Category: Long-Term Disability Insurance

In Arizona, having a pre-existing condition can significantly impact your long-term disability claim. A pre-existing condition is any health issue that you had prior to obtaining your disability insurance policy. Insurance companies often scrutinize these conditions closely, as they can use them as a reason to deny your claim. For instance, let’s say you have a history of back problems and later suffer a debilitating back injury at work. The insurance company might argue that your disability is due to your pre-existing condition, not the workplace accident.

This can make it more challenging to secure the benefits you need. However, Arizona law provides some protections for individuals with pre-existing conditions. The state follows the “active treatment” rule, which means that if you have not received treatment for your pre-existing condition within a certain period before your policy started (usually six months), it cannot be considered a pre-existing condition.

What If My Disability is Aggravated by a Pre-Existing Condition?

In some cases, a pre-existing condition might not be the direct cause of your disability, but it could exacerbate your condition. For example, suppose you have a pre-existing heart condition, and you suffer a stress-related heart attack at work. In this case, your pre-existing condition didn’t directly cause your disability, but it may have made it worse. Under Arizona law, if your disability is aggravated by a pre-existing condition, you may still be eligible for benefits. However, the insurance company might try to reduce your benefits, arguing that your pre-existing condition is partially responsible for your disability. In such cases, an experienced attorney can advocate for your rights.

Can I Get Long-Term Disability Benefits if My Pre-Existing Condition Worsens?

Yes, you can potentially receive long-term disability benefits if your pre-existing condition worsens due to a work-related incident or accident. However, you’ll need to prove that your work incident significantly contributed to the worsening of your condition. Let’s say you have a pre-existing condition of arthritis, and a work-related accident leads to a severe worsening of your condition, leaving you unable to work. In this case, you may be eligible for long-term disability benefits. However, you’ll need to provide medical evidence showing that your work accident significantly worsened your arthritis. A talented attorney can help you gather the necessary evidence and present a strong case to the insurance company or in court if necessary.

What if I Have Multiple Pre-Existing Conditions?

Having multiple pre-existing conditions can make a long-term disability claim more complex, but it doesn’t automatically disqualify you from receiving benefits. Each condition will be evaluated individually, and the cumulative impact of all your conditions on your ability to work will be considered. For example, suppose you have pre-existing conditions of high blood pressure and osteoarthritis, and you suffer a work-related injury that leaves you disabled. The insurance company might argue that your high blood pressure and osteoarthritis contributed to your disability. However, with the help of an experienced attorney, you can gather medical evidence showing that your work injury is the primary cause of your disability, despite your pre-existing conditions.

What if the Insurance Company Denies My Claim Due to a Pre-Existing Condition?

If the insurance company denies your long-term disability claim due to a pre-existing condition, don’t lose hope. Arizona law provides avenues for you to challenge this decision. An experienced attorney can help you appeal the denial, presenting evidence to counter the insurance company’s claims. For instance, suppose you have a pre-existing condition of diabetes, and you suffer a disabling injury at work.

The insurance company denies your claim, arguing that your diabetes contributed to your disability. In this case, your attorney can help you gather medical evidence showing that your work injury, not your diabetes, is the primary cause of your disability.

What if I Didn’t Disclose My Pre-Existing Condition When I Got My Insurance?

If you didn’t disclose your pre-existing condition when you obtained your insurance, it could complicate your long-term disability claim.

Insurance companies often require policyholders to disclose any pre-existing conditions when they apply for coverage. If you fail to do so, the insurance company might argue that you misrepresented your health status and use this as a reason to deny your claim. However, even in these situations, you may still have legal options. For instance, if you weren’t aware of your pre-existing condition when you obtained your insurance, or if you can prove that your disability is unrelated to your pre-existing condition, you may still be able to secure benefits. An experienced attorney can help you navigate these complex situations, advocating for your rights and striving to secure the benefits you need.

What Role Does an Experienced Lawyer Play in Long-Term Disability Claims?

