According to the United States Census Bureau, 9 percent of Washington’s population under age 65 was disabled during the period between 2012 and 2016. Thousands of Washingtonians today continue to live with conditions that limit their movements, activities, or ability to sense the world around them. They are also struggling to obtain the individual and group disability insurance benefits to which they are entitled. Fortunately, help is available.
The top-rated individual and long-term disability lawyers at DarrasLaw know how Washington’s disability insurance carriers work, from their confusing claim application questions to their one-sentence wrongful denials. Our team is led by Frank N. Darras, America’s top disability attorney who has devoted his career to helping people get the individual and group disability insurance benefits they deserve.
For more than 30 years, Frank N. Darras and his firm’s award-winning disability attorneys and ERISA lawyers have fought to recover wrongfully delayed and denied individual and group ERISA disability benefits. We have taken on every behemoth insurer trying to deny disabled people benefits—and won. To schedule a free consultation with a member of our outstanding team, call our office today at 800-898-7299 or contact us online.
Applying for Washington Group Disability Benefits
Before you accepted your current job, you likely looked at the list of employee benefits offered—especially from a corporate employer. You may have elected to receive group long-term disability insurance, as some employers pay the premiums.
Employer-sponsored disability insurance generally covers about 60 percent of your salary or hourly wage if you become disabled. However, you must have a disabling illness or injury that qualifies as a “disability” under the specific terms and limitations of your group disability insurance policy to get benefits. Common but disqualifying illnesses and disabilities include:
- Illnesses or injuries sustained as a result of war
- Injuries sustained if you took part in a violent rally or protest
- Self-inflicted injuries
- Motor vehicle accidents that occurred as a result of driving under the influence of drugs or alcohol
Your claim forms may have tricky questions designed to trap you into a disqualifying answer. This is often just the first hurdle in applying for and receiving individual or long-term group disability insurance benefits.
You should always take advantage of the free disability insurance policy analysis and free claim consultation offered by DarrasLaw before you submit your initial claim forms for benefits. Our experienced disability attorneys can help ensure that you use the correct legal and medical terminology when applying for benefits to avoid the wrongful denial traps your disability insurer may set.
Many disability claim forms are designed to confuse applicants, especially if you’re facing questions about pre-existing or self-inflicted injuries. Do not try to guess or understand the complex and intentionally vague questions. Instead, take your forms for disability benefits to the experienced disability lawyers and ERISA attorneys at DarrasLaw.
Our disability policy review and claim consultation is free because we are passionate about ensuring that all American workers receive protection against deceitful, corporate disability insurance companies. The disability insurance lawyers and ERISA attorneys at DarrasLaw can help people in Washington State prevent a wrongful delay or denial of benefits by assisting with confusing and ambiguous claim form questions.
Maintaining Your Group ERISA Disability Benefits and Fighting Wrongful Denials
Employer-sponsored group disability insurance generally only replaces a percentage of your lost income.
If your disability insurance company wrongfully cuts off your benefits, getting them reinstated may take months or years. For this reason, contact a nationally recognized long-term disability lawyer and ERISA insurance attorney from DarrasLaw early in the disability application process. We can help you avoid wrongful delays and denials that may result in financial losses for you and your family.
Our experienced individual disability insurance attorneys and ERISA lawyers at DarrasLaw know the traps your individual or group disability carrier will set for you. We can review your carrier’s request for an independent medical examination or functional capacity evaluation, review your treating physician’s chart notes, and analyze your disability insurance policy’s benefits and limitations.
Common Reasons for Disability Denials in Washington State
In Washington, you may face a wrongful delay or denial of disability benefits for many reasons. Common reasons for the cancellation, termination, or failure to pay your disability benefits may include:
- Mental health and self-reported policy limitations. This includes temporal limits on how long you can recover from conditions like depression, fibromyalgia, migraines, chronic fatigue, or PTSD. Insurance companies design these provisions and limitations to avoid paying for disabilities that are self-reported. However, our long-term disability and ERISA insurance attorneys understand these conditions and can help you and your treating doctors to present the proper evidence to your disability carrier.
- Limitations on certain medical conditions. The American Chiropractic Association reports that lower back pain is the leading cause of disabilities worldwide. Naturally, your disability insurance company will want to avoid paying valid claims for disabling back pain. You may be surprised, however, to find limitations in your disability policy governing how long you can receive benefits while recovering from self-reported disabling back, neck, or musculoskeletal pains.
- Insufficient evidence of appropriate treatment. As long as you claim your individual or group long-term disability benefits, your disability insurance carrier will require you to submit periodic attending physician statements. While this is understandable, what happens if you’ve reached “maximum medical improvement” and no amount of additional treatments will help? What if you are trying more natural forms of treatment, such as acupuncture? If you can’t show your carrier that you are receiving the most appropriate medical treatments for your disability with a licensed physician, you may experience a termination of benefits. It will not always matter that you are truly, legitimately disabled. If your disability insurance carrier doesn’t like what’s documented in your records, it will deny your benefits.
