Our Oregon Disability Lawyers Can Help
Millions of Americans suffer from some type of physical or mental disability. In fact, the Centers for Disease Control (CDC) estimates that 1 in 4 U.S. adults lives with a disability that impacts major life activities. Physical and mental health conditions can make basic life activities much more difficult. Our Oregon disability lawyers know that for some disabled individuals, they may need financial assistance due to an inability to work. Insurance companies and select government agencies provide benefits that can help cover lost income. However, these benefits may be difficult to access when they are needed the most.
The disability lawyers at Tucker Law Group understand that acquiring disability benefits can be an arduous task for former workers and disabled veterans. After all, our Oregon disability lawyers have decades of experience helping these parties appeal denied claims. Our attorneys can help you or a family member fight for benefits.
Group Disability Insurance Policies and ERISA
The Employee Retirement Income Security Act, also known as ERISA, is a federal law responsible for regulating certain benefits policies offered by private employers. If you have a group disability policy through a private employer, then chances are ERISA is responsible for upholding your rights under that policy.
Employers who administer these plans have multiple responsibilities under ERISA. For instance, the employer must provide information on how your policy works. Your employer must inform you of what disabilities your policy covers, any significant changes to your policy and how to file a claim.
Unfortunately, it can be difficult to claim benefits under a group disability policy. You will need to obtain a significant amount of evidence that demonstrates your inability to work within your career. This could include undergoing an evaluation by a physician or licensed physical therapist.
Filing an appeal may work if you receive a denial, but suing the provider may also be a necessary course of action. You would need to exhaust your appeal options before filing a lawsuit against the provider. ERISA claims go before a judge in federal court, and cannot be tried before a jury. There are also limitations on what you can obtain from a successful ERISA claim.
Private Individual Disability Insurance
ERISA governs groups policies offered by private employers. Many other workers in Oregon may be self-employed, and thus enrolled in an individual policy. Oregon state law governs these policies.
Like many other states, Oregon requires insurance providers to act in good faith. Insurers must abide by the terms of the policies they provide for consumers. Specifically, insurers must act “reasonably prudent” under the circumstances to be in compliance with state law. Insurance companies that fail to meet this standard could face legal action. Affected policyholders may have grounds to file a lawsuit.
Your lawsuit could also go before a jury if a settlement is not reached and a trial becomes necessary. Additionally, you may obtain your benefits and damages incurred due to being unable to access those benefits.
Disability Claim Denials in Oregon
If you have an ERISA or individual policy, there are a number of reasons why an insurer may deny your claim. Common reasons for a denial include but are not limited to:
- Missing information or medical records;
- The disability is not covered by the policy in question;
- Failing to meeting procedural deadlines, such as filing paperwork;
- Failing to meet the policy’s definition of a disability.
If you received a denial, it does not mean you can never obtain benefits. Disability benefits are notoriously difficult to obtain due to confusing policy language, strict rules for medical evidence, and important procedural deadlines and requirements. It is important to include as much additional evidence as possible during your appeal.
If you received a denial of benefits, then you should contact a disability attorney immediately. An attorney can help you obtain important medical evidence, argue your case, and meet important filing deadlines. Many individuals with a disability would have an extremely difficult time braving the appeals process on their own, regardless of whether the claim involves ERISA or state law.
VA Resources in Oregon
Disabled veterans also need assistance when they are unable to work. Oregon has resources for veterans who need assistance filing a disability claim. Consider taking advantage of the following resources:
How to File a Disability Claim With the VA
Veterans with disabilities could be eligible for benefits through the U.S. Department of Veterans Affairs (VA). You can file a claim at your regional VA office, or you can fill out an online claims form for benefits.
To access benefits through the VA, you must demonstrate that you suffer from a mental or physical disability that directly resulted from your military service.
You could file a VA claim for a number of injuries or illnesses, such as a traumatic brain injury, musculoskeletal injury, post-traumatic stress disorder (PTSD), severe burns, amputations or severe hearing loss. This is not an exhaustive list of possible conditions that are eligible for benefits.
Cities We Serve
Contact Our Oregon Disability Lawyers
Tucker Law Group is a nationally recognized disability law firm. We help clients across the country fight for the benefits they deserve. If you are facing an uphill battle with your insurance company or the Department of Veterans Affairs, then we encourage you to call us. Our disability law firm has years of experience helping individuals with disabilities, including former veterans.