An experienced lawyer can play a crucial role in your long-term disability claim, especially if you have a pre-existing condition. They can help you understand the complexities of Arizona law, gather the necessary evidence to support your claim, and advocate for your rights against the insurance company. For instance, suppose the insurance company denies your claim, arguing that your disability is due to a pre-existing condition. In this case, your lawyer can help you appeal the decision, presenting evidence to show that your disability is not related to your pre-existing condition. A talented lawyer can negotiate with the insurance company on your behalf, striving to secure the maximum benefits you’re entitled to. They can also represent you in court if necessary, fighting for your rights and interests.

If you have been involved in a situation that has led to long-term disability, call Roeschke Law today at 800-975-1866 for a free consultation!

Understanding the ins and outs of long-term disability can be so frustrating. The financial stress you may be under as well as the challenges of your disability can compound this frustration. Even the most seemingly basic questions can seem impossible to answer. If you are wondering whether your medical condition, or even a combination of medical conditions, qualifies for long-term disability benefits, then we have answers for you.

What Conditions Qualify for Long-Term Disability?

In general, you should be aware that a long-term disability is considered to be a disabling condition that lasts longer than 12 months or is fatal. The condition itself can include a wide range of medical issues including an injury, one that is genetic in nature, or one that is related to an illness. The truth is that many different medical conditions will qualify for long-term disability depending on the level of severity. Oftentimes, the disability is the result of multiple illnesses, injuries, or other medical conditions.

To verify whether your condition qualifies for long-term disability benefits, you must turn to your specific policy and plan documents. Carefully review these documents as long-term disability benefits eligibility will depend on the terms set forth in them. Some of the more common conditions that qualify for long-term disability benefits include cancer, autoimmune disorders, and mental health disorders.

Cancer involves the uncontrolled development of abnormal cells in the body which, in turn, attack healthy tissues and organs. There are a variety of cancer types, many of which will qualify a person for long-term disability benefits. Some of the more common types of cancer that will lead to qualifying for disability benefits include:

• Breast cancer
• Leukemia
• Lung cancer
• Lymphoma
• Melanoma

When a person has an autoimmune disorder, the body’s immune system mistakes its own tissue for foreign tissue and attacks. With your immune system attacking its own health tissue, the damage sustained by the body can be severe. That is why autoimmune conditions will often qualify a person for disability benefits. Some of the more common autoimmune conditions include:

• Multiple sclerosis (MS)
• Lupus
• Rheumatoid arthritis
• Type 1 diabetes

Mental health disorders will also act as the basis for qualifying for long-term disability benefits. Often, such disorders involve alterations in mood, processing thought, or behavior. Depending on the severity of the condition, some of the more common mental health conditions that qualify for long-term disability benefits include:

• Anxiety
• Bipolar disorder
• Depression
• Personality disorders

The list of conditions above is by no means exhaustive and some qualifying conditions will vary based on individual policy. The main point to consider is the fact that the terms of your policy will dictate what conditions will qualify for benefits.

The insurance company carries the burden of proving that you do not actually qualify for long-term disability benefits pursuant to policy terms. In order to try and do this, insurance companies will be exhaustive in their requests for your medical records and other relevant documentation. Be diligent in responding to such requests and pay close attention to any reason an insurer provides for a denial of your request for benefits as it may be misinformed.

Disability Attorney

For assistance accessing long-term disability benefits under your policy, talk to the team at Roeschke Law. Contact us today.

Long-term disability insurance can provide critical financial support should an injury or illnesses require you to miss work for an extended period of time. While some employers offer long-term disability as an employment benefit, this is not always the case and people often seek long-term disability coverage on their own. Other times, a person may wish to have additional coverage on top of that offered by his or her employer. In any event, it is important to understand the benefits you are signing up for when you get a long-term disability insurance policy. For instance, you will want to know how much of your salary will actually be covered should you need to access benefits under your long term disability insurance policy.

How Much of Your Salary Is Covered by Long Term Disability Insurance?

The short answer to this is, it depends. More specifically, it depends on the coverage of your policy. The terms of your policy will dictate how much of your salary will be covered under your long term disability insurance. That is why it is important to get long term disability coverage that will provide enough pay out benefits to provide you with the percentage of your salary that you will depend on to get through being out of work due to your disability.

