You should never pay up-front for legal fees or for retainer fees for a long-term disability claim. That’s risky because you can lose your money, and if you’re not working the last thing you need is to lose more money. If your claim has merit, you can find a lawyer who will take your claim on a contingent fee basis. A contingent fee means you don’t pay unless you win. You should only have a lawyer help you on a contingent fee basis and not upfront fees.
All disability claims have limits in what they cover. If you have a group long-term disability policy, there’s a good chance that it includes a complete exclusion for any disabilities caused by a pre-existing condition. Many private long-term disability insurance policies normally include this exclusion as well. To get around this exclusion, some policies force individuals to pay higher premiums for special coverage that does not include this exclusion.
With a pre-existing condition, whether physical or mental, you might not be able to receive benefits if your disability arises from the pre-existing conditions. By contacting Herren Law in Houston TX, long-term disability attorney William Herren fully understands the nuances of pre-existing condition exclusions in LTD policies. As such, if you are thinking of claiming disability benefits, call attorney Herren today by dialing (800) 529-7707. Free consultations are always available.
A disability insurance pre-existing condition is a mental or physical condition that the applicant has prior to the effective date of the insurance policy. If you have such a condition that you knew about or should have known about for two years prior to the effective date of the policy, then you need to look over your policy, as many LTD insurance policies won’t pay benefits for disabilities coming out of a pre-existing condition.
The company that issued the LTD insurance may deny a claim if it finds that the disability:
Additionally, a pre-existing condition is defined as:
It is important to note that some insurance providers misuse the exclusion to avoid paying disability insurance claims or to delay or deny payment of legitimate claims. As such, when three years or more have elapsed since the onset of a disabling condition which manifested itself from a pre-existing ailment, then, in theory, the insurance company should pay benefits. Nevertheless, the insurance company may still deny benefits, in which it is highly advised to contact an experienced disability insurance attorney.
There are virtually endless pre-existing conditions that can form the basis of a disability. However, some of the most common pre-existing conditions to know about include, but are not limited to:
To minimize the chances of your claim being denied because of a pre-existing medical condition, there are a couple of things you can do. For instance, you should be aware of the medicines you are taking, as some medicines may classify you under a high-risk group. Also, take note of any past injury treatments administered before you purchased your policy; these may be used against your claim. Lastly, simply understand that any record of treatment or surgery that shows you are prone to suffer disability can also be used to deny a claim.
If your insurance claim is denied due to a pre-existing condition and you might want to appeal, make sure to call Houston TX long-term disability attorney William Herren today. We offer comprehensive legal representation to make sure that your rights are protected and that your voice is heard. In the Houston area, we have helped numerous people just like you with their insurance claims, and we have the resources and legal know-how to represent your interests in front of the major insurance providers, including the Social Security Administration.
For a free, no-obligation consultation with attorney Herren, call Herren Law in Houston today at (713) 682-8194.
No. Again, in the same manner punitive damages are not allowed by the ERISA Statue, juries are not allowed by the ERISA Statue either. You cannot have a jury decide your long term disability claim. Most of the long term disability claims are decided by federal judges because of the ERISA Act.
If there is one thing considered a constant when filing a Social Security disability claim, it’s that these claims take a very long time. Social Security disability (SSD) claimants know this, and the Social Security Administration knows this as well. As such, in almost every case where the claimant is awarded his/her SSD benefits or SSI benefits based on disability, then the past due disability benefits (known as disability “backpay”) is also awarded. The amount of backpay usually goes back to when the initial application was filed, though in some cases it can be earlier.
If you applied for SSD benefits, it’s essential to have an experienced Houston SSD benefits attorney on your side. At Herren Law, we boast years of experience and helping hundreds of Houston residents with their disability benefits, and we can help you too, including with issues such as backpay. For a free consultation with Houston attorney William Herren, call our law firm today at (713) 682-8194.
In the meantime, you can learn more about Social Security disability back payments below.
Back payments are paid to successful SSD or SSI applicants for the months between the application date and the day you’re awarded benefits. This is generally due to the fact that there are many people applying for benefits, and the SSA is notorious for taking forever with the SSD application process. Furthermore, for Social Security Disability Insurance (SSDI) payments, there is always a five-month waiting period, and for some applications, there might be retroactive benefits available. In general, the main factors that determine an applicant’s backpay include the application date, the date of disability, and the five-month waiting period.
The first factor that determines the amount of your backpay is the application date for your Social Security disability or SSI benefits. When applying for SSD benefits, the SSA will give successful applicants backpay that satisfies monthly payments back to their date of application. Furthermore, some applicants may be considered for retroactive benefits during the year prior to the application date. Retroactive benefits might not be available to SSI applicants; SSI applicants can receive back pay that dates back to the first month after filing an application.
