Chicago LTD Lawyers Fighting for What You’ve Earned
Disability can strike at any time and for any number of reasons. If and when it does, and you are fortunate to have group long-term disability (LTD) insurance through your employer, you expect your LTD plan to deliver on its promise to protect your income when you need it the most. But too often, LTD plans don’t live up to their promises.
That’s where we can help. If you’re looking for disability claim assessment, DeBofsky Law ERISA and long-term disability lawyers can assist you.
Top Rated ERISA LTD Lawyers Advocating for Your Rightful Benefits
As the largest plaintiff-side employee benefits law firm in Chicago and the Midwest and one of the largest in the U.S., DeBofsky Law is well-versed in the federal Employee Retirement Income Security Act which governs group long-term disability plans like yours.
From our Chicago and Seattle offices, we handle federal ERISA claims for clients across the United States. We have taken insurers, employers, and ERISA plan administrators to court and obtained justice for our clients whose LTD benefits claims were wrongfully denied.
Collectively, we have over 60 years of experience and nearly 100 appellate decisions to our name. Our work has helped to level the playing field for claimants like yourself who feel helpless against multi-million dollar insurance companies. You are not helpless. We are on your side.
Common Reasons for LTD Claim Denials
Long term disability policies tend to be long and complex and contain many exclusions and limitations that can trap unsuspecting policyholders. Denial letters often contain legalese, and it can be hard to discern what additional evidence is needed to perfect your claim. Common reasons an LTD claim may be denied or terminated include:
- Alleged lack of coverage
- Late notice of claim
- Pre-existing conditions
- Limited-duration benefits for mental illness
- Limited-duration benefits for “subjective” illnesses
- Change in the definition of disability (from “own occupation” to “any occupation”)
- Lack of treatment
- Lack of “objective” medical evidence
- No “measured restrictions and limitations”
- Lack of treating physician support
- Activities of daily living that “contradict” disability
- Video surveillance & social media activities
- “Illegal Acts” exclusions
If your LTD claim has been denied for any of the foregoing reasons (or another reason not listed above), odds are we have seen and successfully overcome the argument before. Call DeBofsky Law today for a consultation.
When You Need an LTD Lawyer
While some claimants successfully navigate initial applications alone, certain situations require immediate legal guidance:
Denial or Termination of Benefits
If you’ve received a denial letter, time is critical. ERISA group policies provide only 180 days to appeal – a deadline that cannot be extended. Individual policies have varying deadlines under state law. The appeal stage represents your only opportunity to build the administrative record, making professional guidance essential.
Independent Medical Examination Scheduled
When insurers schedule an IME, they’ve selected and paid a physician to evaluate you. These examinations often last 15-30 minutes yet generate reports claiming you can work. Having legal counsel before the IME helps you understand your rights and properly document the examination.
Surveillance or Investigation Activity
If you notice repeated vehicles near your home or someone photographing you, surveillance may be underway. Insurers use brief video clips out of context to justify denials. Legal counsel helps address surveillance evidence properly.
Approaching Definition Change
Most policies change from “own occupation” to “any occupation” after 24 months. This transition represents a critical juncture where many benefits terminate. Preparing evidence in advance protects against termination.
Individual vs. Group Policy Considerations
Individual disability policies purchased privately offer different rights than employer-sponsored group coverage. Individual policies may allow state court litigation, jury trials, and bad faith claims. Group policies typically fall under ERISA with federal court jurisdiction and limited remedies. Understanding which type you have affects strategy and timeline.
Know Your Rights
You are potentially eligible for many different kinds of disability compensation, including:
- Retroactive (past-due) benefits
- Future benefits
- Interest paid on past-due benefits
- Attorney’s fees
Work with attorneys who know how to get you everything you deserve.
Does This Apply to You?
If your long-term disability benefits have been delayed, reduced, or denied, you don’t have to face the insurance company alone. Contact DeBofsky Law for a confidential consultation. Our attorneys will review your situation, explain your rights, and help you understand the best next steps toward getting your benefits reinstated.
Why Choose DeBofsky Law for Your LTD Claims?
