To get through long term disability claims in Ajax you need to know how to read complicated insurance policies and deal with companies that put their profits above your health. We have helped many people who thought their insurance company would help them through tough times only to have their claims denied or delayed without warning. When you can’t work because of a disability the stress gets worse when the money you were counting on suddenly disappears. At Longo Lawyers we know how tough things are for you and are committed to helping you get the benefits your policy promises.
Long term disability insurance is a contract that protects your income if you can’t work because of an illness or injury. But insurance companies don’t always follow these agreements without a fight. Their business model is based on collecting premiums and making as few payouts as possible which means even valid claims are closely scrutinized. They hire groups of adjusters, lawyers and medical reviewers whose job is to find reasons to deny or cut benefits. We use our experience and knowledge to make sure your rights are protected and your insurance company does what it says it will do.
To make a successful claim you need to know exactly what your disability policy says. These contracts use technical language and exact definitions that have a big impact on whether or not you get benefits. The definition of disability varies among different policies. Some say you can’t do your own job while others say you can’t do any job you’re reasonably suited for. This difference is huge because it changes what you need to show to get benefits. We read your policy to figure out which standard applies and come up with a plan that fits your coverage and situation.
Medical records are the most important part of any disability claim but getting the right evidence is more than just getting a doctor’s note. Insurance companies want detailed reports that explain your diagnosis, treatment history, current symptoms, functional limitations and most importantly how these things stop you from doing your job. It’s not enough to just say you can’t work. We help you work with your doctors and nurses to get detailed medical records that answer all of your insurance company’s questions. This often includes functional capacity evaluations, consultations with specialists and reports that clearly link your medical limitations to certain job duties.
If you’re making a claim for restaurant and bar liability injuries that have left you with permanent disabilities you’ll need to provide a lot of proof of how bad and how long lasting your injuries are. Insurance companies may admit the first incident happened but then they may say you should have healed or that your ongoing symptoms are worse than the injury. We gather proof of the real effects of your condition through new medical reports, expert opinions and sometimes job evaluations that show why your limitations still exist. This all-encompassing approach proves your disability is real and ongoing not just a temporary problem or an exaggeration.
It’s very important to pay attention to the details and meet strict deadlines when applying for long term disability benefits. You need to fill out the forms completely and correctly with clear descriptions of your job duties, medical condition and any limitations on your ability to do things. Small mistakes or not answering all the questions can cause benefits to be denied or take a long time to get. We help with the whole application process to make sure everything is sent in correctly and on time. This planning is often what makes the difference between getting approved and getting denied especially when the disability isn’t immediately clear to someone who doesn’t know your specific situation.
Most people don’t expect denials to happen as often as they do even for claims that seem clearly valid and well documented. Insurance companies may deny benefits for a number of reasons such as not having enough medical evidence, not agreeing with your doctors or saying you haven’t tried all the treatments available. A lot of denials happen because insurance company doctors review your case but never see you in person. These paper reviews look at your medical records from a distance and come to conclusions that are often different from what the doctors who treat you and know your case say. We fight against these unfair reviews by pointing out their flaws and emphasizing the credibility of doctors who know your condition firsthand.
There are strict time limits for the appeals process for denied claims. Most policies give you 30 to 90 days to file an appeal after you get a denial. If you miss this deadline you can never challenge the decision again. We make sure appeals are filed on time and include strong arguments backed up by more medical evidence. You can’t just disagree with the denial to win an appeal. You need to respond to each reason given and provide new information that shows why you should get benefits under your policy.
A lot of disability claims in Ajax are for conditions that can’t be proven with objective tests. Insurance companies often question subjective symptoms that are very important for chronic pain disorders, fatigue syndromes, cognitive impairments and mental health conditions. They may say your symptoms are worse than they really are or that you could work if you tried harder. We have developed ways to present these cases by using detailed records of your symptoms, statements from people who know you well that back up your claims and medical opinions that prove your condition is real. Even if a blood test or imaging scan can’t show it, your disability is still real.
Insurance investigators often use surveillance as a way to look for inconsistencies in disability claims. Companies may hire people to follow you, watch what you do in public and check your social media accounts to find proof that goes against what you say you can do. This feels intrusive and makes you feel like you’re being treated like a liar instead of someone who needs help. We help you understand that having trouble doing some things doesn’t mean you’re not disabled. Just because you have to run errands, go to the doctor or go to family events doesn’t mean you can work full time. We make sure any surveillance footage is clearly explained and not misrepresented to make it look like recovery.
When you can’t work and your disability claim is still open the financial pressure can become too much. It might seem like you can’t afford to hire a lawyer right now. We only charge you legal fees if we win your long term disability case and get you benefits. This arrangement means everyone can get good legal help no matter how much money they have right now. We only do well when you do well so our interests are completely aligned with yours.
We want you to be able to talk to us throughout your case. You should know what’s going on at every step of the legal process, even if it’s hard to understand. We use simple language to explain what’s going on and we’re always here to answer your questions. You should never be unsure about the status of your case or what to do next. Regular updates and honest explanations can help reduce anxiety during a stressful time.
Your doctors who are treating you are important to your claim but they may need help figuring out what information insurance companies need. Doctors are more interested in diagnosing and treating illnesses than in writing down disabilities for insurance purposes. We work with your medical team to get full reports that go into detail about your functional limitations, work restrictions and prognosis. Sometimes this means asking for extra evaluations or setting up specialized tests that give objective proof to back up your claim.
Another problem we often see is the end of benefits after the first approval. Sometimes insurance companies will approve your claim at first but later decide you’ve recovered or can do other work. These terminations often happen without warning and may be based on medical opinions that aren’t clear or a misunderstanding of what you’ve been doing. We fight against wrongly ending benefits by showing the person is still disabled with current medical evidence and pointing out mistakes in the insurance company’s reasoning. Personal Injury Lawyer Fabio Longo is dedicated to helping clients recover the compensation they deserve with professionalism, integrity, and proven results.