Stories from Doctors: Resources 4 Feb 2025, 9:59 pm

Watch Now The worst long-term disability policy for doctors that I’ve ever come across:

Resources

We have created a plethora of resources to help people navigate the frustrating world of long-term disability claims. Especially for doctors. Remember, we are here for you.

• Free Denial Letter Review: If your claim has already been denied, we urge you to take advantage of this free service that we provide. Our highly experienced team will review your denial letter and give you personalized feedback on what your next steps should be (whether that means hiring us or not).
• Pre-Claim Consultations with Our Expert Attorneys: We hope that this book has guided you to feel confident in your next steps. If you feel as if you need additional guidance and our expertise can help you, learn more about our pre-claim consultations where our goal is to set you up for success.
• YouTube Library: Ben answers some of the most frequently asked questions when it comes to disability claims in videos on our YouTube.
• Our Blog: To find more resources like specific insurance company denials or answer frequently asked questions, visit our website’s blog today and filter by the ‘long-term disability’ category.
• Our Reviews: Providing excellent customer service to our clients is one of the most important aspects of our law firm. At the time of writing this book, we have over 330 5-star reviews from our clients.
• Our Case Results: Don’t just take it from us that we’re America’s Long-Term Disability Law Firm, read more about the people that we’ve helped along the way.

The post Stories from Doctors: Resources appeared first on BenGlassLaw.

Your Neighborhood Personal Injury Law Firm 22 Jan 2025, 5:15 pm

You made it! Thanks for scanning your Harris Teeter RX Bag to arrive here.

Here’s a message just from you from personal injury lawyer, Brian Glass.

The post Your Neighborhood Personal Injury Law Firm appeared first on BenGlassLaw.

What to Do When Lincoln Denies Your Long-Term Disability Claim 3 Jan 2025, 9:41 pm

If your Lincoln Insurance long-term disability claim was denied, you’re not alone. This article explains why denials happen and how to fight back, including options for appeals and legal action.

Quick Facts

• Lincoln Financial denies claims due to lack of medical evidence, misinterpretation of policy language and administrative errors.
• If denied, it’s time to appeal, so get your evidence together and call your attorney to help your case.
• Being prepared for Independent Medical Examinations (IMEs) is key; accurate representation of your condition can make all the difference in your claim.

Lincoln Financial Long-Term Disability Denials

Lincoln Financial Group denies claims for many reasons which seem arbitrary and unfair to the applicant. By understanding the common reasons for denials including those related to Lincoln financial disability, claimants can build their case and avoid common mistakes.

Lack of Medical Evidence

One of the main reasons a disability claim is denied is lack of sufficient medical evidence. Lincoln Financial requires numerous supporting documents including explicit medical records that explain your condition and how it impacts your ability to work. Small omissions or discrepancies in these records can be used as grounds for denial.

To avoid denials, you must keep detailed and organized medical records. Lincoln Financial may ignore any records that don’t fit their narrative. Submit all relevant information.

Be aware that surveillance may be used to challenge your claim. Make sure there is no discrepancy between what you report and what’s in your medical records.

Policy Exclusions and Definitions

Understanding the fine print and specific exclusions in your policy is key to navigating a disability claim with Lincoln Financial. These policies have specific definitions of what constitutes a disability which can vary from short term to long term insurance. For example, some disabilities caused by conditions that pre-date the coverage may be excluded in the first year.

Before you file a claim make sure to read through all exclusions and restrictions in your policy. Do this proactively to avoid confusion and ensure all required evidence is submitted according to the policy criteria. When your submission matches what’s included and excluded in your policy’s definition you increase your chances of approval.

At BenGlassLaw, we offer consultations with our experienced long-term disability lawyers where you can get advice BEFORE you file your claim so that your setup for success. Contact us today to learn more.

Administrative Errors

Another reason for claims denial is administrative errors. Rejections can happen fast if there are errors such as incomplete forms or no medical records with no further exam. To avoid this, double check all documentation and make sure all necessary documents are attached to your submission.

Be thorough in submitting paperwork to avoid unnecessary delays and denials.

Lincoln Financial Disability Claim Appeal

If your claim is denied, don’t lose hope. This is not the end. Your next move is to appeal. Understanding the process can greatly increase the chances of reversing that denial. Although this process can be tricky, with detailed records and a plan you can navigate through it.

Administrative Appeal

Challenging a denial through an administrative appeal is a process that must be done quickly. You have 180 days from the date of denial to submit your initial appeal. Make sure to request your file from Lincoln Financial as soon as you’re denied, as this file has all the information used in their decision making.

In your appeal, it should be a formal petition with additional documentation or evidence to support your case. To strengthen your argument, Get updated medical or vocational assessment. Remember you can only do two administrative appeals before you can pursue legal avenues.

Add Evidence to Your Appeal

Make sure to add recent medical records and get statements from your doctors. If you had an Independent Medical Examination (IME) and the report doesn’t support your case, get a counter statement from your primary doctor.

Get the IME report from Lincoln Financial as soon as possible so you can prepare a response. Gather all relevant documents, recent medical records and comprehensive report of your health status to build your case.

Having a detailed package of documents for your appeal can make a big difference in the outcome of your claim.

Multiple Appeals

Before you can file a lawsuit, Lincoln Financial requires claimants to do two administrative appeals. If your first appeal is denied, you can still submit a second one which is your last chance to settle internally. This process can be slow and may require information. Make sure to exhaust all internal appeal options so you can build your case if you need to go to court.

Long-Term Disability Lawyer for your Denied Lincoln Claim

Getting a short-term or long-term disability insurance lawyer can be key in handling a denied Lincoln Financial disability claim. An experienced disability lawyer, like our team at BenGlassLaw, can help by navigating the process and making sure all necessary documents are gathered and submitted during your appeal against the insurance company.

How We Can Help

Disability insurance attorneys help during the appeal process. They can gather necessary documents, write your appeal letter and manage all the submission process. Their expertise is most valuable when a disability insurance claim is denied due to pre-existing condition or complex disability insurance issues.

Working with an ERISA lawyer can increase your chances of winning. They focus on detailed evidence gathering and dealing with Lincoln Financial to get your initial denial reversed.

Who to Choose

Choosing the right lawyer is key to a good outcome in your case. Make sure to pick someone who has experience in disability insurance claims and has a track record of success.

Lincoln Financial’s Denial Tactics

Lincoln Financial uses several ways to deny long-term disability claims. Knowing these tactics can help you build your case and respond to denials.

Common tactics include reviewing medical records without patient interaction, monitoring activities and changing the definition of disability.

Paper-Only Medical Reviews

Lincoln Financial uses medical reviewers from third parties to review disability claims through paper-only reviews. The decision is made solely based on the medical records submitted, without any patient interaction. This process can be biased and error-prone since those reviewing don’t get the full picture of the claimant’s health.

Dependence on documentation-only reviews can be detrimental to claimants as important details of their health condition might be missed. To minimize this risk, make sure to keep your medical records up-to-date and comprehensive when submitting them for review.

Monitoring and Investigations

Lincoln Financial uses surveillance to validate claims. This may involve monitoring your daily activities to find evidence against your reported disabilities. The definition of disability can also change after 24 months and surveillance increases.

Changing Definitions of Disability

After 24 months, Lincoln Financial often changes the definition of long-term disability benefits from ‘own occupation’ to ‘any occupation’. This means claimants have to prove they can’t do any job, not just their previous one, making it harder to keep benefits.

Knowing these changes and preparing for it can help you get through this.

Have You Received A Long-Term Disability Denial Letter from Lincoln Financial?

If you’ve already recieved your short-term or long-term disability denial letter from Lincoln Financial, we urge you to take advantage of our free and confidential Free Denial Letter Review Service.

Our highly experienced team will review your denial letter for free and provide you with custom feedback for your next steps, whether we think that means that hiring us would be good for your case or not.

Conclusion

Filing a denial of Lincoln Financial long-term disability can be a long and grueling process. Knowing the common reasons for denials, understanding the appeals process and getting legal help can make a big difference. Whether it’s an administrative appeal or preparing for an Independent Medical Examination (IME) or court proceedings – every step requires attention to detail in gathering and organizing the necessary information.

Don’t forget you’re not alone. Stay on top of your case. Make sure all records are detailed and don’t be afraid to get legal help. With perseverance and the right strategy on your side, you can win your long term disability denial so you can get what’s yours.