- 60+ years combined experience
- Thousands of successful appeals handled
- Nearly 100 published appellate decisions
Understanding Legal Fees for LTD Claims
A denied LTD claim often means lost income. Concerns about legal fees should not prevent you from exploring your options. We offer flexible fee arrangements for long-term disability cases, including contingency fee options where you pay nothing for our services unless your claim succeeds. Learn more about how our fee structures work.
Occupations We Serve: Who We Represent
Only one third of the U.S. workforce is fortunate to have long term disability coverage through an employer. Employers that offer such coverage tend to be large employers, unionized employers, and employers in the professional services, banking, technology, and other sectors that must compete for highly skilled employees.
At DeBofsky Law, we pride ourselves on representing clients across a wide range of occupations, including executives and business owners; professionals (including lawyers, doctors, accountants, bankers, and salespeople); skilled tradesmen, including plumbers, electricians, and carpenters; and machine operators, forklift operators, hand packagers, and laborers, just to name a few.
We recognize that each occupation is unique, and we work with our clients (and partner with vocational experts as necessary) to formulate a winning appeal and/or litigation strategy that takes into account all of the material duties of your occupation as well as the restrictions and limitations that prevent you from returning to your occupation or to other comparable occupations.
Causes of Disability: Which Conditions Qualify for LTD?
The leading cause of long-term disability is musculoskeletal disorders (29%), followed by cancer (15%), pregnancy (9.4%), mental health issues (9.1%), and injuries such as fractures, sprains, and strains of the muscles and ligaments (9%). However, there are countless other medical conditions that can qualify you for long-term disability benefits if they prevent you from performing your job. These include:
- Degenerative disc disease, herniated disc, foraminal stenosis, and other back and spine problems
- Cancer and residual effects from cancer treatment
- Cardiac diseases such as Heart attack, stroke, coronary artery disease, aneurysm, hypertension
- Accidents and injuries
- Traumatic brain injury and post-concussive syndrome
- Neurologic conditions such as multiple sclerosis, Parkinson’s disease, epilepsy, amyotrophic lateral sclerosis (ALS)
- Fibromyalgia and chronic fatigue syndrome
- Auto-immune disorders such as lupus, rheumatoid arthritis, myasthenia gravis, Addison’s disease, Graves disease, pemphigoid, and HIV/AIDS
- Hepatitis C, cirrhosis, and kidney disease
- Degenerative joint disease, osteoarthritis, carpal tunnel syndrome, tarsal tunnel syndrome, and torn rotator cuff
- Chronic obstructive pulmonary disease (COPD), emphysema, and other pulmonary disorders
- Chronic migraine headaches
- Diabetes mellitus and complications related to diabetes, including peripheral neuropathy and diabetic neuropathy
- Vision disorders such as macular degeneration and nystagmus
- Balance disorders and vertigo
- Depression, anxiety, post-traumatic stress disorder (PTSD), bipolar disorder, schizophrenia, and other mental illnesses
- Endometriosis and pelvic floor dysfunction
- Gastrointestinal disorders, including Crohn’s disease, gastroparesis, and pancreatitis
- Genetic conditions, including Ehlers-Danlos syndrome
- Other conditions not listed above
Don’t Wait Until Your Claim Is Denied to Hire a LTD Lawyer
Long term disability claims are complex, and the insurance company is inherently conflicted. We can help you navigate the pitfalls of the LTD claim process so as to maximize your chances of getting approved in the first instance and avoid an extended interruption in your income.
Contact our lawyers today. We can help you:
- Anticipate and address potential objections and obstacles
- Build the strongest case you can from both a medical and vocational standpoint
- Lay the groundwork for a successful appeal in case of denial
We’ll guide you through the complications of disability benefits. We can work to get you your benefits without litigation. Talk to us about our hourly consulting rates.
Insurance Companies We Have Beaten:
- Aetna Life Insurance Company
- Continental Casualty Company (CNA)
- Dearborn National
- Guardian Life Insurance Company of America
- The Hartford Life Insurance Company
- Liberty Mutual
- Lincoln Financial Group
- Lincoln Life Assurance Company of Boston
- Life Insurance Company of North America (LINA / CIGNA)
- Lloyds of London
- Madison National
- Massachusetts Mutual Financial Group
- Metropolitan Life Insurance Company (MetLife)
- Minnesota Mutual
- Mutual of Omaha / United of Omaha
- Northwestern Mutual Life Insurance Company
- Principal Financial Group
- Prudential Insurance Company of America
- Reliance Standard
- Sedgwick
- The Standard Insurance Company
- Sun Life Financial
- Unum Life Insurance Company of America
Long Term Disability Frequently Asked Questions (FAQs)
Long Term Disability FAQs
What Steps Should I Take When Filing an LTD Claim?
