Long Term Disability Claims for Architects

Being an architect is a unique occupation and only a small percentage of the population practices this demanding profession. Architects devote thousands of dollars to education, invest many years of intense training, and their working life typically includes countless hours of overtime. Whether designing small projects or large constructions, architects are critical for commercial activity.

From designing new structures, to managing and coordinating projects of all sizes, to overseeing entire construction sites, architects – performing the tasks and duties of their occupation – rely upon high-level cognitive abilities and physical capacity to be successful in performing their work duties.  Becoming an architect is not easy, and most are dedicated to their practice and love their work.

If you are an architect and a sickness, injury, or accident causes you to become unable to perform the work you love and find financially rewarding, what would you do?  

Architects often have two kinds of long term disability insurance to protect their income: group LTD policies offered as part of their employment benefits (ERISA) and private or individual LTD coverage. Both kinds of LTD insurance are designed to replace a certain percentage of your income if you are unable to work.  

The disability insurance company will seek medical proof supporting that you cannot work due to a medical condition.  They may often focus on your diagnosis, while our disability law firm focuses instead on your impairment and what makes you unable to work.  Each policy carries its own definition of what disability means and what standard you must meet to secure benefits.  Under most policies, you will need to demonstrate how and why you cannot work in your occupation as an architect.  It may not be how you specifically perform the work but would likely be the class of occupation.  

The nature of an architect’s work involves a combination of physical and cognitive skills.  If you are an architect seeking to file for disability insurance benefits, it is crucial to articulate both aspects of your work to your disability insurance company.  Unless you provide a robust explanation and picture of your work responsibilities and job functions as an architect, your insurance company may minimize how your symptoms and condition impact upon your ability to perform your occupational duties and may deny your claim.

How Can You Best Support Your Disability Claim?

From our years of representing architects in disability cases, we offer several important ways to document how your symptoms, condition and functionality is impacted in performing your work as an Architect:

Coordinate Claims Documents with Treating Physicians: When a claim is filed, you will need the strong documented support from your medical team. In advance of a claim, one should gather medical records to demonstrate impairment  to support the disability claim.  This typically includes records from treating providers, diagnostic testing (which varies by condition), and supporting statements from physicians. Your medical support must  give more than the diagnosis, treatment plan, and prognosis but also specify how your condition affects both your physical and cognitive functions.

Additional Expert Support and Testing: After reviewing your medical records, we may find your medical reports are not sufficient to support a successful claim. In these cases, we work with a network of highly qualified experts to have additional testing and/or opinions from specialists to support an architect’s claim. For architects, we tap vocational experts or occupational therapists who are knowledgeable about the demands of the architect’s job, can explain the specific tasks required and offer objective evaluations of the disability’s impact on job performance.

Job and Impairment Description: We have developed powerful job descriptions with our Architect clients to provide the insurance company with an explanation of how and why you cannot perform your demanding, high level work. Your impairment statement must cover the array of physical and cognitive issues which impact upon activities and serve to impair.

Document Changes in Job Performance: It is challenging for people who are accustomed to high performance levels to document their problems and inabilities, but this information supports the claim. If you aren’t already documenting changes in your work performance that you believe are related to your disability, start immediately. You’ll want to be able to show performance impairment, like having problems traveling to meetings, being unable to communicate effectively with clients or colleagues, or even struggling with deadlines or completing projects.

Maintain Consistency: From the onset and throughout the disability insurance process, consistent documentation is critical – inconsistency can be fatal to a claim. All of the materials supporting your claim should align to present a total picture of your disability and, most importantly, how your disability is impacting your ability to work as an architect.

There are many reasons, both physical, cognitive, or mental health, which can cause someone to become disabled. The stress of being an architect may impact upon one’s ability to work. Claims for mental/nervous/anxious disabilities will often face challenges when filing for disability. An experienced disability insurance attorney is prepared for the battle.

Why Would My Claim Be Challenged?   

Cognitive Demands of Architectural Work: Architecture involves advanced executive skills, including the ability to problem solve, understand spatial and mathematical concepts, and keep multiple thought processes at the same time. Cognitive thinking functions don’t show up on x-rays or MRI scans. Proving their existence is challenging, and the disability insurance company will attempt to block a claim based on a lack of subjective evidence.

Physical and Mental Challenges: The average claims adjuster has no idea what the working life of an architect or engineer is. They don’t know the mental stress of project deadlines, problem solving and pressures experienced by architects on a regular basis. They also won’t understand the physical challenges of being an architect (see below). 

Architecture is Not Always a Sedentary Job: The architect is often required to travel to job sites, often managing multiple projects in distant states. For those who are more focused on designing, an orthopedic injury can make it impossible to sit for extended hours to complete work on plans and blueprints.  A problem with eyesight could short-circuit an architect’s entire career. 

Complex Claims Process and Requests: The architect who thinks they can manage a long term disability claim on their own is often surprised to find out how challenging the process is. Add the complexity of reporting requirements and deadlines to provisions in the policy that simply don’t make sense to the layperson, and claimants often become overwhelmed. This is not what you want to deal with when you are already battling a disability.

An experienced disability insurance attorney can guide you through the disability insurance claim process, and protect you, while giving your claim the best chance of success.

When representing clients with their disability insurance claims, we help in several ways, at varying stages:

Examine Coverage(s) and Identify Claim Issues: Having reviewed thousands of claims, we review the claim and spot issues of concern.  Our first step is to examine your disability insurance coverage and each policy. The policy terms are the roadmap to the treasure (benefits), and understand the terms and identify benefits, limitations, and other concerns.

Manage All Contact With the Insurance Company: Newfield Law Group represents your interest with the insurance company. This serves two purposes: it insulates you from the aggravation of dealing with the insurance company, removes the emotion from the process and ensures that the insurance company is dealt with by an experienced professional. We don’t allow you to be harassed by the insurance company or their many representatives. Our job is protecting you and your claim.

Developing Support for Your Claim. We know what your disability insurance company is looking for when reviewing your claim, and make sure they receive the information needed. This includes medical records, diagnostic tests, narrative reports, and any expert evaluations. We understand the process of assembling the evidence needed and the channels to be navigated within the insurance company.

Preparing Appeals of Denied or Terminated Claims: A large part of the firm’s practice is preparing appeals for claims. We will determine where your initial claim went wrong, or the real reasons for a claim to be terminated and attack it in a powerful appeal.

We Litigate Cases When Necessary: If your disability appeal is denied, the Newfield Law Group is prepared to assist you with litigation. For more than two decades we have effectively represented claimants in Federal court.  We are committed to advocating for our clients’ rights. 

Call our Office to Learn How we Can Help.

Jason Newfield offers a free consultation to evaluate your claim. We encourage you not to delay calling, as there are time limits to appealing a denied claim. He has worked with many architects through this process and will be able to provide insight into your claim and what you can expect from your disability insurance company.  In the same way you would urge a homeowner to consult an architect, we urge you to not do this on your own.

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