Navigating Long Term Disability Claim Denials in Pennsylvania 

In Pennsylvania, from the bustling city life of Philadelphia to the industrial heritage of Pittsburgh, residents contending with long-term disability insurance claims face significant challenges. The Newfield Law Group represents Pennsylvania residents through the intricate and often daunting process of both short-term and long-term disability insurance claims.

This web page aims to shed light on the common issues faced by long-term disability claimants in Pennsylvania, the role of ERISA attorneys in assisting when group disability claims are denied and crucial considerations when filing an initial claim and addressing a claim denial.

Navigating these claims requires careful strategy, as insurance companies implement rigorous evaluations to identify grounds for denying or delaying paying benefits. While these tactics are commonplace across the insurance industry, they place enormous pressure on individuals, jeopardizing their financial stability and impacting their quality of life. 

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Why do insurance companies oppose long-term disability claims in Pennsylvania? 

The most common reason for claims to be denied are:

  • Failure to Meet Definition of a Disability
  • Occupational Duties Disparity
  • Surveillance Evidence
  • Missed Deadlines

Additional Challenges Faced by Claimants:  

Complex Legal Procedures: For group policies, ERISA regulations impose strict deadlines and procedural requirements for filing appeals, which can be confusing for claimants without legal expertise.

Insurer Bias: Insurance companies often prioritize their financial interests, leading to biased claim evaluations and unjust denials.

Insufficient Medical Evidence: Establishing the extent of disability through medical evidence can be challenging, especially when insurers dispute the severity of the claimant’s condition.

The Essential Role of an ERISA Appeals Lawyer in Pennsylvania

 Pennsylvania, like many other states, adheres to ERISA regulations concerning employer-sponsored long-term disability insurance plans. While these plans are designed to provide financial protection to employees unable to work due to injury or illness, claim denials are unfortunately common. Insurers may deny claims for various reasons, including insufficient medical evidence, failure to meet policy requirements, or administrative errors.

The Role of Experienced ERISA Attorneys:

In the face of these challenges, retaining the services of an experienced ERISA attorney like Jason Newfield can be invaluable. ERISA attorneys specialize in navigating the intricate regulations governing long-term disability claims and can provide the following assistance:

Comprehensive Case Evaluation: An ERISA attorney can assess the strengths and weaknesses of a claim, identifying potential grounds for appeal. Jason Newfield likes to explain the value of “preventing the spill to avoid having to clean up the mess.”

Understanding the Policy: Long term disability insurance policies are actually legal contracts between the claimant and the insurance company. The provisions are often convoluted and difficult for the layperson to understand. An experienced ERISA attorney is familiar with the built-in pitfalls presented by the contract and can address challenges inherent in the policy.

Evidence Collection and Presentation: Attorneys work closely with medical professionals to gather compelling evidence supporting the claimant’s disability. Disability attorney Jason Newfield has a national network of  prominent medical specialists who provide the gold standard of tests and analysis.

Navigating Legal Procedures: ERISA attorneys are well-versed in the procedural requirements of the appeals process, ensuring that all deadlines are met and paperwork is filed correctly.

Considerations When Filing an Initial Claim: While the prospect of facing a claim denial can be daunting, claimants can take proactive steps to strengthen their initial application. 

The process to apply for long-term disability benefits requires detailed and precise documentation, critical from the initial filing through to any appeals. Failures in this documentation can significantly damage the strength of a claim. Our firm excels in preemptively tackling potential issues, engaging closely with medical experts to ensure that every piece of evidence submitted is clear and convincing.

Responding to a Denied Disability Claim in Pennsylvania

Navigating the complexities of long-term disability claim denials in Pennsylvania requires a strategic approach and a thorough understanding of ERISA regulations. By enlisting the support of an experienced ERISA attorney and taking proactive measures when filing the initial claim, claimants can maximize their chances of obtaining the benefits they rightfully deserve. 

If you’re facing a denial on your long-term disability claim in Pennsylvania, don’t hesitate to seek legal assistance and explore your options for appeal. You are invited to call Jason Newfield at 877-406-7883 to discuss your case. The call is free and there is no obligation.  

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    Newfield Law Group does not handle Social Security Disability Claims