Long Term Disability

insurance claim form

Long Term Disability (LTD) insurance should cover you if you become disabled as a result of an injury or illness. Unfortunately, insurance companies regularly deny valid claims for LTD benefits. While you may be able to get by for a couple of months on your savings, you have an LTD policy because you knew you couldn’t survive for an extended period of time without an income.

You’ve done the right thing by protecting yourself, the insurance company should be doing the right thing by paying your benefits, but they often don’t. At the Bonnici Law Group we assist sick and injured individuals in obtaining the insurance benefits they’ve paid good money for and are entitled to receive.

Since your benefits are based on the contract you signed with your disability carrier (usually provided by your employer) it is very important to understand the terms, definitions, and provisions in your LTD policy. Each policy is a bit different, and most policies have many “hidden provisions” regarding timing, pre-existing conditions, or other ways insurance companies base their denials upon. It is best to have an attorney versed in LTD and ERISA law review your denial letter and plan policy as soon as your claim is denied. It is not unusual to find mistakes and omissions in denial letters.

ERISA-based LTD plans only allow 180 days to submit an appeal. While that may sound like an ample amount of time, in reality, there is much work to be done during that 6-month time. Time is of the essence in starting your counter-attack to the insurance company’s denial of your disability plan.

At Bonnici Law Group, we understand the pressures that a LTD denial places on you and your family, and how to make the most of the time available during your appeal. We will review your denial letter, plan policy, and administrative file with you for no charge to see if we are able to help you get the benefits you deserve. 

Joshua Bonnici has been serving San Diego’s LTD needs for years, and has been a go-to source for ERISA and LTD issues for attorneys throughout the county. Reach out to him today for a free case evaluation.

Social Security Disability

If you are unable to work because of a medical condition, you may be eligible for Social Security Disability. Unfortunately, applying for and obtaining Social Security Disability can be a very difficult and lengthy process.

Nearly 65% of Social Security Disability applications are denied at the administrative level. To pursue the claim further an appeal must be submitted within specific time constraints. Our job is to inform you of the process, what is expected, gather evidence, and present it to Social Security for you. Having an experienced disability lawyer on your side greatly enhances your chances of success.

What is Social Security Disability?
The Social Security Act defines disability as the “inability to engage in substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months.”

The Social Security Administration administers two federal disability programs:
Social Security Disability Insurance (SSDI), and Supplemental Security Income (SSI).
There are substantive differences with both programs and therefore, it is important that individuals be apprised of the differences associated with each.

Social Security Disability Insurance (SSDI) provides monthly cash disability payments to those who qualify. Almost every working individual pays FICA taxes. If you have paid sufficient FICA taxes, you are considered “insured” and may be eligible for SSDI. If not, the Supplemental Security Income (SSI) program is designed to assist those that do not qualify for SSDI, but are still unable to work due to some medical condition. It too, provides monthly cash disability payments to those who qualify.

How does it work?
The process is initiated by submitting an application to your local Social Security Administration office or applying online at www.ssa.gov.

What if my claim is denied?
Be aware, the majority of claims are denied at the initial stage, so try not to get discouraged. Rather, just look at it as one of the hoops you have to jump through in order to obtain disability benefits. Upon denial, there are certain time constraints and forms that must be filed in order to challenge the denial. This is the point where things become a little more difficult, and hiring an experienced attorney is crucial.

Request for Hearing by an Administrative Law Judge
If your request for reconsideration is denied (which, again it likely will be) the next stage is to file a request for hearing before an Administrative Law Judge. If you choose to hire an attorney, they will appear at this hearing with you, and prepare you for what to expect.

How Do You Get Paid?
At Bonnici Law Group, we understand the financial hardship you are under as a result of your disability. Therefore, we handle SSDI claims exclusively on a contingency fee basis; which means we are paid at the end of your claim after we have successfully obtained an award of disability benefits. The Social Security Administration will pay us directly, thus there are no out-of-pocket payments from you.

The Social Security Administration is extremely understaffed and overwhelmed, thus having an Attorney to represent you may help expedite your claim and ultimately get your claim accepted. Although there are obviously no guarantees your claim will be accepted, we have had a great deal of success for our clients. Having someone in your corner who knows the process and requirements certainly helps.

Attorney Steven Martin has been helping clients throughout Southern California get the Social Security Disability benefits they deserve for years. Let him help you too. Contact him directly today for a free consultation. He can be reached at (619) 259-5199 x.105.