Additionally, some applicants can have a “protective filing date.” This date generally occurs before the applicant filed for benefits, and the applicant can receive back pay going back to this date.
Next to the application date, the second most important factor when determining backpay is the date of disability. Essentially, this refers to when the disability occurred, and when filling out your claim application, you’ll have to include this date, known as the alleged onset date (AOD).
When approved for disability benefits, your DDS disability examiner or administrative law judge will give you an established onset date (EOD). Unlike AOD, which you determine, the EOD is dependent solely on the claimant’s medical records and work history. Some evidence considered for your EOD include doctor’s reports, lab results, and disability application.
It’s important to note that, for SSI, the Social Security Administration won’t give an EOD that occurs before the application date. This is due to the fact that SSI applicants cannot receive benefits before the month of application. Also, if the SSA states that your EOD is after the application date, then the SSI applicant will receive benefits starting on the EOD, not the application date. Remember, this is only for SSI applicants.
For SSD and SSDI applicants, you may be able to receive retroactive back payments if there is an established EOD before the application date.
The last major factor in SSD back payments is the five-month waiting period. This waiting period only applies to SSDI applicants, and not SSI applicants. This means that successful SSD applicants with an EOD may have five months of benefits removed from the beginning of their disability. In other words, the applicant is entitled to benefits 5 months after the EOD.
There are numerous factors involved in every Social Security Disability case, whether that involves the date of disability, the evidence of disability and an inability to work, and so forth. In any case, you should expect a long and complex process, which is why it’s critical to get an experienced Houston SSD attorney at your side. For a free consultation with Herren Law, call our Houston law firm today at (713) 682-8194. We work on a contingency basis, meaning that you won’t pay a penny unless we win your case.
The federal statute known as ERISA shields insurance companies from liability. However, there is some progress being made. Some 26 states at this point in time have passed legislation that disallows the discretion that’s given to insurance companies in deciding these claims. In the future, claims will be decided on a more reasonable basis by judges, most likely federal judges. Insurance companies are fighting this and they’re resisting the change. I think we can expect change is good.
When you or a loved one joined the military, you, like thousands of other veterans, dedicated everything to your service, giving the Army, Navy, Marines, Air Force, etc your 110%. Nevertheless, the VA is notorious for inefficiencies when getting disabled veterans their much-needed benefits. Despite your dedication, that may have left you disabled, the VA all-too-often rates the severity of a disability lower than it should be, or the VA takes way too long.
At Herren Law in Houston TX, we strongly believe that disabled veterans deserve their rightful and full benefits in a timely manner. With the help of Houston VA disability benefits attorney William Herren, we’ll help you through the VA benefits process every step of the way, from gathering and filing the claim to vigorously representing your case. We work on a contingency basis, meaning that you don’t pay a thing unless we win your case. If you are looking to claim your VA disability benefits, don’t hesitate and call Herren Law today at (713) 682-8194. Free consultations are available.
Once the VA has determined that you have a service-connected disability, the organization will rate the severity of your disability on a scale between 0 and 100, whereas 100 is the most severe (offering the highest amount of benefits) and 0 is the least severe (offering the lowest amount of benefits, but still making health care and other benefits available to veterans).
This rating is designed to give veterans a fair amount that reflects the severity of their disability and their inability to work. However, like many disabilities, a veteran’s disability might not be static and could worsen over time. Additionally, the VA is not perfect, and they can sometimes rate a veteran’s disability as too low.
Keep in mind that the VA disability benefits process is time-consuming and complex, for both the VA and the veteran, and if your documentation isn’t complete or as clear as possible, then the VA might not connect the dots.
However, if you approach your VA disability claim (with the help of an experienced VA disability attorney) with the same discipline and grit as your military career, then you stand a chance of beating the VA and getting the full and fair benefits that you’re entitled to.
It’s no surprise that getting your VA disability documentation together is a full-time job. To start, you’ll need to get your VA claim file and your service medical records.
If you don’t have these records, you can request them from your local VA regional office or by mailing a Freedom of Information Act (FOIA) request.
Next, do your due diligence and research any disability or condition in your records and connect that disability with the 38 CFR Part 4: Schedule of Ratings. Write up a summary of your conditions as well as any dates of treatment (during and after service), and bring this documentation with a one- to five-page summary. This documentation should be in addition to doctor’s opinions and, ideally, a nexus letter.
Although there is already a ton of documentation to gather (seeing a trend?), your VA C-File is perhaps the most important document that you’ll need. Don’t wait until your hearing and go to your local VA regional office to try and get a copy.
