LONG TERM DISABILITY BENEFITS

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Long Term Disability (LTD) benefits are cash payments made to you if you are unable to work due to an illness or injury.

 

Generally, LTD benefits are available:

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• Through a Plan purchased by your employer

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• If you purchased your own LTD insurance policy

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Am I eligible to receive LTD benefits?

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We will be happy to help you figure that out. The rules and regulations about who is eligible for LTD benefits you receive through employment are governed by a federal law known as ERISA-The Employee Retirement Income Security Act of 1974. This law sets minimum standards for most health plans in private industry and was designed to protect people enrolled in those plans.

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As you might expect, ERISA is a highly technical and complex set of rules and regulations, which are spelled out in the LTD Plan Documents everyone gets (and most people never read) from your employer.

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We read and do know all about the ERISA rules and regulations and how they affect your ability to file for and receive Long-Term Disability benefits.

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If you purchase your own plan, the rules are set forth in documents provided by your insurance company which are also complex and can be confusing.

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We are also able to explain how your LTD benefits are affected by other disability benefits such as State Disability Insurance, Workers’ Compensation benefits, and Social Security disability insurance benefits.

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One of the most important and timely facts about LTD/STD Appeals is this:

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ERISA and private plan rules do not allow the submission of medical records once the administrative determination is complete.

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It is, therefore, vital to get an attorney to manage your claim right away, after the first administrative determination is made. Once that decision is handed down, it is important to fully develop the medical evidence in your claim to achieve a favorable determination.  Once the claim is denied administratively, it is case over. That terrible outcome can be avoided if you act quickly, call us, and we will ensure that the administrative record is complete and all filing is done on your behalf before any final administrative decision is made.

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We also stand with you before the US District Court or California Courts if an appeal is required after an unfavorable administrative decision. LTD cases are an important part of our practice and we will fight for you from Day #1 and keep fighting until the cash award is enforced and you receive the benefits you deserve.

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What we do for you:

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• We meet with you and hear you out, asking questions along the way.

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• We become experts on you, your medical situation, and your insurance policy.

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• We analyze your plan documents thoroughly so we know what critical information is needed for a successful outcome,

• We analyze your medical and vocational information for use in making the strongest case for you to receive the maximum benefits.

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• We tell you what work documents we need and help you get them, using them to construct the most favorable review of your vocational profile required for such cases.

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• We speak with your doctor(s) to discover his or her opinion of your functional abilities and limitations and gather all the medical records to establish the requisite limitations to establish your claim.

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• We pursue your claim administratively to make sure cash awards are enforced and paid out to you.

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• We see the case through, from beginning to end, keeping you informed all along the way (with copies of all documents for your files).

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• We have been very successful at having claims awarded for the maximum benefits administratively, but we will stand with you through appeal, and sue for cash benefits before the US District Court and California Courts if necessary.

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We have more than 21 years of experience with Long-Term Disability cases. We know what we are doing and use our expertise to avoid costly mistakes and give you the best chance of receiving the maximum benefits.

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The team at the Law Offices of Sima G. Aghai are ready to be your advocates. Call us soon so we can help ensure you get the benefits you need to secure your future.