When looking for long term disability insurance coverage, you will need to analyze how much you will need to live on should you be out of work for an extended period of time. The general rule of thumb is that your long-term disability insurance policy should cover anywhere from 60 to 80 percent of your take-home pay. Insurance payments are not taxed like income is so you will not need to account for that. 

To get a clearer idea of how much coverage you will really need, make a list of your monthly living expenses. Start with the basics such as food, housing, utilities, etc. Account for the fact that you will likely have some entertainment expenses such as books and movies. You are also likely to have disability-related costs, such as mobility devices (wheelchairs, etc.) and other healthcare costs. If you have a high deductible on your health insurance or your coverage is not great, account for the fact that you are likely to have a significant increase in healthcare-related costs.

Total everything together to arrive at how much you will need to live on should you be out of work on disability leave. Get long term disability coverage that will meet this need. Enjoy the peace of mind that will come with knowing you will have enough insurance coverage in the event that you are unable to work for an extended period of time due to a disabling injury or illness.

Disability Attorney

Do you have questions about long term disability coverage? Roeschke Law has answers. We are here to support you in any way we can. Contact us today.

Q: How has the pandemic impacted day programs for the disabled?

For all the progress made on behalf of the disabled community since the Americans with Disabilities Act was enacted 30 years ago, day-to-day life remains challenging for many. And the pandemic has only made things worse—especially for people who rely on day programs. 

First off, applying for disability benefits in Arizona is a complex and often time-consuming process that many people trust to a skilled disability benefits attorney. The federal government offers two different disability benefits which programs which, other than sharing the requirement of meeting a common definition of what constitutes a “disability” are quite different in their other criteria. 

In a nutshell, one program (SSDI) is for those who previously worked and can satisfy the work credits history requirement, while the other (SSI) is for those of extremely limited financial means. Being “disabled” is defined as “the inability to engage in substantial gainful activity due to a medically determinable impairment that has lasted or is expected to last a minimum of 12 months or result in death”. A comprehensive list of physical and mental impairments that generally qualify an applicant for benefits is the Social Security Administration’s Blue Book. 

Whether an applicant is born with a qualifying impairment or becomes disabled later in life, they may end up needing disability support services like day programs. 

What is a day program?

Unlike a residential facility where residents live on a 24/7 basis, day programs generally provide adults with intellectual and developmental disabilities a place to go during the day to receive services such as:

• exercise classes;
• arts classes;
• job training; and
• other activities. 

The funding for day programs differs state by state, but generally, these programs are funded through the federal and state government.

As a result of the pandemic, many of the day centers were closed for several months and, even for those who were able to eventually reopen, there’s the continued struggle of dramatically-reduced attendance. Some folks can’t access staff or transportation to help them get to the program, while others may have pre-existing medical conditions that make the virus more dangerous and they fear going out in public at this time. Of course, even those centers that have re-opened may be threatened by future closure orders if cases surge in upcoming weeks and months. Not all centers offer virtual or remote programming and not all disabled people are able to access such programming if it is available due to lack of technology or challenges to using it, or other factors. 

As a result of these serious and prolonged revenue challenges, many day programs are at risk of having to close their doors if the financial situation doesn’t change through government assistance or other methods.

If you or a loved one needs assistance applying for federal disability benefits, or appealing the denial of benefits, or have any other questions, the disability attorneys at Roeschke Law can help you. Contact us today to schedule a free consultation.

From our offices in Tempe, Phoenix, and Tucson, we represent disabled people and their families throughout Arizona in all matters of disability law. 

Replacement income from long-term disability insurance can provide tremendous relief in uncertain times. Long-term disability (LTD) insurance provides wage replacement to people who can’t work due to disability. However, policy coverage alone does not guarantee the approval of long-term disability claims.  

When filing for LTD, claimants are pitted against insurance agents whose job is to save their company money by delaying or denying claims. Experienced disability attorneys offer protection against insurance bad-faith practices, and best position your claim for approval. 

Phoenix, Arizona disability attorneys can help you avoid common reasons why your LTD claim may be denied. They understand the tactics used by insurance companies to delay or deny claims and will put their skills to work for your best interest.