BenGlassLaw Can Help You Today

Filing a Lincoln Financial Group disability denial is scary but knowing the process and your rights can help you fight back. From reviewing the denial letter and gathering medical evidence to filing an appeal and getting legal help, every step matters to get the benefits you’re entitled to.

Remember, you don’t have to do this alone. Our team at BenGlassLaw can help you navigate the appeals process and get you the best possible outcome — no matter where you live in the US. Stay on top of it, informed and persistent.

Contact our team today for a free, zero obligation consultation to learn how we can help you.

The post What to Do When Lincoln Denies Your Long-Term Disability Claim appeared first on BenGlassLaw.

Cigna Denied My Long-Term Disability Claim. What Now? 3 Jan 2025, 8:55 pm

Receiving a denial for your long-term disability claim from Cigna can be extremely frustrating and stressful. If you’ve been denied, you might be wondering what steps to take next to challenge their decision regarding Cigna insurance long-term disability denial. This article will guide you through understanding why Cigna denies claims and how to effectively appeal their decision, ensuring you have the best chance to secure your long-term disability benefits.

Key Takeaways

• Seeking legal assistance can help navigate the complex appeals process and increase your likelihood of success in securing long-term disability benefits.
• Cigna often denies long-term disability claims due to insufficient medical evidence and specific policy exclusions, so it’s crucial to understand these reasons when preparing an appeal.
• Gather and submit comprehensive medical documentation and meet the 180-day appeal deadline to significantly improve your chances of overturning a denial.

Navigating Cigna Insurance Long-Term Disability Denial: Steps to Take

Facing a disability claim denial from Cigna can be overwhelming, but understanding the process and preparing strategically can make a big difference. Cigna’s policies, combined with general long-term disability laws, require careful attention to detail to build a strong case. These benefits are essential for providing financial support when serious health issues prevent you from working.

Like other insurance companies, Cigna has a financial incentive to minimize payouts. This often leads to denied claims due to minor errors or missing documentation. Knowing this can help you prepare a more thorough appeal and avoid common pitfalls.

Getting professional legal assistance can significantly improve your chances of success. Experienced disability lawyers understand the appeal process and know how to meet strict requirements and deadlines. Their guidance can help you challenge Cigna’s denial effectively and secure the long-term disability benefits you’re entitled to.

Common Reasons for Cigna Long-Term Disability Denials

Understanding why Cigna denies long-term disability claims is vital for preparing a strong appeal. Common reasons include insufficient medical evidence, policy exclusions, pre-existing conditions, and not meeting the specific definition of disability.

These denials cause significant emotional and financial distress, making it crucial to address these issues directly.

Insufficient Medical Evidence

A lack of adequate medical evidence frequently leads to the rejection of claims. Cigna mandates that a claim be supported by extensive documentation, encompassing all records pertaining to treatments and consultations related to your medical condition. Insufficient or scanty evidence can heighten the risk of your claim being denied. It is crucial to collaborate with healthcare professionals involved in your care to gather complete and relevant information for submission.

In instances where denial arises from inadequate medical evidence, fortifying your case entails collecting supplementary documents as well as possibly submitting yourself for additional examinations. This rigorous gathering process aims at establishing a more solid foundation on which you can counteract the grounds on which Cigna has dismissed your claim.

Policy Exclusions and Pre-Existing Conditions

Exclusions in Cigna’s insurance policies for pre-existing conditions often present significant obstacles. Should your condition have been present prior to the activation of your policy, it may serve as grounds for Cigna to reject your claim.

These policy exclusions tend to be wide-ranging and encompass a multitude of conditions and situations. It is Essential to fully comprehend the scope of these exclusions before you proceed with submitting a claim.

Failure to Meet Definition of Disability

To qualify for benefits, you must align with Cigna’s particular disability criteria. These stipulations demand that your ailment obstructs the execution of your occupational responsibilities and reduces your earnings to below a specified threshold of your income. Should Cigna conclude that you retain the capability to work, albeit under specific limitations or in an alternate role, it could result in the rejection of your claim.

Adherence to this precise definition is critical for ensuring the approval of your claim.

What Should You Do if Your Disability Claim Was Denied by Cigna?

Have you received a letter from Cigna denying your disability claim? You are far from alone. We see denial letters from Cigna every day, and in most cases we can help. If Cigna has denied either your short-term or long-term disability claim, send us your denial letter for a free strategy review.

This is extra important if your claim is under the Employee Retirement Income Security Act (ERISA). If your employer purchased the disability insurance policy from Cigna for you, then most likely your claim is an ERISA claim. And ERISA claims are tricky!

Under ERISA, by law, Cigna must follow certain rules. However, ERISA is very difficult to navigate and that makes it hard for YOU, the claimant, to know what the rules are. Of course, it’s hard to hold Cigna accountable if you don’t know the rules they are supposed to be playing by. And Cigna wants to keep it that way. Cigna will want you to believe that it’s easy to appeal your claim denial decision without an attorney. It may be easy (your Cigna claim manager will tell you that all you need to do is write “I appeal,” and your claim will be reviewed) but it is NOT smart. After you write “I appeal,” Cigna will simply write, “We reviewed our decision and we were right all along. Your claim is still denied.”

To protect yourself, you should talk to an attorney who has experience with ERISA before appealing any short-term or long-term disability denial by Cigna. At BenGlassLaw, we will review your denial letter and send you custom feedback for free. There is no reason not to get an attorney’s opinion about your denial.

The Appeal Process for Cigna Long-Term Disability Claims

The appeal process for Cigna long-term disability claims is structured and involves multiple steps, governed by ERISA, which grants Cigna significant authority over claim evaluations. Understanding the steps involved and preparing thoroughly can greatly improve your chances of a successful appeal.

Usually, an appeal of Cigna’s denial of your ERISA disability claim starts like this:

• You have 180 days to appeal from the date you received Cigna’s denial letter to file your appeal. This is called an administrative appeal. This means that someone at Cigna will review your appeal and make a decision;
• Cigna will have 45 days to answer your appeal;
• Cigna is allowed one 45-day extension.

Preparing Your Appeal

Assembling your appeal requires the compilation of all essential documents to create a complete appeal package. This package is final once it enters litigation, meaning that you must incorporate every pertinent piece of medical documentation including evaluations and physician testimonies from the outset. To enhance your case, consider obtaining supplemental assessments such as MRIs, laboratory tests, or x-rays.

Should there be an anticipation of medical improvement, Cigna might seek fresh statements from the physicians overseeing your treatment. Securing comprehensive and up-to-date documentation along with current medical records is vital in forging a robust appeal that may improve your likelihood of prevailing.

Submitting Your Appeal

To enhance the strength of your appeal, it is essential to gather supplemental medical records, statements from your physician, and any pertinent documentation that substantiates your claim. Ensure you abide by the critical timeframe of 180 days to file an appeal following the receipt of Cigna’s denial letter.

Crafting a succinct and well-articulated letter for your appeal that presents a comprehensive overview of your case with all required evidence included can notably bolster its effectiveness.

IMPORTANT NOTE: DO NOT, under any circumstances, miss this 180-day window. If you do not file an appeal, your claim is dead. You cannot sue Cigna for denying your claim unless you first filed a timely appeal.

What to Expect During the Review

Once you have lodged an appeal with Cigna, they will conduct a comprehensive examination of your medical condition and associated claim. The length of this review may differ from case to case, and those appealing should be prepared for possible postponements. In the course of their evaluation, Cigna might seek Details or elucidation concerning your health condition and its treatment.

Maintaining open lines of communication and swiftly addressing any inquiries from Cigna can aid in advancing the process without unnecessary delays.

Long-Term Disability Lawyers for Cigna Disability Claim Denials

Securing legal help is often a vital step in effectively managing the appeals process following denials of disability claims with Cigna. Lawyers specializing in disability, like our team here at BenGlassLaw, provide essential representation and knowledge to challenge the decisions made by Cigna regarding claim refusals.

The probability of overturning a denial through an appeal increases with professional legal support, given the intricate nature of Cigna’s procedures for handling claims related to disability.

When to Seek Legal Help

Should you believe that your claim with Cigna was unjustly rejected, it is advisable to engage the services of an attorney who specializes in handling Cigna cases. This step becomes crucial when faced with repeated rejections despite the legitimacy of your claim or if the rationale behind the denial has not been clearly explained.

