We make sense of pre-existing conditions exclusions.
Most long-term disability claims contain a clause that gives insurance companies the right to deny your claim based on a pre-existing condition. These exclusions and limitations for pre-existing conditions are legal for the insurance company to incorporate into their policies, but the way in which they’re interpreted can vary widely. Because the interpretation of your policy can be broad, so it’s important to review your policy thoroughly and get the facts before filing a claim.
What defines a pre-existing condition?
During the months immediately before your effective date of insurance, the insurance company will review certain facts related to your illness or injury to determine if it’s pre-existing. This is also known as the “look back period.” While generally three months in length, some look back periods extend to six months or more. Medical treatment, consultations with medical professionals, and prescription drugs administered for the condition will typically be assessed.
Sometimes, insurance companies make mistakes.
Errors in diagnoses aren’t uncommon. Some insurance companies may even attempt to say that the illnesses and injuries in question aren’t severe enough to impede job performance. And while some pre-existing conditions are relatively clear-cut, things get complicated when multiple injuries with overlapping symptoms occur over time. With the help of your medical providers and records, the disability benefits attorneys at Andalman & Flynn can help make sense of confusing pre-existing exclusions when they arise. We’re happy to answer your questions and explain what you can expect while your appeal and denial are pending. You can count on our legal acumen and compassionate presence to guide you through the challenging disability benefits process.
If you have a pre-existing condition, count on the knowledgeable attorneys at Andalman & Flynn to explain your options and enforce your legal rights. Please contact us today to schedule a consultation.
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“Elliott and his staff won my case! Thank you again for all your help with my case. Elliott and his staff were outstanding to work with during this trying time for me and my family. I have a number of physical issues that hit me all around the same time, as well as complications from… one of my four surgeries I had within a four month period of time. I quickly exhausted all my sick and annual leave, leave donated to me, and also had been on three months of leave without pay. I was a U.S. Air Force program manager with a heavy workload. My team covered for me while I was out of the office and did a great job, but someone needed to be in my position doing the job on a daily basis. After learning that my primary care doctor, surgeon, and civilian doctor on base would support my disability claim, I did a search online and contacted Andalman & Flynn. Elliott and his staff were very understanding and supportive through the entire process. It was a trying time for my family and me to include the financial strain of missing so much work without pay. Elliott and his team were always available to answer questions, and even just talk when I needed them. I never waited longer than 24 hours for an email response or a returned call. Elliott and his team let me know every step of the FERS disability retirement application process and gave me an approximate time-line of the process from beginning to end. My case took approximately 10 months from start to finish. Understanding all cases are different and that some are decided in a shorter time or longer. My case was about the average time it takes to complete. Again, Elliott and his team were all over my case and even though this was a stressful time with all my health issues, I was at peace knowing they were always there for my family and me. My wife and I both appreciate the outstanding service, empathy, and support Elliott and his team displayed toward my family and me during this process.
I thank Elliott and his team again for all they have done for my family and me, and I highly recommend Andalman & Flynn to anyone looking for an outstanding and experienced firm in the field of disability law. Thank you Elliott!” Read more “Client Testimonial”
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When you need experienced legal counsel, turn to Andalman & Flynn. Our renowned team is here to provide vigorous representation for your most pressing family law and disability law issues and disputes.
Please contact us today to schedule a consultation.