We Provide Representation in Hawaii

Our Disability Lawyers in Hawaii Can Help With Your Appeal

There are millions of individuals in the United States living with disabilities, including here in Hawaii. In fact, estimates released by the Centers for Disease Control and Prevention (CDC) suggest that slightly more than 20 percent of adults in Hawaii are living with a disability. Our disability lawyers in Hawaii know from experience that injuries and illnesses can occur without warning. Physical and mental disabilities may prevent some people from being able to work. For this reason, some people purchase disability insurance to cover lost income and other expenses. Veterans also may have access to benefits through the VA.

Accessing disability benefits can be a difficult prospect. Insurers may deny a valid claim, and the VA has its own assortment of well-publicized problems. However, you may have legal options to recover benefits. Tucker Law Group is a Florida-based disability law firm with experience handling ERISA claims and VA disability claim appeals nationwide.

Disability Insurance Claims

ERISA Claims and Individual Disability Insurance Policies

There are key differences between the two main types of disability policies purchased by workers. Some private employers offer group disability insurance plans. These plans are likely governed by ERISA, a federal law. On the other hand, other workers may purchase their own policies. Individual policies fall under state law.

This is an important distinction, because your potential legal options for filing a claim or fighting an appeal could differ depending on which policy you have.

How Do I File a Disability Insurance Claim?

The language in your disability insurance policy should specify the steps involved with filing a claim. For an ERISA claim, you and your employer will need to complete several forms to file the initial claim. However, there are some universal aspects that are common to all types of disability insurance claims, regardless of the policy.

First, your insurer must investigate your claim. There are a couple of ways your insurer could assess your disability and functionality. You may need to undergo a physical exam performed by a physician. Additional types of evidence could include:

  •     Medical records
  •     Claim forms
  •     Pharmacy records and physician statements
  •     Financial records

The claims administrator will review this evidence and deny or approve your benefits. If you receive a denial, then you may be able to appeal your case. Depending on the type of insurance policy you have, the appeal process and what you can obtain from an appeal differ.

How Do ERISA Claim Appeals Work?

If your insurer issues a denial, then you have up to 180 days to file an appeal. You can include additional evidence in your appeal. Keep in mind, it helps to have an attorney who has experience with disability claims and appeals during this process. Experienced attorneys have a strong understanding of which types of evidence are the most important for an appeal.

You may have a couple of options if your appeal is unsuccessful. After you exhaust your options for seeking an appeal, you may be able to file a lawsuit in federal court against the insurer. However, a judge decides the outcome of this lawsuit based on the available evidence and other possible factors. You also cannot obtain bad faith or noneconomic damages from an ERISA lawsuit.

How Do Individual Disability Claim Appeals Work?

Much like a policy governed by ERISA, the language in your policy could outline the appeals process. Some insurers may continue to deny benefits after an appeal, even on a valid claim. In other cases, insurers may run afoul of Hawaii state law. These are possible examples of “insurance bad faith.”

You have a couple of potential options for dealing with an insurance bad faith claim in Hawaii. For instance, you could file a lawsuit against the insurer in state court. Unlike an ERISA claim, your case could go before a jury and you may receive economic and noneconomic damages if your case is successful.

Listed below are possible examples of insurance bad faith in Hawaii:

  •     Failing to investigate a claim
  •     Failing to provide a policyholder with important information on their claim
  •     Unreasonably delaying benefits on a claim
  •     Failing to pay a valid claim

Insurers in Hawaii must meet the state’s “good faith” requirement. Our Hawaii disability attorneys can help you determine if your insurer failed to meet this standard.

VA Disability in Hawaii

If you are a veteran with a disability, then you may be able to recover benefits through the U.S. Department of Veterans Affairs. However, you must be eligible to receive benefits.

Filing a Claim for Veterans Disability Benefits

You can file a claim with the VA or a regional office. You may be eligible to receive benefits if the following are true:

  •     A physician diagnosed you with a current medical condition;
  •     You can demonstrate that your injury, illness or disease arose during your service.

Additional requirements could apply to your case, so it helps to speak with an attorney if you have any doubts. Much like a private insurer, the VA requires evidence of a disability. Medical records, service records, family testimony, financial records and discharge papers could factor into your case.

VA State Resources in Hawaii

There are helpful resources that veterans can access in Hawaii, including:

Our attorneys can offer assistance if you are appealing a claim for benefits with the VA.

Cities We Serve in Hawaii

  •     Honolulu
  •     Hilo
  •     Pearl City
  •     Kailua
  •     Waipahu
  •     Kaneohe

Contact Our Disability Lawyers in Hawaii

The Hawaii disability attorneys at Tucker Law Group can help with ERISA claims and VA appeals nationwide. If you have an individual policy claim, we can offer legal counseling for claims in Hawaii.

We encourage you to reach out to us for a consultation if you have any questions about what your next steps should be for an appeal or claim. You can reach our disability lawyers in Hawaii by dialing (866) 233-5044 or by using the contact form on our website.