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Do You Have Disability Insurance?

Many people are insured through a Group Long Term Disability Benefits Plan provided by their employer. Or, you may have purchased your own individual Disability Income policy from an insurance company. This insurance replaces a percentage of your income if you become disabled. Each insurance plan or policy has its definition of disability. Some policies provide benefits when you can no longer perform the duties of your own occupation, other policies pay benefits only if you are disabled from every kind of employment, and others may change the definition of disability after a specified period of time. Some plans do not pay or limit benefits for certain illnesses. Your rights are determined by the specific language in your plan.

The Law Firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP can handle your Long Term Disability Benefits claim from start to finish and will only charge a fee if benefits are collected. We can file your claim, collect and submit the necessary evidence, handle all correspondence with your physicians and the insurance company, prepare and file any administrative appeals, and, if necessary, handle any litigation in the State and Federal Courts.

Why do I need advice if my claim has not been denied, or even filed yet?

Many group plans are governed by the federal Employees' Retirement Income Security Act of 1974 ("ERISA"). ERISA gives the Insurance Company many legal advantages. If the insurance company finally denies your claim ERISA makes proving your case in Court very difficult. It is extremely important to develop and submit all your medical and vocational evidence to the Insurance Company before your claim is finally denied. ERISA permits you to inspect the Insurance Company's file to discover any unfair claims practices. Your ERISA appeal to the Insurance Company must contain all the evidence you need to rely on in Court, in case of denial. Attorneys experienced in the ERISA process can help obtain your benefits before a final denial, and a lawsuit is necessary.

Claims under private individual insurance companies frequently require detailed financial information and analysis to prove a loss of income, as well as sufficient medical proof of disability as defined in their particular policy. Our extensive experience in these matters will help you get your benefits as quickly as possible, and help to avoid falling into any of the many possible pitfalls placed along the way by some Insurance Companies. In fact, assertions of improperly denied claims for long term disability benefits under individual and group policies led the largest provider of disability insurance in the United States to enter into a settlement with New York and other states requiring it to pay a $15,000,000 fine, to change it's claims handling procedures, and to a review of the more than 200,000 claims it had denied since 1997!

Our trial experience is a powerful weapon, and it often makes the lawyers and insurance companies representing our opponents choose to offer favorable settlements to our clients rather than face us in a trial. These lawyers and insurance companies know that we stand ready, willing and able to take your case to trial when necessary to protect your rights.

You should call for an appointment with our firm as soon as you think you may stop working because of any illness or injury if you believe you have Long Term Disability Benefit insurance.

These are complicated cases and you will likely need professional help to protect your rights. Group benefits ERISA claims are judged under the demanding legal standard requiring you to show that the insurance companies denial was "arbitrary and capricious". Under the usual legal standard the party with the most evidence, or the "preponderance of evidence", wins. But under ERISA you must show that the insurance company had no evidence to support this denial. ERISA also provides that you lose your right to have a jury decide your case, and no new evidence of your disability is permitted beyond that which the insurance company had before it when your case was decided. No testimony, not from you, not from your doctor, is permitted. When you have an ERISA claim it is vital to submit complete proof of your disability to the insurance company. Our experience will help you to obtain and file the necessary evidence in this complex process.

Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP will provide a free consultation for any client who has questions regarding any aspect of Disability Benefits. We specialize in Workers Compensation, Social Security Disability, Municipal Disability Pensions, private and ERISA Long Term Disability Benefits.

You can speak to Chris Latham at (212) 341-7997.