Attorney to Appeal Liberty Mutual Denial of LTD Benefits
[Note: Liberty Life Assurance Company of Boston is a Liberty Mutual company. As such, although much of the discussion uses the company name Liberty Mutual, the same information applies to Liberty Life Assurance.]
Just because you have to stop working, that does not mean that your monthly bills stop. If you are unable to work due to an illness or injury, it can be difficult to pay your car bill, rent or mortgage, your utility bills and more. That is why some employers offer Long Term Disability benefits through the Liberty Mutual Insurance Group.
According to Liberty Mutual’s own website, “disability insurance can help cover daily living expenses”. If you are fortunate to have long term disability coverage, then you may indeed be entitled to financial support while you focus on your physical and/or mental well-being. However, LTD benefits are not always paid out as they should be by insurance companies, including Liberty Mutual.
Liberty Mutual has been known to deny long term disability claims based on a number of factors. For example, a Liberty Mutual denial letter may state that there is a general lack of supporting documentation or information. The denial may state that the claimant’s condition fails to meet the insurance policy’s definition of disability. The insurance company may have conducted surveillance and denied coverage or cut-off benefits because of video surveillance evidence that is inconsistent with a disability claim. Or, the claimant may have missed a deadline and filed the claim or appeal too late.
Definition of “Disability” in a Liberty Mutual Policy
The term “Disability” is defined in each individual policy. Your definition may be different than the sample one below. You should always check your own policy to determine how the insurance company defines the term “disability” in your long term disability claim. However, to give some insight into how Liberty Mutual may define disability, this is how it defined the term in a past case that went to litigation:
As used in the above provision, “disability” refers to total disability, and is defined as follows:
i. that during the Elimination Period and the next 24 months of Disability the Covered Person, as a result of Injury or Sickness, is unable to perform the Material and Substantial Duties of his Own Occupation; and
ii. thereafter, the Covered Person is unable to perform, with reasonable continuity, the Material and Substantial Duties of Any Occupation.
Partial disability benefits is defined to cover situations where the covered person, as a result of injury or sickness, can:
1. perform one or more, but not all, of the Material and Substantial Duties of his Own Occupation or Any Occupation on an Active Employment or a part-time basis; or
2. perform all of the Material and Substantial Duties of his Own Occupation or Any Occupation on a part-time basis; and
3. earn between 20.00% and 80.00% of his Basic Monthly Earnings.
The burden of proof in a disability claim is on the claimant. Under the same policy quoted above, the claimant was required to submit “proof” of disability, which was defined to include the following types of evidence, though the list was non-exhaustive:
1. a claim form completed and signed (or otherwise formally submitted) by the Covered Person claiming benefits;
2. an attending Physician’s statement completed and signed (or otherwise formally submitted) by the Covered Person’s attending Physician; and
3. the provision by the attending Physician of standard diagnosis, chart notes, lab findings, test results, x-rays and/or other forms of objective medical evidence in support of a claim for benefits.
Improve Your Chances by Consulting with an Experienced LTD Attorney
When filing a claim for LTD benefits or appealing a denial under a Liberty Mutual disability plan, the guidance of an experienced Liberty Mutual disability lawyer can be extremely helpful and improve your chances of obtaining the benefits you are entitled to receive.
Nick A. Ortiz is the founder of the Ortiz Law Firm and an experienced Liberty Mutual LTD claims attorney who understands the difficulties pursuing a Liberty Mutual claim for LTD benefits. Mr. Ortiz has helped dozens of clients in long term disability claims. He represents clients at the initial application stage, during the administrative review appeal process, and in state and federal court when a lawsuit must be filed.
Legal Help in Getting Your Liberty Mutual Claim Approved
When filing a application or appealing a denied claim for long term disability benefits under a Liberty Mutual plan, it can be helpful to have the assistance of an experienced lawyer. We work closely with our clients throughout each stage in the LTD claims process, including:
- Gathering all medical records and other documents to support the claim;
- Obtaining opinion evidence from doctors and perhaps vocational experts;
- Organizing your financial records;
- Reviewing and answering all questions on the disability claim application; and/or
- Filing your claim and/or appeal in the manner that maximizes its chance of approval.
Unfortunately, even the most severe disabilities and the best prepared claims may be denied by Liberty Mutual. In the event that you receive notice of a denied claim in a denial letter, you should be aware that you have the right to file an appeal. In the event that you have exhausted your appeals, you may have the right to file a lawsuit under the ERISA act. Nick A. Ortiz is an long term disability attorney and can help you obtain the benefits you deserve. Our disability law firm offers detailed advice on the many issues related to the claims and appeals process, including:
- Helping you understanding the reasons for your denial;
- Acquiring additional evidence, including medical records and other documents in support of the appeal;
- Completing the appeals paperwork;
- Filing your appeal within the time limits allowed;
- When necessary, filing an ERISA lawsuit in Federal Court; and/or
- Briefing your case for consideration by a federal judge during the ERISA lawsuit.
You don’t have to face your battle against Liberty Mutual alone. The Ortiz Law Firm is here to help in the application and appeal process.
Contact our office today at 850-308-7833 to schedule a free consultation to discuss your case with an experienced Liberty Mutual disability claims lawyer.