What If My Doctor Refuses to Complete Disability Forms?
How Are Lawyer Fees Handled in an LTD Case?
What Happens if I Change from ‘Own Occupation’ to ‘Any Occupation’?
What kind of medical evidence is needed to support my LTD claim?
Insurance companies require objective and consistent medical documentation that clearly explains why you cannot perform your job duties. This may include physician treatment notes, diagnostic test results (like MRIs or lab reports), and detailed statements from your treating specialists describing your restrictions and limitations. Vocational assessments and symptom diaries can also strengthen your claim by showing how your condition impacts your ability to work.
What are the Most Common Reasons Long-Term Disability Insurance Claim Decisions are Delayed?
LTD claim delays often occur when insurers repeatedly request additional records, send your case for multiple medical reviews, or claim they’re waiting on documentation from your doctors. Delays can also result from internal insurer backlogs or unclear communication about what evidence is still required. These tactics often serve to slow the process and discourage claimants, but you have rights under federal law to a timely, good-faith review.
Can I Appeal an LTD Denial or Termination?
Does Receiving Other Benefits Affect My LTD Claim?
Why Do Insurance Companies Request Independent Medical Exams?
Why is Early Legal Help Important for My LTD Claim?
As early as possible. Early legal help can simplify paperwork and anticipate obstacles. An attorney can gather the right medical and vocational proof from the start, cutting the chance of a drawn-out denial or an interruption in benefits.
What Can I Do About a Long-Term Disability Insurance Claim Delay?
If your insurer is delaying your claim, start by requesting written confirmation of what information they’re missing and when a decision will be made. Keep records of all communications and provide prompt updates from your medical providers. If delays persist or seem unreasonable, an LTD attorney can demand compliance with ERISA deadlines and hold the insurer accountable for failure to act in good faith.
What Does Long-Term Disability Insurance Cover?
Long-term disability insurance provides partial income replacement if an illness or injury prevents you from working for an extended period, typically longer than six months. It usually covers both physical and mental health conditions that make you unable to perform your job duties on a full-time, consistent basis. LTD benefits are designed to protect your financial stability while you focus on treatment and recovery.
Our Recent Victories Related to Long Term Disability
We know the tricks insurers and plan administrators use to deny claims. We’re here to fight on your behalf. See How We’ve Won Your Rights.
Ward v. Reliance Standard Life Insurance Co.
DeBofsky Law achieved a favorable ruling where the court found that Reliance Standard Life Insurance Company abused its discretion in terminating long-term disability benefits for COVID syndrome. The court determined that the insurer failed to properly consider comprehensive medical evidence of cognitive impairments. Consequently, the case was remanded for further proceedings to ensure a thorough review of the disability claim.
Robinson v. Aetna Life Ins. Co.
DeBofsky Law won two cases for our client. In the first, the court denied Aetna’s motion to dismiss, noting the plan did not address retroactive SSDI awards. The judge found Robinson’s claim was not time-barred due to her voluntary appeals. In the second, the court ruled the denial of benefits arbitrary and capricious due to Robinson’s retroactive SSDI award and found Aetna’s refusal to toll its review problematic.
Scanlon v. LINA
A system analyst with spinal pain and a sleep disorder won his appeal with the help of DeBofsky Law. The court ruled that the district court erred in its assessment, failing to properly consider the claimant’s functional capacity and inability to earn 80% of his income due to his condition. This decision underscores the importance of thorough evaluations in long-term disability cases, especially the impact on job performance.
“While the basis of the case still presents such a challenge in life, I celebrate with you.”
“This is FANTASTIC news [about our victory in the court of appeals]. While the basis of the case still presents such a challenge in life, I celebrate with you. I cannot express the amount of gratitude I have for your time, efforts and dedication.
Thank you on behalf of my 4 and 5 year old sons as well. God will make beauty from ashes each and every time.”
Client
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