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A large number of California residents are struggling with long-term disabilities that make it impossible for them to continue working. Many of these individuals are covered by some form of long-term disability insurance, such as a plan offered by their employer. Unfortunately, having disability insurance does not always mean the insurer will pay when a claim is filed.
The long-term disability attorneys at Kantor & Kantor, LLP provide skilled, professional representation to San Francisco residents who need help obtaining the benefits they are entitled to under an employer-provided or individual disability insurance plan. We understand how difficult it is to fight with an insurance company while you are simultaneously dealing with a chronic illness or other serious medical condition. That is why our legal team will make every effort to assert your rights and obtain a favorable resolution of your long-term disability case.
One aspect of the law that confuses many California workers is the distinction between employer-provided and individual disability plans. The main difference is that an employer-provided or “group” plan is governed by a federal law known as the Employee Retirement Income Security Act (ERISA). Individual long-term disability plans, in contrast, are insurance contracts typically governed by California state law.
Why does this matter? Under the ERISA, injured workers are required to go through an administrative appeals process if their initial claim for benefits is denied. In other words, you need to ask the insurance company to review and reconsider its own decision first before you can take formal legal action. If you are dissatisfied with the insurer’s review, you must take your case to federal court, where a judge will decide your appeal based largely on the existing administrative record. However, with an individual long-term disability plan, you do not need to jump through the hoops of the insurance company’s review process. You can also file a lawsuit in California state court and have your case heard by a jury, which may consider any relevant new evidence you introduce.
Regardless of which process you follow, it is critical to work with an experienced long-term disability attorney who understands the law in this area. At Kantor & Kantor, LLP, we can assist you at all stages of the process, from helping you file your initial application and claim for disability benefits, to gathering any necessary supporting documentation and following up with the insurance company.
If you are faced with a disabling condition and unsure of what steps to take next, contact our long-term disability lawyers in San Francisco today to schedule a free consultation so we can sit down and learn more about your situation. Please note, you do not pay unless we win your claim.
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