The average denial rate in 2011 in front of the Board of Veterans’ Appeals (BVA) was around 24.2 percent, and that same year, according to the Board of Veterans’ Appeals Annual Chairman’s Report (Fiscal Year 2011), veterans who were represented by an attorney had a denial rate of about 17.7 percent. By knowing the law, and using your right to have a VA disability at your side, some benefits will include:
There are many paths to take when proving to the VA your disability and service connection. Always remember what you’re building in your claim: Eligibility, Service Connect, Impairment Rating, and Effective Date. With any of these four factors, if you have bad or wrong evidence, you may thoroughly sabotage your claim. When gathering your evidence, remember these 5 tenants of good VA disability evidence:
Unlike the battlefields you faced in your service, filing for your VA disability benefits claim is a battlefield that you can choose and control. The most important parts of this process are gathering the correct evidence and documentation and making sure that the evidence and documentation are complete and clear. For these reasons, it can be extremely helpful to have an experienced, knowledgeable VA disability attorney at your side. For a free, no-obligation consultation with Houston VA disability benefits attorney William Herren, call our law firm today at (713) 682-8194.
Disabilities that are connected to a veteran’s service are not always physical and visible. Actually, it’s not really news that active military service can have dramatic and incapacitating effects on the human mind. Although “shell shock” isn’t quite the medical term that accurately describes the complexity of an affected veteran’s mental condition, thousands of veterans throughout Texas suffer from PTSD, depression, anxiety, alcohol or drug addictions, and more.
Many veterans are reluctant to seek VA disability benefits for mental disorders; however, these disorders can be just as debilitating as physical disorders. By calling Houston VA disability benefits attorney William Herren, you discuss the possibility for disability benefits for a condition connected to your service in the U.S. armed forces, whether Army, Navy, Air Force, Marines, U.S. Coast Guard, and others.
To speak with Houston attorney William Herren, we invite you to call our Houston law firm today at (713) 682-8194. Consultations are always free, and if we decide to take your case, you won’t pay anything unless we win.
The stigma about mental health problems is still prevalent among veterans, especially due to the “tough” and “strong” atmosphere prevalent in many areas of the military. However, since the increased media attention regarding PTSD and other mental and emotional conditions, this stigma has reduced. Furthermore, the VA disability benefits for eligible veterans are worth pursuing, as the benefits include free medical attention as well as monthly payments, depending on the severity.
The most common VA disabilities include tinnitus and hearing loss, but PTSD is the most common mental condition, alongside drug and alcohol abuse. When the VA is determining whether or not you have a mental disability, the organization will organize several tests to determine the severity of your disability and how it affects your ability to work. The VA will also determine whether or not your disability is truly connected to your service in the military.
Unlike physical disabilities, such as an amputated arm or a musculoskeletal disability, mental illnesses require different evaluations to determine their severity. To evaluate a mental illness, the VA uses its VA Schedule of Ratings Disabilities, which itself follows the criteria detailed in the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition (DSM-IV), which is published by the American Psychiatric Association. The categories of mental illness include:
Just like other disabilities, you’ll need to prove to the VA that your disability is connected to your military service. To get compensation, therefore, you must have:
In general, the VA doesn’t provide VA disability compensation for illnesses that result from genetic or developmental defects. In other words, if you have a mental illness that existed before your military service, you may be ineligible for compensation. Such conditions can include mental retardation and personality disorders.
However, if you have a pre-existing mental condition that was aggravated by your military service, then you still may be able to qualify. For instance, if a veteran diagnosed with a personality disorder enters the military, and during his/her service, an event causes the veteran to develop PTSD, then he/she may be able to receive benefits based on the PTSD.
Once the VA has determined that your mental illness is related to your military service, the VA then determines the level of disability severity and, therefore, how much compensation you may be entitled to. In addition to looking at the DSM-IV, the VA will consider the veteran’s Global Assessment of Functioning Scale (GAF). This GAF score measures the veteran’s ability to function at work (physically, socially, and emotionally). The GAF score ranges from 0 to 100, and a higher score means that you are more able to function in the workplace.
Furthermore, the VA provides ratings of 0%, 10%, 30%, 50%, 70%, or 100% for psychiatric conditions. 0% doesn’t provide any monthly compensation, but you still may be eligible for health care and other benefits. 100% provides the highest amount of benefits.
If you or a loved one suffered a mental condition that resulted from active service in the military, it’s important to file a claim with the VA for disability benefits. These benefits can be essential in your continued recovery while helping with finances if you’re unable to work to your maximum capacity. At Herren Law in Houston TX, disability benefits attorney William Herren has helped numerous veterans with their benefits associated with mental disorders. To get started on your case, it’s important to call attorney Herren as soon as possible. For a free consultation, call today at (713) 682-8194.
Yes it is. As far as the initial application is concerned, the Veteran Service Organizations can help a veteran make his claim. After that claim is denied, it’s best to obtain professional advice.
