Under doctor care about to lose my job because of disability. Insurance denied long term disability claim! What are my rights?

Asked over 1 year ago - Kissimmee, FL

I was in an accident have exhausted my FMLA and extended medical leave. My job doesn't want to offer me a sit down position, rather fire me, AND the insurance company that was paying my short term disability says DENIED me of long term because the doctor office notes for each visit didn't list my restrictions! The restriction are to stay off my job, which is stand for an 8 or more hr. shift. They are saying this my evaluations and medical notes stating to stay home from work until further evaluation isn't enough and they want specific restrictions... restrictions from what? Work! That's 'not enough' for them. As of Dec. 17th my job, per HR rep, will be gone. they will take me off schedule and if i want to work with them i have to reapply after 6 months. Where do I go from here?

Attorney answers (2)

  1. Ryan Michael Davidson

    Pro

    Contributor Level 15

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    Answered . You hire an attorney that contests these sorts of decisions. Disability insurance companies will use any excuse possible to deny a claim. You're going to need representation here.

    Fortunately, most of these cases are handled on a contingency basis, so you shouldn't need to pay anything up front.

    This answer does not constitute legal advice and does not establish an attorney-client relationship.
  2. Jeremy Lyle Bordelon

    Pro

    Contributor Level 14

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    Answered . I agree with Mr. Davidson that you're going to want to talk to an attorney to help you on the long term disability claim. Specifically, you're probably looking for someone who specializes in ERISA, which is the federal law that governs employee benefits like short term and long term disability (unless you worked for a church or a government entity). If you really are unable to work, and you really have used all of your FMLA and other medical leave, then there is probably no way to protect your job - it's probably legal for your employer to fire you. But, that doesn't mean your long term disability claim should be denied. There are a number of good attorneys in Florida who work on these kinds of cases, and if you don't find one you like there, feel free to look anywhere. Because ERISA is a federal law, it doesn't change much from place to place, and attorneys in one place can handle these kinds of cases from just about anywhere. For example, from here in Tennessee, I've handled cases for people in Hawaii, North Dakota, Rhode Island, Texas, etc., etc.

    One more thing - I DO NOT recommend filing any appeals on your long term disability claim without speaking to an attorney first. You likely have 180 days to appeal the denial, and you'll want to speak with an attorney as soon as possible, leaving the attorney as much time as possible to do a good job on your appeal. Best of luck to you.

    Jeremy Bordelon is a licensed attorney in the State of Tennessee only, and is authorized to practice in all... more

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