6 Common Reasons Long Term Disability Claims Are Denied

Although it is possible for claims to be denied for various reasons, here are six of the most common ones:

1. Incomplete applications 

Applications with missing paperwork, such as medical records and doctor statements, are considered incomplete. Claims lacking critical support documents are often delayed or denied due to insufficient medical evidence supporting the claim.

2. Pre-existing conditions

Medical conditions linked to symptoms, diagnosis, or treatments before a coverage effective date are considered pre-existing conditions. Insurers may deny claims that can be linked to pre-existing conditions. 

3. Not meeting the insurance policy definition of “disability” 

Insurance policies define which disabilities are considered coverable and which are not. They may also specify how many months of coverage will be provided for some specific conditions. 

If a person’s disability leaves them unable to perform their job requirements, or the duties for any occupation, disability plans generally provide coverage. However, exclusions are often noted, such as for pre-existing conditions or substance abuse.

4. Statement of the treating physician

Insurance companies give considerable weight to the opinion of treating physicians. Doctors should provide comprehensive written statements detailing the work limitations resulting from your disability.  

5. Medical condition has improved 

If the medical condition precluding the claimant from working has improved, the insurance company may attempt to delay, reduce, or deny claim coverage. 

6. Missed Deadlines 

Filing deadlines for both initial claims and appeals of denied claims must be met. Failure to meet deadlines can jeopardize your right to a claim or forfeit your right to an appeal. 

Additionally, prompt response to document requests and early production of evidence is vital. Failure to include evidentiary documents in the administrative record will bar them from being introduced into court proceedings. 

Having an experienced long term disability attorney on your side is essential. It is an unfortunate truth that some insurance companies are more concerned with profits than the well-being of the disabled.

Contact a Phoenix, AZ Long-Term Disability Lawyer Today

Navigating disability insurance is a daunting task. Long-term disability lawyers are best suited to work on your behalf during the claims process, fighting against big insurance and bad-faith practices. 

If you are an Arizona resident preparing an initial LTD claim, have already filed your claim, or have been denied coverage, our Phoenix, AZ long-term disability attorneys can help. Our legal team is skilled in all aspects of long-term disability claims and appeals and will get you the compensation you deserve.  Contact one of our disability attorneys today. 

Is a ban on plastic straws unfair to the disabled?

Anti-plastic legislation, including bans on single-use plastic bags typically used for grocery shopping and plastic drinking straws, are being enacted across the country and beyond. Many supporters feel such legislation with respect to banning plastic straws is a no-brainer or a win-win. Merchants save money on straws, environmental waste in the oceans and landfills is reduced, and sea turtles are saved from death by plastic ingestion. 

But there is a cost and it comes at the hands of the disabled community. 

The government’s definition of disabled

Disability attorneys of Arizona help those who are disabled through illness, injury, or accident to secure the government benefits to which they are entitled. 

Qualifying for disability benefits requires meeting the government’s definition of “disabled”. There is an extensive list of recognized physical and mental impairments, and sufferers of some of these conditions require flexible drinking straws for nourishment. For that reason, disability advocates oppose a flat-out ban. 

Laws differ not only from state to state but from city to city. Some of these laws ban plastic straws entirely, but most carve-out some form of exception for disabled people. Paper straws or straws made from other biodegradable materials, or reusable metal straws, may not be suitable for disabled people who need the flexibility and strength of a lightweight plastic bendable straw. 

In some places, patrons are required to ask for a plastic straw rather than being given one with their orders automatically. This approach requires patrons to pause and really consider whether they need a straw or not, which has resulted in a large reduction of the number of straws used according to restaurant and bar owners.

Still, requiring disabled people to request a plastic straw may not only be difficult for some who are verbally- or intellectually-challenged, but could make them vulnerable to a social backlash similar to what is often encountered when disabled people who “don’t look disabled” are harassed for parking in handicapped parking spots. This leads many to ask if plastic straw ban laws discriminate against or unfairly burden the disabled community.

Applying for social security disability benefits

If you need assistance applying for Social Security disability benefits, or appealing a denial of benefits, Roeschke Law can help you. Contact us today for a free consultation. 

From our offices in Tempe, Phoenix, and Tucson, we help disabled people and their families throughout Arizona in all aspects of disability law.