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We Advocate For Our Clients Throughout Every Stage Of The Disability Insurance Claims Process

If you are reading this page, chances are you or someone you love is suffering from a disability and you are looking for answers. Answers to questions such as “What do I do now? What happens if my disability claim is denied? How do I appeal the denial of my benefits?” We can help you apply for disability benefits, appeal the denial of your disability claim or file a lawsuit to get your disability benefits.

At CJ Henry Law Firm, PLLC, we uniquely combine our years of experience in medical and law to deliver high success rates for all of our clients. Our experience, compassion, deep understanding of medical terminology and analyses, and unbridled legal tenacity have earned us great success for our clients. We seek equal access to justice for disabled individuals wrongfully denied benefits by their disability insurance company, and are committed to doing so for you.

CJ Henry Law Firm, PLLC takes a more focused approach, offering each client exhaustive research and considerable support throughout the process. Much of disability law turns on medical documentation and vocational specialists. We thoroughly investigate and research the opposition and our client’s medical and legal issues to present the most compelling argument in appealing our client’s denied or terminated claims.

Do you want a lump sum payment from your disability insurer? It may be possible to get the disability insurance company to pay you a lump sum now instead of continuing with payments in the future. We can help you decide whether getting your insurance company to buyout the claim is in your best interest. If you would like a buyout, we will negotiate with the insurance company to assure you get the best outcome.

What Is ERISA And How Does It Affect My Ocala, Florida Disability Claim?

The Employee Retirement Income Security Act (ERISA) was created to protect Americans’ retirement assets. This was to be done by implementing certain rules that employer provided retirement plans must follow. These rules were put in place to ensure that fiduciaries could not misuse plan assets. Under the Act, plans are required to provide participants with information about their plan’s funding free of charge and on a regular basis.

The Employee Retirement Income Security Act also put in place specific minimum standards for vesting, participation, benefit accrual, and funding for retirement accounts. The Act specifies how long an employee can be required to work before becoming eligible to participate in a certain retirement plan, before beginning to accumulate benefits, and before having a right to access those benefits. It also establishes a list of detailed rules that require the retirement plan’s sponsors to provide funding for the plan. Accountability of plan fiduciaries is required. The Act defines a fiduciary as anyone who has control over a retirement plan’s management or the assets the plan holds, including anyone who may provide investment advice regarding the plan. Fiduciaries who do not follow the rules can be held personally responsible for restoring any losses to the plan.

In addition to making sure that participants are informed of their rights, ERISA grants participants the right to sue for any breach of fiduciary duty. The Employee Retirement Income Security Act guarantees payment of certain benefits to ensure that participants are not forced to lose their retirement contributions, if their plan is terminated. The rules created by the Act also apply to both long-term and short-term private disability insurance provided by most employers. It regulates how disability benefit claims are processed, the timeline allowed for processing your disability claim, and your rights, should your disability claim be denied. These regulations are complex and require the assistance of an Ocala, FL disability law attorney. Not all retirement plans or insurance benefits are subject to the terms of ERISA. The Act does not cover plans that are created and maintained by either government entities or churches.

An Ocala FL ERISA Attorney Can Help You With Your Claim Or Appeal

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We understand how daunting a disability insurance claim can be when you’re not represented by an ERISA attorney. You’re dealing with conflicting information from the insurance adjuster, you’re constantly filling out forms, and you’re pretty sure that a private investigator is tracking your activity. Then, you get a denial letter. While you may feel like giving up, you have options. An experienced ERISA attorney at CJ Henry Law Firm, PLLC can help.

Am I Disabled Under ERISA?

Each disability insurance plan has its own definition of disability. Before you can assess your eligibility for either long term or short term disability insurance benefits, you need to review your plan documents. An ERISA attorney can help you obtain and understand the complicated and highly technical information contained in your plan’s summary plan description (SPD) and plan document.

Generally speaking, you will have to show that you are either unable to perform your “own occupation” or “any occupation” for an extended period of time. While this might sound simple, it’s actually a complicated analysis. Your ERISA attorney might:

Review your medical records and the opinions of your doctors, documenting your diagnoses, limitations, and your likelihood of making a physical or emotional recovery
Assess your education, work history, job duties, and other factors that might impact your ability to obtain a job
Consult with medical and vocational experts that can provide insight into your claim
Assess the disability insurance plan’s exclusions, exceptions, and claim procedures
File detailed written arguments and evidence that supports your claim

If you’d like to learn about ERISA disability claims and your eligibility, contact CJ Henry Law Firm, PLLC for a free consultation.

ERISA Disability Claim Appeals: When Do I Need A Disability Law Attorney?

If your claim for long-term disability benefits ends up being denied by your insurance company, this does not mean that you must give up. Your long-term disability policy provides for at least one level of administrative appeal. Many polices allow for an additional second level and few people are approved without at least one appeal, even with an Ocala, FL disability lawyer on their side.

If your long-term disability plan is a group plan that is provided by your employer, then you are required by federal law to use all of your administrative appeals before you can file a federal lawsuit against your insurance company. Even if federal law does not apply to your plan, you should always exhaust all of your administrative appeals. If you case is approved on appeal, you can avoid having to file a lawsuit.