- Contradictory “independent medical examinations.” According to the Washington State Department of Labor and Industries, “high-quality” physicians are supposed to perform independent medical examinations (IMEs). These physicians are supposed to provide “unbiased, accurate, and medically-sound” opinions about a disabled worker’s medical condition. However, if you’ve ever undergone an IME, you know that this is seldom the case. High-quality physicians rarely need the business that comes with insurance company IME work. Furthermore, these often improperly credentialed doctors may schedule so many daily appointments that your examination can consist of a 30-minute once-over, after which you’re declared cured. Sometimes an insurance company will even declare you to be disability-free because you drove to the exam yourself or walked into the exam room on your own. You may be surprised by what insurance company doctors watch for and will use against you to wrongfully delay or deny your disability benefits.
Getting an individual disability attorney or group ERISA insurance lawyer from DarrasLaw on your side before these examinations can make all the difference. Our seasoned disability lawyers and ERISA attorneys know what the IME doctors are looking for and can suggest protections for you during the examination. We will take the time to review your case and determine whether you were wrongfully delayed or denied rightful benefits—all at no cost to you.
Appealing Your Wrongful Denial of Group Disability Insurance Benefits in Washington State
Disability law is a complicated field. This is especially true during the ERISA group appeals and litigation process, which makes disability insurance law one of the most complex areas of American litigation.
If you have an individual disability policy, which you may have if you’re self-employed or if you purchased a private policy from an agent or broker then you face a more traditional litigation process that may not require an appeal. If you were wrongfully denied benefits under your individual disability policy, you can generally file directly in Washington’s federal or possibly state courts. When you do this, you are entitled to a trial with a jury and to call qualified doctors and witnesses to testify to your disabling conditions. Your treating doctors and loved ones can testify against the insurance company’s unsupported determinations. Your individual disability attorney is also permitted to cross-examine the insurance experts—and put on evidence of their bias.
If, however, you’re wrongfully denied benefits under a group or employer-sponsored disability insurance plan, you are faced with a different set of complex laws. Group and employer-sponsored disability plans generally fall under the Employee Retirement Income Security Act (ERISA). This is an extremely complex area of ever-evolving law, and you need a top-tier disability insurance attorney on your side to help you through an ERISA case.
Litigating a Wrongful Denial of Group ERISA Benefits in Washington Under ERISA
ERISA is a set of federal laws designed to regulate the group health, life, and disability insurance industry. ERISA tends to do more harm than good to the unassuming, disabled beneficiary. If you have group disability coverage and are wrongfully denied benefits, you don’t get your typical day in court. Instead, you must first file a timely, thorough administrative ERISA appeal.
If your valid group disability insurance claim was denied and a comprehensive administrative appeal was timely filed and denied, you may then file an ERISA federal lawsuit. This is where things get tricky.
You do not have the same consumer rights as an individual policyholder. Instead, your case is almost always limited to the documents contained in the administrative record. This means that you can’t call witnesses to testify as to the seriousness of your condition or bring anyone to court, because there is no trial, nor discovery. You cannot bring in additional medical reports that you didn’t think were relevant at the time of your administrative appeal but weren’t included.
Many beneficiaries don’t know that the judge will refuse to consider anything that was not part of your group ERISA administrative appeal. The seasoned, award-winning ERISA attorneys at DarrasLaw know this, and will make sure the judge has all the medical and occupational information necessary to hopefully rule in your favor.
It is absolutely essential that you get an award-winning disability insurance lawyer and ERISA attorney from DarrasLaw on your side. ERISA appeals present challenging issues for many lawyers, but not those at DarrasLaw. Frank N. Darras and his firms have more than 30 years of experience fighting disability insurance companies and have recovered nearly $1 billion in wrongfully delayed or denied group and individual insurance benefits. We know how to win insurance cases and can overcome significant obstacles that may derail other less-experienced lawyers and firms.
Don’t Wait! Your Disability Insurance Company Is Not on Your Side, but DarrasLaw Is!
Whether you were wrongfully denied disability benefits in Seattle, Olympia, Spokane, Tacoma, Vancouver, Bellevue, Kent, Everett, or Renton, the top-rated, experienced individual disability insurance attorneys and ERISA lawyers at DarrasLaw know how to beat the insurance companies at their own game. We evaluate disability claims and appeals from all over the country, including Washington.
There are no risks to contacting DarrasLaw. You will not have to pay any upfront fees or sign a confusing contract to speak with an experienced individual disability insurance attorney or ERISA lawyer at our firm. No matter the amount of your monthly benefit or your occupation, our seasoned attorneys are here to protect and try to help you.
When you have a disabling illness or injury, this is a vulnerable time, and a team of corporate insurance lawyers is doing everything it can to prevent you from obtaining your rightful, legitimate disability benefits. Take advantage of our completely free insurance policy analysis and claim consultation. If you’re struggling with your fight against your individual or ERISA group long-term disability insurance carrier, call us today at 800-898-7299 to schedule your free consultation or contact us online.
