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Legalease
Legalease, Lawyer
Category: Legal
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Experience:  15 years exp all aspects of general law
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Have been denied Long Term Diability thru employers benefit

Customer Question

Have been denied Long Term Diability thru employers benefit company...Sun Life...have physician documentation, feel I need legal reprensentation to gain benefits.
Submitted: 3 years ago.
Category: Legal
Expert:  Legalease replied 3 years ago.

Hello. None of the attorneys on this site can represent you privately -- however, I can give you some advice.

 

You should speak with a few attorneys regarding applying for social security disability payments immediately and then wait a few months after you have filed the social security disability claim and re-file the claim for the long term disability benefits. If your medical conditions are bad enough and the conditions are expected to keep you out of work for a year or more, then you are entitled to apply for and collect social security benefits -- and when you get those benefits, the long term disability provider usually has not choice but to fall in line behind what social security decides because the LTD insurer then puts itself out there as discriminating against you for the very disability that you are applying for. You should try one of the national law firms that handle social security disability and LTD claims -- like Binder & Binder (you can find them on the internet) -- these are the only claims that this firm focuses on and they have affiliates all over the country.

 

In the meantime, while you are trying to sort out getting some money into your household, you should try to see if you can get the opinions of 2 or 3 more Neurologists regarding how bad your condition is and that it keeps you from returning to work. If your disciplinary issues were so bad then why didn't they fire you while you were working? Probably because they were afraid that you would bring a claim of disability discrimination against them for wrongful termination.

 

Also check in with your state's insurance commissioner / division of insurance. There are many of these LTD companies that are being reprimanded by the state governments and being sued privately in class action lawsuits for the wrongful denial of disability claims -- the insurance commissioner's office in your state can let you know if this LTD insurer has issues and problems in the past with refusing to pay legitimate claims and they can probably give you the names of a few law firms that are handling such class action claims. Sokolove Law is one law firm that fights wrongful denials of LTD benefits AND wrongful denials of social security benefits -- here is an internet link to their website so you can check them out -- http://www.sokolovelaw.com/legal-help/disability-insurance-lawyer/long-term-disability-denial/

 

I think with some perseverance and pushing on your part you will get the LTD benefits and eventually social security disability benefits also.

 

GOOD LUCK

 

Please press the GREEN ACCEPT BUTTON so I will be paid for my time. I AM PAID NOTHING UNLESS YOU PRESS THE ACCEPT BUTTON -- I am a single mother and have been hurt badly by this recession just like the rest of the US and I cannot afford to do this for "free" -- if you do not press ACCEPT, I am never paid anything by Just Answer and that would be very unfair for my customers to not honor the honor system and neglect to press ACCEPT.

 

If nothing else, I do believe that you will have luck with Sokolove Law (my own sister had great luck with them).

 

THANK YOU !!



Edited by Mary M., Esquire on 2/25/2011 at 3:26 AM EST
Legalease, Lawyer
Category: Legal
Satisfied Customers: 14511
Experience: 15 years exp all aspects of general law
Legalease and 6 other Legal Specialists are ready to help you
Customer: replied 3 years ago.
I am only 49, turning 50 in July. An attorney suggested that I not apply for Social Security Disability until turning 50. My employer is a hospital, I'm a Respiratory Therapist, the Fibro caused fatigue, pain, memory fog.....worsening of symptoms with any type of stress. Cardiac stents x3 with freq. chest pain and referrals to different cardiac specialists. I want to appeal the deniel from the Sun Life company offered as a benefit through my employer. THEN, do the S.S.........Sun Life has a clause that they wouldn't pay if I was receiving other disability income. I feel like they denied me using my personel record and not taking multiple letters/forms from my doctor on unable to work any longer. I'm either disabled or not..right. The attorney I talked to in DesMoines today said that there isn't an Iowa firm that deals with ERISA, to look at bigger cities, such as Chicago. I don't know what to do. How to find a truthful firm. I have 180 to appeal, June 1st. Do I have a legit claim?
Expert:  Legalease replied 3 years ago.

I most definitely believe that you have a legit claim. LTD insurers are getting into big trouble and they are being sued for bad faith wrongful denials of claims like yours all over the country.

 

The age of 50 has nothing to do with obtaining social security benefits -- i know of plenty of people who receive them in the 40-50 year age range. However, if sunlife will not pay due to social security, then it probably is wise to wait on that.

 

Contact the law firm that I gave you the link to above -- they can put you in touch with a lawyer or firm closer to you and that firm will be associated with the Sokolove law firm so if you can also sue SunLife for a bad faith denial of LTD benefits, these are the guys that will get it moving for you.

 

--Mary

Legalease, Lawyer
Category: Legal
Satisfied Customers: 14511
Experience: 15 years exp all aspects of general law
Legalease and 6 other Legal Specialists are ready to help you
Customer: replied 3 years ago.
Would you be willing to ready thru a 23 page paper the atty I talked to today encouraged me to read. HA! Its all in Legal mumbo-gumbo (I can decifer medical but not legal). I could email the document to you. I would just like your opinion on it , how it applies to me, what you get out of it that would help me. This atty was highly recommend in DesMoines but was very cold on the phone and said he refuses to handle claims like this bc it takes hundreds to thousands of hours and money to work on it and usually denied and that a firm that deals with this type has the game plan down pat....then he said he would send a paper he had written for Drake University that would help me (written by him). I need income. My husband is upset with me for not being fired up about this, but I was a respected Therapist and I feel like my medical employer turned its back on an employee that had a medical issue..when its our job to show compassion. Thank you, XXXXX XXXXX you will accept the emailing of the document and give me your input and then you can be free of me tonight. :)
Expert:  Legalease replied 3 years ago.

Hello.

 

When he said that a firm that deals with these types of claims all of the time and has it down pat -- he is right on that point. As I said earlier, there are firms that specialize in this sort of claim and they are so used to doing it that they are very efficient and very good at it. Send it to to marymeaden at comcast.net -- I cannot look at it tonight (it is late here) -- but I can take a look at it tomorrow at some point and give you my assessment in here by tomorrow night, so long as you are willing to press ACCEPT again at that time for the time it will take me to review it.

--Mary

Customer: replied 3 years ago.
Sounds good...........I'll send it.......you read and give me your opinion...and of course I'll hit accept again. Thank you again for your advice.
Expert:  Legalease replied 3 years ago.

Hello.

 

Okay -- I will get back with you tomorrow. Please do not respond to this last message from me because it will put your question back on the open list -- this way it will stay in my customer column for the night until I get back to you tomorrow afternoon -- evening -ish with my assessment.

 

--Mary

Expert:  Legalease replied 3 years ago.
Hello again Kellie -- I am sorry for the delay. I just reviewed the article that you sent to me and I wonder what the attorney's point was in sending it to you? Perhaps he was trying to make the point that you will have to show that the insurance company abused its discretion when it turned down your claim -- and that is a tough thing to prove (abuse of discretion is very subjective). However, I still think that you should appeal this again because you may be able to show that they denied the benefits in bad faith -- and that will get you into the realm of showing abuse of discretion. Try the lawyers that I gave you a link to in the earlier boxes. If that does not work, then you will have to try appealing this on your own. Let me know by email what happens after contacting that firm and perhaps another lawyer recommended by them. If you have no luck and want to try an appeal yourself, I can help you with paperwork from here for a reasonable fee if you would like. -- Mary

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