem to be overwhelming, consider getting help from an experienced disability lawyer.
Long Term Disability Denials for Neurological Conditions
There are a number of reasons why your claim may have been denied. Some may be as simple as insufficient evidence to show the severity and extent of your condition, an incorrect policy number or a legal technicality. Other reasons include:
- A missed deadline
- Missing medical records or insufficient evidence documenting your condition
- A pre-existing condition or one that isn’t covered in the policy
- Results from an independent medical exam, by a physician the insurer hires to dispute your claim.
- Failing to meet the insurer’s definition of “disabled.”
- Your condition isn’t as severe as you claim, “self-reported,” or your condition’s symptoms are subjective
- The insurer’s investigation of your claims observe you doing something you claim is impossible, or find similar evidence on social media
- Mistakes made by the insurer
Insurers are not interested in paying claims, and will fight vigorously to avoid doing so. Getting assistance from a disability lawyer can help with an appeal.
How to Appeal a Long Term Disability Denial
If your claim is denied, you’ll receive a letter detailing the reasons for denial. Keep this letter with the rest of your documentation—you’ll need it when filing an appeal. At this point, working with an experienced disability law firm is your best chance of winning.
ERISA, or the Employee Retirement Income Security Act of 1974, allows you to file a lawsuit should they deny your claim. ERISA claims and appeals are different. They are not easy because the law is literally rigged in favor of the insurance company. For example, you must file an appeal before you file a lawsuit, and you will not be allowed to submit any additional evidence in the lawsuit phase to support your claim. That’s why it’s so important to obtain as much evidence as possible and include it with your original claim when you file it. The judge will see everything you submitted at the beginning, and will use that evidence to decide your claim.
Pay attention to the appeal letter and the deadlines—they may be as short as 30 days. Miss it, and you’ll lose your chance of appeal entirely.
Our Long Term Disability Attorney Can Help
The application process for any long-term disability claim is complicated and difficult. In many cases, insurers present added challenges for claimants who are filing a claim for benefits they need. Detailed documentation is key to a successful claim and/or appeal.
If you’ve been denied after filling out forms, getting medical exams and complied with additional stipulations, it’s time to get help from someone who is experienced in dealing with disability policies and the tactics from the insurance company. Get started immediately with a long-term disability lawyer who can act quickly on your behalf. Delaying action means you can completely lose your right to appeal. Don’t let that happen to you.
The Law Office Of Kevin J. McManus is ready to help you. If you haven’t yet submitted an application, schedule a strategy session with us in order to make sure your application is complete and submitted correctly. You may not need anything else. If your claim is denied, and you decide to work with us on an appeal, we’ll credit your consultation fee towards it.
Already have a denial letter? Whatever you do, don’t wait, or you may miss a deadline. Contact us at 816-203-0143. We’ll review your denial letter for free, and offer you a strategy for moving your case forward.