Promptly seeking counsel from such a lawyer can be instrumental in steering through the complexities of legal proceedings and bolstering your prospects for overturning the denial on appeal.

How an ERISA Lawyer Can Help

Attorneys specializing in ERISA law are instrumental when individuals must contend with the appeals process of long-term disability claims. These legal experts offer vital support to construct and present compelling arguments against claim denials, ensuring that appeals are meticulously prepared.

Due to the intricate nature of ERISA regulations and the significant authority wielded by insurance companies over long-term disability claims, securing legal counsel is critical for achieving a favorable outcome.

Contact us now for a free, zero-obligation consultation to learn if we can help you.

Choosing the Right Attorney

Choosing an experienced attorney is essential to successfully maneuver through the complicated appeals process for disability claims. It’s important to find a lawyer with specific knowledge of ERISA cases since this expertise is crucial in grasping the nuances of Cigna’s policies and the legal statutes that oversee disability claims.

There’s a reason our team has over 300 five-star reviews and great case results on behalf of our clients.

Avoiding Common Mistakes in the Appeals Process

Steering clear of typical blunders throughout the appeals process is vital for obtaining a favorable result. Minor slip-ups could cause your appeal to be rejected, thus it’s imperative that you meticulously adhere to all specified rules and deadlines with utmost precision.

Recognizing common traps can significantly enhance your ability to successfully maneuver through the procedure, thereby boosting your odds of acquiring long-term disability benefits.

Failing to Provide Updated Medical Records

It is vital to maintain up-to-date medical records in order to prevent Cigna from denying your disability claim. A lack of recent medical documentation can result in a rejection of your Cigna disability claim.

To fortify your appeal, it’s important that your healthcare providers promptly reply to any requests made by Cigna for updates on medical records.

Missing Submission Deadlines

Frequently, claim denials are attributed to the failure to meet submission deadlines. It is essential for the timely filing of claims and appeals since insurers typically set a restricted period in which you can appeal. To prevent difficulties and maintain the viability of your claim, it’s important that all submissions, including documents and appeals, adhere strictly to these predetermined time limits.

Inadequate Documentation

A successful appeal often hinges on the provision of thorough and detailed documentation. It is crucial to bear in mind that an appeal represents your final chance to introduce new evidence, which underscores the importance of collecting and presenting all essential documents to enhance the likelihood of a favorable outcome.

What Happens if Cigna Denies My Appeal?

If Cigna decides that they were correct in denying your benefits, then you have one last option. You can file a lawsuit in federal court.

You will absolutely want an attorney for this lawsuit as it can be difficult to overturn Cigna’s decision in court. Despite courts’ criticism of Cigna’s claim handling, the sad fact is that the law is written to favor insurance companies like Cigna. In fact, of cases that went to a judge to decide, insurance companies like Cigna won 7 out of every 10. Those are long odds!

The attorneys at BenGlassLaw know how to handle these lawsuits. Cigna will try to show that they were right in denying your benefits, but a federal judge will make the final decision. With our help, you can show the judge where Cigna abused its discretion to manage and decide your claim. That is the path to the closure – and benefits – you deserve.

How BenGlassLaw Can Help With Your Cigna Long-Term Disability Claim Denial

Facing a Cigna disability denial is a daunting experience, but understanding the process and knowing your rights can empower you to fight back. From reviewing the denial letter and gathering strong medical evidence to filing an appeal and seeking legal counsel, each step is crucial in securing the benefits you deserve.

Remember, you don’t have to navigate this journey alone. Our team at BenGlassLaw is available to guide you through the complexities of the appeals process and ensure you have the best chance of success — no matter where you’re located in the United States. Stay proactive, informed, and persistent in your pursuit of justice.

Contact our team today for a free, zero obligation consultation to learn how we can help you.

The post Cigna Denied My Long-Term Disability Claim. What Now? appeared first on BenGlassLaw.

What to Expect During Free Consultation With A Personal Injury Lawyer 3 Jan 2025, 5:57 pm

If you’ve been injured in a car wreck or another accident in Fairfax, you might feel overwhelmed and unsure about your next steps. At BenGlassLaw, we understand how stressful this time can be, and that’s why we offer a free personal injury consultation to help you understand your options and rights. Whether you’re looking for a car wreck lawyer to hire for your case or general guidance from an experienced Fairfax personal injury lawyer, we’re here to help.

Quick Hits

• Your free consultation at BenGlassLaw is a full case evaluation with no obligation to hire us.

• BenGlassLaw’s personal injury lawyers work on contingency so you only pay if we win your case, making legal help more affordable.

• We have a long history of getting big results for our clients in many types of personal injury cases, so we mean it when we say we’re committed to justice.

What to Expect at Your Free Consultation

When you schedule a free consultation with BenGlassLaw you get a full and compassionate evaluation of your situation. Our experienced team will spend time with you to get all the details of your accident and resulting injuries as soon as you walk in the door, and how it’s changed your life.

We’ll go over the details of what happened to you, and shed light on the legal options available to you. We want to make sure when we’re done you’re informed of all the possibilities. By reviewing the evidence we can assess the strength of your case and map out a plan.

What’s great about this initial conversation is that it’s no obligation—you’re not committed to hire us after we talk—you have the freedom to decide what’s best for you without any strings attached. Our advice is straight up. We’ll answer all your questions so by the end of the conversation you feel good about what to do next.

To go over specifics related to the incident that happened to you we explain our contingency fee structure. We do this so you can focus on healing from your injury and navigating the legal process.

Free Personal Injury Consultation: Ask Questions & Share Your Story

A free consultation with our team is your opportunity to ask questions, share your story, and get a professional opinion about your case. Here’s what to expect:

1. A Listening Ear
   The first step of the consultation is simple: we listen. We want to understand the details of your accident, the injuries you’ve sustained, and how the event has impacted your life.

2. Case Evaluation
   Based on the information you provide, we’ll assess the strengths of your case. We’ll explain what factors could influence your claim’s value, including medical bills, lost wages, and pain and suffering.

3. Next Steps Guidance
   If we believe you have a strong case, we’ll outline the next steps. You’ll get a clear picture of the legal process, potential timelines, and what we’ll need from you moving forward.

4. Transparent Fee Discussion
   Our consultations are always free, but we also take time to explain our contingency fee structure. At BenGlassLaw, you won’t pay any attorney fees unless we win your case.

5. No Pressure to Commit
   After the consultation, the decision to move forward is entirely yours. There’s no obligation to hire us, but we’re here when you’re ready.

Questions to Expect

Our team performs a six-point assessment of your case to determine whether hiring an attorney makes sense for you. 

1. Fault. Virginia is a contributory negligence state. If you are at fault for your accident, even 1% at fault, you cannot recover damages. Often, insurance companies use this to reject personal injury claims, even when the victim didn’t contribute to the accident. 

2. Current injury. The worse your injury, the more it makes sense to hire a lawyer for your personal injury claims. Auto accident victims with serious injuries, like broken bones or torn ligaments, should consult with an attorney before making any recorded statements with the insurance company. 

3. Previous injuries. Insurance companies love to use previous injuries as a reason to deny accident claims. They will point to your previous injuries and claim your accident injuries are “pre-existing.” We will review your past medical history to see what impact it might have on your settlement. 

4. Treatment. Insurance companies have a “length of treatment algorithm” that they use to determine how long your treatment should last. If your medical treatment takes longer than the insurance company deems is normal, they will not give you a fair offer for your medical bills. 

5. Car Insurance. We have seen more good cases torpedoed by poor insurance than we can count.  If the person who caused your accident is uninsured or underinsured, we will need to look at your policy to see if we can find coverage to pay for your damages. 

6. Health Insurance. Many health insurance companies will seek repayment of bills they paid on your behalf. We will make sure they don’t get more than they deserve (which is sometimes zero). 

Meet Your Fairfax Personal Injury Lawyers

Our personal injury team at BenGlassLaw has deep knowledge of Virginia’s personal injury laws so we can provide the best representation for those we serve out of our office in Northern Virginia.

Meet Brian Glass, a Virginia personal injury lawyer with many years of experience serving clients in Fairfax, who is committed professionally and in the community. He’s involved beyond the law practice as he coaches youth sports for his sons and likes to explore new places with his family.