As soon as you receive a denial letter, you should request or have your Ocala, FL disability law attorney request a copy of your entire claim file from your insurance company. The company is legally required to provide you with a free copy of your own file. Once you have exhausted all your administrative appeals, the administrative record of your case is closed. No new evidence can be considered beyond this point, if you file a lawsuit against the insurance company. It is very important to load your administrative record with as much evidence as you can while that record is still open. Your file should already contain all your medical records. If any record of treatment is missing, it must be sent to the insurance company for approval.

You should also submit an opinion from your doctor, detailing your limitations. It is best to ask your doctor to be very specific about your physical or mental impairments and how they are sure to affect your daily life. If your doctor is not willing to help you with your disability case, it may be necessary to find another doctor who is more helpful. Your Ocala, FL disability lawyer may request that you get statements from your friends and family members, detailing their personal observations of your medical issues. They should be careful in these statements, however, to avoid giving a medical opinion, as non-medical professionals.

It cannot be overstated how important it is to work with a disability law attorney in Ocala, FL. Your insurance company will immediately use what you don’t know against you, if you are not represented. The first time you miss a deadline, your case is dead in the water. Having an experienced Florida disability law attorney on your side improves the chances of your case being approved immeasurably. Your attorney will understand exactly how to craft a convincing appeal letter to your insurance company and precisely what types of medical evidence you will need to submit in order to get your case approved. An experienced lawyer will also be able to recommend doctors in your area who would be willing to attempt to help with your case as they see fit.

Client Testimonials

“Thank you and your staff for all that you have done for me. You may not know how much you have changed my life. I cannot find the words to say how thankful I am that you do the quality of work that you do both for me and other people in similar situation. Again with much thanks. And forever grateful.”

– Jeff T

CJ Henry Law Firm, PLLC Fighting For The Disabled In Ocala, Florida

Attorney Henry of CJ Henry Law Firm, PLLC is a compassionate, experienced disability law attorney serving the Ocala, FL area. As a former nurse, Attorney Henry has the unique skillset to expertly represent you in your Florida disability case while evaluating your medical evidence with ease and understanding. CJ Henry Law Firm, PLLC offers passionate representation to those who are struggling with any sort of disability claim:

Long Term Disability Insurance
Individual Disability
Bad Faith Insurance Claims
Social Security Disability
Negotiating Disability Settlements
Veterans’ Disability

CJ Henry Law Firm, PLLC will handle your claim with respect and empathy. Our office is committed to prompt and honest communication. We are here to listen to your story today.

What Is The Employee Retirement Income Security Act (ERISA)?

The Employee Retirement Income Security Act of 1974 (ERISA) regulates all employer-funded benefit programs. This includes employee benefits such as:

Pensions
Healthcare insurance plans
Disability insurance plans
Employer-sponsored life insurance
Accidental death and dismemberment coverage
Other insurance plans and benefits

When ERISA covers an insurance plan, the company and its representatives must follow certain policies and procedures. The law also controls the claims and appeals processes.

How Can An Attorney Help You Appeal A Denied Claim?

It’s important to understand that claims under ERISA are handled very differently than other insurance claims (like those involving car crashes). If you disagree with an insurance company’s denial of benefits you must follow a two-step appeal process.

Administrative appeal: the insurance company must review your claim again, assess any additional information you submit, and issue another decision. At this stage, you can submit as much evidence as you want that supports your claim.
Federal lawsuit: after the administrative appeal process is complete, you can file a lawsuit in federal court. However, the judge will not consider any newly-provided evidence that you try to submit. Instead, they will consider whether the insurance company violated certain standards, based on the information in your insurance company case file (sometimes called your “administrative record”).

Both appeals have their own filing deadlines and other requirements as well. An ERISA attorney can make sure that you don’t miss anything that could be detrimental to your appeal.

Because you can’t submit new evidence during a federal court appeal, it’s vital that you get legal assistance early on. Unfortunately, some insurance adjusters discourage disabled workers and their families from consulting with an ERISA attorney. Even if the adjuster or claims representative seems pleasant, they are not on your side. And if you wait too long to speak with an experienced lawyer, you might lose your right to disability insurance benefits.

Disabled Workers Deserve Honest Advice And Tireless Advocacy

The sooner you retain an experienced ERISA attorney, the sooner they can start reviewing your claim, stacking your administrative record with supporting evidence and building a comprehensive disability claim strategy for you and your loved ones.

At the CJ Henry Law Firm, PLLC we’ve built a strong reputation for ERISA advocacy. Our team offers a unique combination of both legal and medical experience that we put to use for our clients and their families. We understand the complexities of both administrative and federal ERISA appeals and help our clients fully understand their legal options. To request a free, no-risk evaluation, contact us today.

Speak With An ERISA Attorney At CJ Henry Law Firm, PLLC

It’s time to stand up to the insurance company and demand the benefits that you deserve. An ERISA attorney at CJ Henry Law Firm, PLLC can help. Our experienced team of professionals carefully studies each and every case we handle and fights for the benefits that our clients need to survive. We also give our clients the practical advice, respect, and compassion that they deserve during a difficult time. If you’d like to learn more about our approach to ERISA disability insurance claims, contact us today.

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