DISABILITY FAQ

If your long-term disability coverage was part of a group policy, it is governed by ERISA which does not provide for a jury trial.

This is not advisable as there is no opportunity to introduce any additional evidence once the final decision is made and suit is filed, and if you are not experienced in this area, it is unlikely that you will know what information is needed.

It is necessary to show that the denial was arbitrary and capricious meaning that it lacked a reasonable basis, which is a difficult burden of proof for any litigant to overcome.

Fees are awarded if you prevail, however, a number of factors must be satisfied the most difficult of which is proving bad faith, which requires more than a showing that there was an improper denial of the claim. Further, no fees are awarded for any work performed prior to the filing of the complaint.

A claim can be barred by a preexisting condition, or reduced by the payment of Social Security or workers’ compensation benefit payments. Also, many policies limit payment of psychological claims to only 24 months.

The state of New Jersey provides disability income insurance for a period of six months, and if you are a state employee, disability pension coverage may be available. Social Security Disability Income coverage may also be available.

Regrettably, no. It is simply part of the mix of information to be considered.