Brian’s determination isn’t limited to the law. It also shows up in crazy things like finishing the tough Umstead 100-mile race in under 23 hours—proof he brings to the table when fighting for justice for each client in a personal injury case.

Next up, meet Lisa Derco, Partner and Personal Injury Lawyer at BenGlassLaw. Her prior nine-year tenure as a defense attorney for a major insurance company, where she litigated thousands of cases, provides her with invaluable insider knowledge of insurance industry operations.

Lisa’s client-first mentality and ability to connect personally with clients and their families enable her to achieve optimal results. Her dedication to helping injured clients obtain favorable settlements underscores her commitment to justice and client well-being.

When you hire BenGlassLaw you get more than just any attorney—you get lawyers and a support team who will fight for fairness in the toughest situations caused by car accidents or other types of harm. We’ll guide you through the whole process of the legal system and work hard to get good results for your life and your loved ones. There’s a reason our team has over 300 5-star reviews!

Types of Personal Injury Cases We Handle

At BenGlassLaw our team handles all types of personal injury cases. We represent people who have been injured by the negligence of others. Auto accidents (whether it be cars, trucks, motorcycles) are a common source of personal injury claims in Fairfax and often are caused by distracted driving or drunk driving.

We also handle wrongful death cases where someone’s death is directly caused by someone else’s negligence—entitling surviving family members to get damages for their loss. We understand the emotional and financial burden on families in these situations so we’ll be compassionate and aggressive in our advocacy.

We also handle dog bite cases where Virginia law holds pet owners responsible if their animal hurts someone—even if there was no prior aggression. If you or a loved one gets hurt by a dog bite. We’ll be with you every step of the way through the process—we’ll get you what’s yours.

How Much Does a Fairfax Personal Injury Lawyer Cost?

When looking for a personal injury attorney the cost is a big concern. At BenGlassLaw our fee structure is contingency based. No legal fees unless we get damages for you. This means you can focus on healing not worrying about medical bills.

During your free consultation we’ll explain this fee structure in detail. We’ll be transparent about the financial commitment so you can make an informed decision about your case.

If we don’t get damages for your injury claim you won’t owe any lawyer fees—although there may be some costs. Our goal at BenGlassLaw is to provide affordable legal help so everyone who seeks justice—the financially strapped included—can have their day in court with lawyers fighting hard for them to get fair compensation for their personal injury cases.

What You Can Recover in a Personal Injury Case

Understanding the types of compensation available in personal injury cases is key. In Virginia personal injury cases there are compensatory and punitive damages. Compensatory damages break down into economic and noneconomic harm. Economic damages are quantifiable financial losses such as medical bills—past and future—lost income and other expenses related to your injury. These are meant to ease the financial burden of your injuries so you can get back parts of your life that were affected. Noneconomic damages are for intangible losses like physical pain, emotional distress and loss of quality of life.

In cases of gross negligence—for example drunk driving—punitive damages may be awarded to punish the at fault party and deter similar behavior in the future. During your free case review our experienced lawyers will determine if you have a case and what kind of compensation you might be entitled to.

Having experienced legal counsel often gives you an edge in settlement negotiations and getting higher offers from the insurance company. Working with BenGlassLaw gives you insight into both the settlement value and how to get it. Our firm focuses on making sure our clients get what’s theirs for their pain and suffering and getting control of their life back after an incident.

Don’t Wait to Get the Help You Need

The sooner you speak with a lawyer, the better your chances of building a strong case. Evidence can disappear, and delays can jeopardize your claim. Contact BenGlassLaw today to schedule your free consultation and take the first step toward justice. Call us today, fill out our online form, or chat us to get started. We look forward to hearing from you!

The post What to Expect During Free Consultation With A Personal Injury Lawyer appeared first on BenGlassLaw.

Insights from 2024 ERISA Disability Cases in Virginia Courts 20 Nov 2024, 8:47 pm

Four important trends in the ERISA Long-Term Disability Cases from Virginia Federal Courts in 2024

We recently reviewed all of the ERISA long-term disability cases from the federal district courts in Virginia, covering decisions through January 1 to November 7, 2024.

These cases reveal important trends, particularly around insurers’ reliance on procedural standards and objective evidence requirements. Out of the cases reviewed, insurers prevailed in five, while claimants won four, with one mixed ruling. Below, we break down the key patterns observed and offer insights for claimants navigating similar claims.

1. Objective Medical Evidence is Key

One of the most significant hurdles for claimants was the demand for “objective medical evidence” to support their disabilities. In several cases, courts sided with insurers when claimants lacked sufficient objective documentation, such as diagnostic tests or clinical evaluations.

Case Example: In Learn v. Lincoln National Life Insurance Co., Lincoln argued that the claimant’s subjective reports from family members about her condition did not meet the plan’s criteria for objective medical proof. The court ultimately agreed, ruling in favor of Lincoln and underscoring the weight courts place on objective evidence under ERISA plans.

Takeaway for Claimants: Secure comprehensive medical documentation, including diagnostic tests and specialist evaluations, wherever possible to support your claim.

2. Social Security Offsets as a Common Dispute

Social Security offsets were another frequent issue, particularly where insurers attempted to apply offsets to earned-income Social Security benefits rather than just Social Security Disability Insurance (SSDI) benefits. Courts generally ruled that only SSDI should be offset, but this distinction can be nuanced.

Case Example: In Doe v. Unum Life Insurance Co., Unum attempted to offset earned Social Security retirement benefits against the claimant’s long-term disability payments. The court disagreed, finding that the plan did not clearly allow such an offset, ruling in favor of the claimant. Similarly, Aisenberg v. Reliance Standard Life Insurance Co. highlighted a trend where courts scrutinize plan language carefully in disputes over offsets.

Takeaway for Claimants: Review your plan’s offset language and be prepared to challenge offsets that are not explicitly allowed under the policy.

3. Procedural Reviews and the “Full and Fair” Standard

ERISA requires that insurers conduct a “full and fair review” of claims, a requirement that proved pivotal in multiple cases. Courts scrutinized whether insurers adhered to procedural standards, including timelines and balanced consideration of all medical evidence.

Case Example: In Cogdell v. Reliance Standard Life Insurance Co., the court found that Reliance’s procedural delays and inadequate consideration of the claimant’s long-COVID symptoms violated the full and fair review standard, ruling in favor of the claimant. This trend emphasizes the importance of procedural accuracy, as courts often penalize insurers for failing to meet these standards.

Takeaway for Claimants: Ensure timely submissions and seek assistance in preparing appeals, as procedural oversights can play a significant role in the outcome of your case.

4. Complexity in Legal Standards Highlights the Need for Representation

These cases reveal the complexity of ERISA regulations and judicial standards, underscoring the importance of legal representation. In several instances, judges referenced nuanced federal regulations and legal precedents, indicating the difficulty for claimants to navigate these cases alone.

Case Example: In Wonsang v. Reliance Standard Life Insurance Co., the court noted procedural missteps that unfairly restricted the claimant’s ability to respond to Reliance’s findings. The judge referenced 29 CFR § 2560.503-1, a regulation outlining ERISA’s procedural requirements, illustrating the difficulty for claimants without legal expertise to identify such regulatory violations.

Takeaway for Claimants: Given the legal complexity, consulting an ERISA attorney can be invaluable, especially if procedural issues or specific plan language are involved.

Case-Specific Highlights

To illustrate these trends, here are summaries of some notable 2024 Virginia cases:

• Aisenberg v. Reliance Standard Life Insurance Co.: The court ruled in favor of the claimant, finding that Reliance Standard improperly offset retirement-related Social Security benefits instead of SSDI benefits.
• Paff v. Lincoln Life Assurance Co. of Boston: Lincoln Life won this case, as the court emphasized the need for objective medical evidence, which the claimant failed to provide adequately.
• Doe v. Unum Life Insurance Co.: The court ruled in favor of the claimant, stating that Social Security retirement benefits could not be offset against long-term disability payments unless explicitly defined as disability-related in the plan.

Advice for Claimants

If you’re preparing an ERISA long-term disability claim, keep these strategies in mind to improve your chances of success:

1. Prioritize objective medical documentation: Include as much medical evidence as possible, such as diagnostic tests, clinical evaluations, and reports from specialists.
2. Review and understand offset provisions: Familiarize yourself with your plan’s language around Social Security offsets to avoid unexpected reductions in benefits.
3. Consult a legal professional: ERISA cases are procedurally complex, and an attorney can help ensure that procedural rights and evidentiary standards are fully leveraged in your appeal. Our highly experienced team offers 100% free consultations and Free Denial Letter reviews to put you in the right direction.

Conclusion

These 2024 cases suggest that Virginia’s federal courts are applying ERISA standards rigorously, often scrutinizing procedural compliance and the requirement for objective evidence. This trend may encourage insurers to follow tighter procedural standards, potentially benefiting claimants who ensure thorough documentation and legal support in their appeals.

You Need An Experienced Long-Term Disability Lawyer For Your Case

The most crucial part of your long-term disability claim happens before you ever step into a courtroom. If your administrative appeal is weak, incomplete, or lacking in key evidence and arguments, you’ll have little chance of winning in court. The moment your claim is denied, you need an experienced attorney on your side to guide you through the appeal process and set the stage for success.

At BenGlassLaw, we specialize in ERISA long-term disability claims. We know how to navigate the complexities of the administrative appeal, and we make sure every argument is made and every piece of evidence is submitted, so you have the strongest case possible when you need it most.

Don’t risk your future benefits by going it alone. Call us today for a free consultation, and let’s build your case from day one—because in ERISA long-term disability claims, that’s where cases are won.

The post Insights from 2024 ERISA Disability Cases in Virginia Courts appeared first on BenGlassLaw.

Reliance Standard Denied My Long-Term Disability Benefits 20 Nov 2024, 8:15 pm

Been denied long-term disability by Reliance Standard? You’re not alone. Reliance Standard long-term disability insurance benefit denials are common. We’ll explain why claims get denied and how to appeal and strengthen your case.

Quick Facts

• Reliance Standard denies long term disability claims for lack of medical evidence or pre-existing conditions so knowing these reasons is key to your appeal.

• Act fast after a denial—file an appeal within the timeframes and consider hiring a disability lawyer to help you through the process.

• Get all your medical records and expert opinions together to build your case as this will help you win a denial.

Reliance Standard Long-Term Disability Denials

Reliance Standard has a reputation for denying long-term disability claims more often than approving them. They put profits over claimants so denials are common and can be very frustrating and unfair. Reliance Standard disability denies claims for seemingly random reasons which can put claimants in tough financial and emotional situations. This is where our highly experienced long-

Knowing why Reliance Standard denies is key to your appeal. Understanding common tactics and reasons for denials will help you prepare better for the appeal process and increase your chances of winning. Here are some of the reasons why claims get denied.

Reasons for Denial

Reliance Standard denies claims because there is no medical evidence. If your medical records don’t prove your disability Reliance Standard will use this as a reason to deny your claim. They also deny claims for pre-existing conditions and usually include exclusions for these conditions from the start.

Reliance Standard looks for reasons to deny claims so they use tactics to discourage you from appealing after an initial denial and give up. Especially in cases where details are unclear they will push you into legal action.

ERISA and Disability Claims

Disability claims under ERISA (Employee Retirement Income Security Act) which usually applies to long term disability insurance provided by employers tend to favor the insurance company. This makes the appeal process tougher for individuals trying to get their benefits because these rules advantage the insurance company when there’s a dispute.

As part of the claims process most ERISA plans require you to also apply for Social Security Disability Insurance (SSDI). Employer sponsored plans may be cheaper than individual long term disability insurance but they come with strict rules that can make things tough during the appeal process if you’re trying to get your benefits.

What to Do After a Reliance Standard Long-Term Disability Denial

Getting a denial letter from Reliance Standard is discouraging but you must act fast. File an appeal within the timeframes or you’ll miss the deadline and risk losing the appeal. After a denial the internal appeals process with the insurance company begins. Having a lawyer from the start will help you navigate these deadlines and expected objections and give you a better chance of winning.

Winning the denial involves several steps. Review the denial letter, get your medical records and consider hiring a disability lawyer to help you with your appeal.

Review Your Denial Letter

The denial letter from Reliance Standard is your roadmap to understanding why they denied your claim. You must review this denial letter thoroughly so you can address and fix these issues within your appeal process.

Fighting Reliance Standard’s big obstacles can be tough especially with their tactics to reduce claims payments. A thorough review of the denial letter will help you build a stronger appeal by knowing what corrections or additional information is needed.

At BenGlassLaw, our highly experienced and highly rated team will review denial letters and give you personalized feedback on what your next steps should be. This is 100% free and confidential!

Get Your Medical Records

A winning disability claim is built on solid medical evidence. You must get all your medical records, with emphasis on test results like MRIs or CT scans that support your claim. Including custom residual functional capacity forms can be a game changer.

Getting additional opinions from medical and vocational experts can help strengthen your appeal. Building a strong administrative record at this stage is crucial because this will be the foundation of your case throughout the internal appeals and any future legal actions.

Get an Experienced Disability Lawyer

A disability lawyer who handles long-term disability cases can help you with your appeal and often get better results. With knowledge of ERISA and Reliance Standard’s tactics a lawyer gives you an advantage. Many of these lawyers offer contingency fee arrangements – they only get paid if you win your claim so you don’t have to worry about upfront costs.

Fighting the appeals process alone can be tough when up against the insurance company’s legal team. Getting advice from an ERISA lawyer gives you important help and increases your chances of winning in the long term disability appeals process.

Appeal Process

Building a strong appeal is critical to reversing a denial and to build your administrative record before considering further legal action. Having a long-term disability lawyer can be very helpful in building an effective appeal making sure all the necessary evidence is included and presented properly. They know what evidence to look for and how ERISA rules apply.

When building your appeal make sure to follow policy definitions, provide additional evidence and avoid surveillance traps that can hurt your long term disability claim.

Policy Definitions

To be eligible for disability benefits you must show you can’t do the essential tasks of your regular job. This is required in the first 24 months. Reliance Standard denies claims because they don’t meet their policy’s definition of disabled especially within this initial period.

After that 2 year mark the standards change and you must show you can’t do any occupational duties to remain eligible for benefits. Vocational experts will evaluate your work capacity and quantify your level of disability. Medical doctor records are crucial in documenting the exact restrictions caused by your injury or health condition.

Additional Evidence

Adding new medical and vocational evidence can help your appeal. Medical expert opinions can support your case and counter the insurance company’s arguments.

These experts will provide opinions and testimony based on your medical history and current health status. Their expert evaluations including an independent medical examination will often be key to supporting your claim and any work restrictions you have.

Surveillance Traps

Be careful with your social media and public activities because they will be monitored during the appeal process. Reliance Standard may use surveillance tactics to gather information that can be used against you.

To minimize risks be sure to lock down your social media and don’t post anything that can be misinterpreted.

Appeal Process

After you submit your appeal to Reliance Standard there is a 45 day review period. During this time they will review the evidence and documentation you submitted with your appeal.

To navigate the appeal process with Reliance Standard you need to understand it’s internal and external reviews. Here are the details below.

Internal Appeal Process

You have 180 days to file an administrative appeal after a claim is denied according to ERISA. If you need to provide additional information after your disability insurance claim is denied you must do so within this time frame. Once you file your appeal Reliance Standard will review it and they have 45 days to do so.

Make sure to include all relevant evidence and documentation when you file your initial administrative appeal. This is critical because if you don’t you may be hurt later on. Reliance Standard may use external medical reviewers during their review process.

Make sure to send any communication or documents to the address listed in your denial letter from Reliance Standard if it’s different from the standard submission channels.

External Review and Litigation

You must complete the insurance company’s internal appeal process before you can go to court. If that doesn’t work then you may need to file a federal lawsuit to contest the denial.

Understanding the process and potential outcomes of going to court will help you make informed decisions moving forward. Talking to an attorney will give you more clarity and guidance throughout this process.

How to Win Your Reliance Standard Disability Appeal

Fighting Reliance Standard during the disability claim appeal process can seem like David vs Goliath. Using smart legal strategies will help your chances of winning. You need to address any excerpts from medical records that have been misinterpreted or taken out of context early on in the claims process with Reliance Standard.

To strengthen your case get experts in medical and vocational fields on your side. Below are some tips to help you navigate the process of appealing a disability claim.

Medical Experts

Medical professionals are key to validating disability claims through their professional opinion and expertise. Their testimony matches your medical records and health status and counters the insurance company’s arguments.

The detailed exams and statements from these medical professionals will greatly impact your appeal. Their comprehensive exams will dispute the insurance company’s allegations and support your disability claim.

Vocational Experts

Vocational experts are important for disability claims because they give an independent assessment of an individual’s ability to work. They look at how a person’s medical condition affects their ability to get a job and provide detailed reports and expert witness testimony that challenges the insurance company’s view of your work capacity.

Using vocational experts in your appeal process will help strengthen your case. Their analysis and statements will be a strong counter to the insurance company’s denial and increase the chances of reversing the disability benefits denial.

Administrative Record

During the appeal process you need to build a robust administrative record. Under ERISA rules evidence not included in the administrative record will not be admissible in court later on. So you need to get all the information in from the start including medical records and statements.

Having a comprehensive and organized administrative record allows a federal judge to review your case and see if the insurance company made an error. The more detail and depth of this documentation the better your chances of winning.

Results and Next Steps

If you win your appeal you may get benefits with back pay. If you win your appeal Reliance Standard will have to pay back owed benefits plus interest. This will give you financial relief and get you back on your feet.

Even if your appeal is denied there are still options for you. You can file a lawsuit in federal court against the denial and pursue judicial remedies. Knowing these outcomes and next steps will help you make informed decisions.

Benefits Paid

Winning your appeal means the insurance company will pay you back benefits and interest. This is especially helpful if there’s been a long gap in your benefits, it’s a big financial relief. The insurance company will also pay any past due amounts plus interest so you’ll be made whole for your disability benefits.

This result will validate your long-term disability claim and reinstate your long term disability benefits. This will give you financial peace of mind and emotional relief during this difficult time.

Denial and Litigation Options

If your appeal is denied again you can pursue justice by filing a lawsuit in federal court. This will involve disputing Reliance Standard’s decision through a long and arduous legal process.

Considering the possibility of further denial and litigation is why you need a disability attorney like our team at BenGlassLaw. Such an expert can help you through this tough time, navigate the legal maze and increase your chances of winning.

Conclusion

Fighting a Reliance Standard long-term disability denial can be tough but knowing why you were denied, what ERISA is and what to do after denial can give you the upper hand. Reviewing your denial letter, getting all your medical records and considering a lawyer are important steps in preparing your appeal.

Using medical and vocational experts, building an administrative record and knowing the appeals process will help you win. Whether you win your appeal or need to file a lawsuit being informed and prepared is key to getting your long-term disability benefits.

How BenGlassLaw Can Help With Your Reliance Standard Long-Term Disability Denial

Fighting a Reliance Standard disability denial is tough but knowing the process and your rights can give you the upper hand. From reviewing the denial letter and getting strong medical evidence to filing an appeal and getting an experienced lawyer each step is important to get the benefits you deserve.

Remember you don’t have to do this alone. Our team at BenGlassLaw can guide you through the appeals process no matter where you are in the US. Stay proactive, informed and persistent.

Contact our team today for a free, zero obligation consultation to learn how we can help you.

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How Are Lost Wages Calculated in Virginia Personal Injury Claims?  12 Nov 2024, 6:05 pm

When you’re injured in an accident that wasn’t your fault, the impact can extend far beyond physical injuries. Many Virginia personal injury victims experience financial strain due to lost wages from time off work for recovery and medical appointments. In this article, we’ll break down the process of calculating lost wages in a Virginia personal injury claim and explain how BenGlassLaw can help you seek fair compensation. 

Understanding Lost Wages in Virginia Personal Injury Claims 

Lost wages refer to the income you miss out on because of your injuries. In Virginia, you can pursue compensation for lost wages as part of a personal injury claim. Calculating this accurately is crucial to ensuring you receive the compensation you deserve. 

Factors That Influence The Calculation 

Lost wages include more than just your base salary. Here are some key factors that go into calculating lost wages in Virginia: 

1. Hourly Wage or Salary: Calculating your lost wages begins with assessing your hourly wage or salary before the accident. This is the base amount that is multiplied by the number of missed work hours or days. 

2. Overtime Pay: If you regularly worked overtime before your injury, that income should be included. Virginia law allows injured individuals to claim compensation for lost overtime if they can show a history of working beyond standard hours. 

3. Bonuses and Commissions: Lost bonuses or commissions are also considered if you can prove that your injury prevented you from meeting performance targets or goals. 

4. Self-Employment Income: If you’re self-employed, calculating lost wages can be more complex. Self-employed individuals often need to provide previous tax returns, profit and loss statements, and contracts to substantiate their income losses. 

5. Sick Leave or Vacation Time: If you used paid leave to cover time off for your injury, you may be eligible to recover these as lost wages. 

How to Document Lost Wages for Your Claim 

To successfully claim lost wages, you’ll need to provide documentation that supports your income loss. Here’s what’s typically required: 

• Employer Verification: A letter from your employer confirming your salary or hourly wage, hours typically worked, and the time missed due to your injuries. 

• Pay Stubs and Tax Returns: These documents help verify your regular income. 

• Medical Documentation: Medical records are necessary to prove that your injuries prevented you from working.  It is helpful to have a note from your doctor taking you out of work for a time period. 

Calculating Future Lost Wages and Earning Capacity 

If your injuries are severe and impact your ability to work in the future, you may be eligible for compensation for future lost wages. This is often calculated with the help of a vocational expert or economist who can assess: 

• Loss of Earning Capacity: If your injuries limit the type of work you can perform, your earning potential may decrease. An expert can calculate the difference in your earning capacity before and after the accident. 

• Expected Work Life: This involves calculating the income you would have earned over your remaining career years if you hadn’t been injured. 

Why Work with a Virginia Personal Injury Lawyer 

Calculating lost wages accurately can be challenging, especially if you’re dealing with complex factors like future earning capacity or self-employment income. A skilled Virginia personal injury lawyer and their team (like us here at BenGlassLaw) can help you document your lost wages, work with experts, and negotiate with insurance companies to maximize your compensation. This will allow you to focus on the most important thing; healing.

Have you sustained an injury in a Virginia accident that wasn’t your fault? Contact Us Today.

The post How Are Lost Wages Calculated in Virginia Personal Injury Claims?  appeared first on BenGlassLaw.

Prudential Long-Term Disability Denial? Here’s How to Handle It 8 Nov 2024, 9:14 pm

Prudential denied your long-term disability claim? Learn the top reasons for denial and what to do.

Quick Facts

• Knowing the reasons Prudential denies disability claims—like lack of medical evidence and non-compliance with treatment—can help you win your appeal.
• After denial, gather more medical evidence, see your doctor and review the denial letter to prepare for appeal.
• Hiring a long-term disability lawyer can help you win your appeal by handling the process and building your case.

Prudential Insurance and Long-Term Disability

Founded in 1875 and headquartered in Newark, New Jersey, Prudential Insurance Company is one of the largest disability insurance companies in the US. They offer group long-term disability insurance which allows employers to provide income protection to their employees if they become sick or injured and can’t work for an extended period of time as well as individual policies. Long-term disability insurance is a financial safety net for employees who rely on it while they are unable to work and can’t earn their regular income.

When short-term benefits run out, long-term disability coverage kicks in and provides ongoing financial help through long-term disability benefits. Knowing how Prudential’s long-term disability policies work can help you navigate the claims process with more confidence.

Reasons Prudential Denies Long-Term Disability

Getting a denial letter from Prudential can be tough. By knowing the common reasons for denial, you can get benefits reinstated. Claims are usually denied for lack of medical evidence. Non-compliance with treatment and policy limitations or exclusions also play a role in denials. If monitoring activities or discrepancies found through social media contradict the impairments you claimed, it will deny your claim.

By knowing these common reasons:

• Lack of medical evidence
• Not following treatment protocols
• Policy limitations or excluded conditions
• Surveillance finding conflicting information with claimed impairments

You can navigate this process better.

Remember insurance companies will use tricks such as shortcuts when reviewing cases, delay on claims decisions and administrative issues with incomplete paperwork as reasons to deny claims. Knowing these tactics can help you avoid common pitfalls and build your case more.

Lack of Medical Evidence

One of the top reasons Prudential denies disability claims is lack of medical evidence. When filing a claim you must provide a full set of medical records as Prudential requires objective proof including clinical exams, lab tests and imaging results. They have an in-house staff of doctors and nurses who review the medical evidence. In our opinion, based on over 25 years of representing claimants, Prudential’s doctors and nurses are trained to find reasons to deny claims.

To avoid denials due to errors on claim forms, make sure to fill out all required paperwork completely. Since incomplete or unclear documentation can give Prudential reasons to deny a claim during the initial review, make sure your medical records are clear and complete. Also, make sure your claim matches what your medical records say.

Non-Compliance with Treatment Protocols

If you don’t follow the prescribed treatment plans, it can be a reason for your claim to be denied. Proper management of your condition by following treatments as recommended is key to determining eligibility. If Prudential finds out that you’re not managing your health due to neglected prescribed treatments, your claim may be invalid.

Policy Exclusions and Limitations

Prudential’s long-term disability policies have many exclusions, limitations and restrictions that can deny claims. Coverage doesn’t apply to specific disabilities and injury causes that are excluded. For example, mental health conditions have a 24 month limit, fatigue and musculoskeletal conditions can be excluded or limited.

Pre-existing conditions

To avoid being denied on pre-existing conditions, it’s essential to review your policy and provide a full medical record. The pre-existing condition exclusion in Prudential’s policies can be overcome if you time your claim right. A pre-claim consult with an experienced long-term disability lawyer can be worth its weight in gold.

What to Do After a Denial Letter

Getting a denial letter from Prudential is devastating. You must act fast after your claim is denied but you must also be smart about your appeal. (You only get one shot at an appeal.)

Review the denial letter carefully to understand why the claim was denied. Once you know the reasons, gather all the necessary documentation and proof to contest their decision. If you think Prudential denied your claim without merit, find an experienced long-term disability lawyer to help you appeal.

Review the Denial Letter

Read the denial letter carefully and follow the appeal process outlined. The letter will tell you why your claim was denied. Missing appeal deadlines (typically 180 days) will bar you from reapplying for benefits or taking legal action against Prudential.

Knowing why your claim was denied is key so you can start your appeal right away.

At BenGlassLaw, we will review your denial letter for FREE and give you personalized feedback on your next steps.

Get More Medical Evidence

You need to get Medical records to support your claim when appealing. Failure to follow treatment plans such as missing appointments or not taking prescribed medications can be a reason for denial. Vocational evaluations are key to showing your work limitations and building your appeal.

Get testimony from family, friends or professional colleagues to strengthen your appeal. Detailed records of doctor visits, following treatment plans and any changes to treatment will support your case.

Talk to Your Treating Doctor

After being denied, you need to talk to your treating doctor about your condition. This may result in more records that can help your appeal. The additional medical evidence and support from your doctor can significantly increase the chances of reversing the denial.

Prudential Long-Term Disability Appeal Process

If your Prudential long-term disability claim is denied, you can appeal this decision. This process allows you to add evidence and fix any gaps in your case. Prudential often denies or delays claims because of lack of documentation.

Having an attorney who specializes in long-term disability denials can help strengthen your appeal. With a lawyer, you have a much better chance of reversing a denial on your long-term disability claim.

Appeal

You have 180 days to appeal after a denial. Be sure to include medical evidence and legal arguments. Submitting your appeal in writing keeps a record of all communication with Prudential.

You must exhaust the internal appeal process before suing Prudential.

Additional Documentation

Comprehensive medical records including tests and progress notes will support your claim by giving more detail into symptoms that may not be reflected in standard reports. Medical assessments or opinions from specialists can be key to strengthen the appeal.

Include vocational evaluations and supporting documentation with your medical records and your appeal will be stronger. Additional diagnostic testing, doctor statements and letters from previous employers are extra ammunition for your case.

Doctor written letters explaining how your condition affects you will give context to support legitimate claims.

Legal Help in the Appeal Process

Having a disability attorney can increase your chances of winning an appeal with Prudential. If your case manager is being evasive about claim delays, you may want to get legal help. Having an ERISA attorney is key when fighting a denial.

Our team of ERISA lawyers has years of experience with Prudential claims and knows how to reverse denials. Working with a long-term disability insurance attorney can help navigate the complex aspects of your case.

Insurance Bad Faith

Bad faith by insurance companies means unlawful and unethical practices to avoid paying claims. Denying legitimate disability claims is bad faith. Insurance companies can act in bad faith by misrepresenting medical records to deny claims.

Bad faith practices can involve cherry picking information to deny legitimate claims and ignoring disability evidence. Insurers may favor opinions from doctors who have not examined the claimant, showing lack of thorough evaluation.

If you suspect bad faith, get legal advice and consider filing a bad faith denial against Prudential.

When to Sue Prudential

If your appeal is denied, you can sue Prudential for bad faith denial to get your benefits back. No valid reason to deny claims is a basis for a lawsuit.

If bad faith is evident in the denial of your claim, you may be able to sue before exhausting all levels of the appeal process. Get legal advice to know your options. An attorney can help you contest wrongful denials and inform you of the legal avenues available to you.

Exhaust the Appeal Process First

Make sure to exhaust all administrative appeal options, potentially multiple appeals, before suing Prudential. According to ERISA, you have 180 days to appeal after a denial letter.

New evidence is not usually allowed after the ERISA appeal process is complete.

Short-Term or Long-Term Disability Attorney

Working with a specialist can help navigate the long-term disability claims and lawsuits. A disability attorney can challenge the insurer’s decision and get you benefits.

How a Long-Term Disability Attorney Can Help

Having a long-term disability attorney is key to handling the claims process and fighting denials. If your claim is denied, this attorney will be your advocate, fighting for you and explaining the legal mumbo jumbo and paperwork.

With their experience, long-term disability attorneys know how to challenge Prudential’s denial tactics. They have established relationships with defense attorneys at Prudential to make the process easier.

ERISA Expertise

An ERISA attorney can guide clients through the appeal process, contesting disability denials.

Add to Your Case with More Evidence

An experienced attorney can get you the evidence you need to appeal. This strong evidence is key to appealing a Prudential long-term disability denial and our law firm has over 25 years of experience doing just that.

Settlements and Litigation

Skilled attorneys are key to negotiating with Prudential to get the best settlements for clients. These negotiators often get settlements without litigation.

If those negotiations don’t get you a good settlement, you may need to sue Prudential. In that case, an experienced attorney is critical to make your case strong, whether in settlement talks or in court.

Conclusion

Appealing a Prudential long-term disability denial can be tough, but knowing the reasons for denial and what to do next can make a big difference. From reading your denial letter to getting more medical evidence and talking to your doctor, every step counts in building your appeal.

You don’t have to do this alone. Get legal advice and know your ERISA rights. Whether you’re appealing or suing, having the right lawyer can get you the disability benefits you’re owed.

How BenGlassLaw Can Help With Your Prudential Financial Long-Term Disability Claim Denial

Facing a Prudential Financial disability denial is a daunting experience, but understanding the process and knowing your rights can empower you to fight back. From reviewing the denial letter and gathering strong medical evidence to filing an appeal and seeking legal counsel, each step is crucial in securing the benefits you deserve.

Remember, you don’t have to navigate this journey alone. Our team at BenGlassLaw is available to guide you through the complexities of the appeals process and ensure you have the best chance of success — no matter where you’re located in the United States. Stay proactive, informed, and persistent in your pursuit of justice.

Contact our team today for a free, zero obligation consultation to learn how we can help you.

The post Prudential Long-Term Disability Denial? Here’s How to Handle It appeared first on BenGlassLaw.

Determining How Much My Lumbar Fusion Personal Injury Claim Is Worth 7 Nov 2024, 6:52 pm

If you’ve recently undergone lumbar fusion surgery due to an injury, you’re likely wondering, “How much is my lumbar fusion personal injury claim worth?” The value of these claims is rarely straightforward and can be affected by factors such as medical expenses, lost wages, pain and suffering, and the specifics of your surgery. This article will break down these factors to help you better understand what you might expect in terms of compensation.

Key Points

• The value of a lumbar fusion claim depends on how serious the injury is, your medical costs, and lost wages. While some states have a “cap” on damages, in Virginia, there are no limits on how much money you can claim.

• Medical and rehabilitation costs from spinal fusion surgery can add up quickly; detailed documentation of all expenses is crucial for your claim, especially if you are a car accident victim.

• Getting legal help is important for complicated cases like lumbar fusion injuries, especially in Virginia where the laws are strict. This can help you get the most money for your claim.

What Is Lumbar Fusion Surgery?

Lumbar fusion surgery is when doctors join two or more bones in your lower back (lumbar spine) together. This helps keep your spine stable and stops it from moving too much. People usually need this surgery when they have serious pain or weakness in their legs because of injuries or conditions like herniated discs or spinal stenosis.

If you’ve been in a car accident and have severe back pain or numbness in your legs, it’s important to see a spine doctor to see if lumbar fusion surgery is needed.

How Does Spinal Fusion Surgery Affect Personal Injury Claims?

Spinal fusion surgery can significantly impact a personal injury claim, because the surgery is a result of injuries sustained from the accident caused by someone else’s negligence.

What to Expect During Surgery and Recovery

The bone graft surgical procedure typically takes several hours to complete, and the recovery process can take several months. During the procedure, a bone graft is placed between the two vertebrae to be fused, and metal plates, screws, or rods may be used to hold the vertebrae together. After the procedure, you will be required to wear a brace to keep your spine aligned correctly, and physical therapy may be necessary to teach you how to move, sit, stand, and walk in a manner that keeps your spine properly aligned.

Why Physical Therapy Is Important

Physical therapy helps after lumbar fusion surgery by teaching you how to move safely. It reduces the chance of complications and helps with recovery. A therapist will guide you on how to sit, stand, and walk properly.

Factors That Affect Your Lumbar Fusion Claim’s Value

Several things determine how much your lumbar fusion claim is worth:

• Injury Severity: How serious your spine injury is matters a lot.

• Medical Costs: The costs of treatment and recovery can add up quickly.

• Lost Wages: If you’re unable to work because of your injury, this will affect your claim’s value.

In Virginia, there are no limits on how much money you can recover for personal injuries, which means that all your medical costs and lost wages can potentially be covered.

Types of Injuries That May Need Lumbar Fusion Surgery

Many injuries may require lumbar fusion surgery, including:

• Herniated discs: A herniated disc occurs when the soft tissue between the vertebrae ruptures, causing the disc to bulge out and put pressure on the surrounding nerves.

• Spinal stenosis: Spinal stenosis is a condition in which the spinal canal narrows, putting pressure on the spinal cord and nerves.

• Spondylolisthesis: Spondylolisthesis is a condition in which a vertebra slips out of place, putting pressure on the surrounding nerves and spinal cord.

• Spinal fractures: Spinal fractures occur when one or more vertebrae break, causing instability in the spine and putting pressure on the surrounding nerves and spinal cord.

These injuries can cause severe pain, numbness, and weakness in the legs, and may require lumbar fusion surgery to stabilize the spine and prevent motion. If you have been involved in a car accident and are experiencing severe back pain, numbness, or weakness in your legs, it is essential to seek medical attention from a qualified spine specialist to determine if lumbar fusion surgery is necessary.

Medical Costs for Spinal Fusion Surgery

Spinal fusion surgery can be very expensive. These costs include everything from tests before surgery to hospital stays and follow-up visits. After surgery, patients often need physical therapy, which adds more costs. Keeping track of all these medical expenses and staying organized is crucial for your personal injury claim (especially after car accidents) to make sure you get the right compensation.

Different types of spinal fusion surgeries can affect how much money you might get in a personal injury case. More complicated surgeries, like those for serious spinal stenosis or ruptured discs, usually cost more and might lead to higher compensation.

Impact of Lost Wages and Future Earnings

Spinal fusion surgery can result in significant income loss during the recuperation period. The necessity for extended absence from work—spanning weeks to months—poses a substantial concern within your personal injury claim, impacting your economic wellbeing.

Injuries to the spine may have enduring consequences on one’s capacity to earn money down the line. Due to physical restrictions stemming from their condition, some patients find themselves unable to resume their former employment or are forced to take up roles with lesser pay. Recognizing this diminishment of prospective earnings is pivotal when determining the worth of your compensation claim. Accounting for future long-term care and rehabilitation expenses becomes crucial as they pose an additional financial burden that needs consideration within any settlement negotiations.

To maximize compensation, it’s essential to document not only your current lost wages but also any future impacts on your ability to earn. This information is crucial in building a strong case for the insurance company or court handling your claim.

Pain and Suffering Compensation

The ‘per diem’ method assigns a daily value to the pain and suffering experienced until you are expected to fully recover. This can be tricky with complex surgeries like lumbar spinal fusion because recovery times vary. Psychological impacts from such surgeries should also be considered in claims, possibly with evidence like psychiatric evaluations or accounts from family members about changes after the injury.

The complexity of your spinal fusion surgery affects potential compensation for pain and suffering. Surgeries involving two or more vertebrae or serious conditions like spinal stenosis often lead to higher settlements because they require longer recovery times and involve the actual spinal fusion process.

To increase settlement amounts for non-economic damages—such as emotional and mental distress—it’s crucial to keep detailed records of all aspects related to your discomfort following the injury.

Understanding Fault in Car Accidents in Virginia

In Virginia, proving who is at fault in a car accident is very important for personal injury claims. If you’re found even slightly responsible for the accident, you may not be able to recover anything due to Virginia’s contributory negligence rule.

Having a good lawyer can help gather evidence and make strong arguments in your favor.

Proving Your Lumbar Fusion Surgery Claim

To prove that spinal fusion surgery was necessary due to an accident, it’s vital to have clear medical records showing what happened and why surgery was needed. It is often important that your lawyer compile your medical records from before the injury and after to prove the difference in your condition. Expert opinions from doctors can also help strengthen your case by explaining how the injury affects daily life.

Getting Legal Help

Hiring a lawyer after having spinal fusion surgery from a car accident can greatly improve your chances of getting more money for your claim. Lawyers help with filing claims, gathering evidence, negotiating with insurance companies, and representing you in court if needed.

In Virginia’s strict legal environment regarding fault in accidents, having an experienced lawyer is even more crucial for ensuring that you receive fair compensation.

By understanding these aspects of lumbar fusion claims and getting proper legal assistance, you can better navigate this complex process and improve your chances of receiving the compensation you deserve.

Summary

Managing a personal injury claim for lumbar fusion surgery can be complicated. You need to think about how much medical treatment costs and how much money you might lose if you can’t work. It’s also important to figure out who is responsible for the accident that caused your injury. The seriousness of your spinal injuries, all the money spent on surgery, and how these issues might affect your future earnings are key to understanding how much your claim is worth. In Virginia, the laws are strict about proving who is at fault, so having a good lawyer is really important for getting the best results.

To get fair compensation, you need to keep careful records of your medical bills, any wages you lost because you couldn’t work, and any pain or suffering you experienced. With the right legal help that understands these factors, you can better handle the challenges of your lumbar fusion personal injury case and make sure you get the money you need to recover fully.

Frequently Asked Questions

What factors influence the value of a lumbar fusion injury claim?

The value of a lumbar fusion injury claim depends on how serious your spinal injuries are, whether you need surgery, and how much your medical bills are. Also, state laws about damages can affect how much money you can get.

How do medical expenses and physical therapy affect my lumbar fusion injury claim?

Your medical expenses are very important for your lumbar fusion injury claim because they directly impact how much money you might receive. Keeping all your bills organized helps support your claim.

What is the impact of lost wages and future earnings on my claim?

Lost wages and future earnings can greatly affect your claim because they show how your injury impacts your finances. It’s important to document these losses to get a fair settlement.

How is pain and suffering compensation calculated?

Pain and suffering compensation is often calculated by multiplying your financial losses or by giving a daily amount for each day you experience pain. They also consider any emotional or psychological effects you’ve had. Read more on this blog now.

Why is legal assistance important for maximizing my claim?

Having legal help is crucial for maximizing your claim because an attorney can guide you through the process, negotiate better settlements, and represent you in court if needed. Their experience helps ensure that you get what you deserve.

Have you sustained an injury in Virginia that requires a Lumbar Fusion? Contact Us Today.

BenGlassLaw for Your Lumbar Fusion Personal Injury Claim After A Car Crash

If you’ve been injured in Virginia and need a lumbar fusion surgery after a car crash, you need a lawyer who knows the intricacies of your case. At BenGlassLaw we will fight for the compensation you deserve so you can focus on getting better.

Don’t wait—contact us today for a free consultation. See why we have over 300 5-star reviews from our personal injury clients.

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