In this video and article, disability insurance attorneys Gregory Dell and Stephen Jessup answer the question: What is the Difference Between a Disability Insurance Lawyer & a Social Security Disability Lawyer?
To answer this question, the attorneys explain:
- A Social Security Claim vs. a Private Disability Insurance Claim
- What is an Employer Provided Disability Insurance Policy?
- The Importance of Having a Disability Insurance Lawyer Represent Disability Insurance Income Policy Claimants
- What Is Needed to Prove Your Disability Insurance Claim
- Why It Is So Important To Comply with the Strict Deadlines In Your Disability Insurance Policy
The Differences Between a Disability Insurance Lawyer and a Social Security Disability Lawyer
GREG DELL: Hi, I’m Greg Dell with attorneys Dell & Schaefer. And today, I’m here with attorney Steven Jessup. And we’re going to talk about something that’s a very common misconception in the world of disability attorneys. And what we’re going to address is what is the difference between a disability insurance attorney and a Social Security disability attorney?
Now, Steve, let’s dive into this in the sense because they are two completely different animals in the sense of a Social Security disability claim and a disability insurance claim. So let’s first talk about the differences between the two different types of policies. Then I think that in itself will evolve in to see why you need an attorney who really focuses in disability insurance claims, which is what we do, versus the different types of lawyers that do Social Security disability work.
There Are Numerous Differences Between an SSDI and Disability Insurance Claim
STEPHEN JESSUP: So there are two types. Social Security is through the federal government. So that’s going to be based upon your work earnings, if you have sufficient credits in the system to be eligible. And then private disability is typically through what’s provided through your employer. The laws that govern them, the rules, everything are completely different.
Social Security has this idea of an any occupation standard from the get go. Can you do any job? Age is a huge factor for them. The younger you are, the harder it is to get.
Whereas an employer-provided policy is usually through a major insurance company. It’s going to have protection from being able to do your own job typically. And it doesn’t matter what age you are. If you’re covered under the policy, you’re covered to be able to make an application for benefits.
GREG DELL: All right, so the easiest most general way looking in the outside is you’re talking public sector, Social Security disability benefits, private sector, disability insurance benefits. I mean, dealing with private companies versus dealing with the government, completely different animals, very different definitions of disability and also tremendously different time frames in terms of when you’re eligible. The Social Security being a statutory government-type benefit, and disability insurance being like a contract or a– it’s basically a contract, whether it’s a private policy or employer-provided, but how you go about if your rights are violated are different.
Over 3 Million Annual Applications for SSDI Versus 160,000 Applications for Disability Insurance
Now, another gigantic difference– just to show the volume of these types of claims– there are over 3 million people a year that apply for Social Security disability benefits, of which they say that maybe 10% or 15% get approved initially. There’s approximately, from what’s reported, 160,000 people a year that apply for private disability, employer-provided disability benefits. So this is not even in the same league, very niche. Most of the lawyers who do the Social Security disability work, who we refer lots of cases to-
STEPHEN JESSUP: That’s what they do.
GREG DELL: –that’s what they do, very high-volume practice. In our world of the private disability-type claims, very small, very limited case volume, tremendously more time involved, totally different requirements in order to get reprove. So let’s talk about though the importance of having a private disability lawyer and understanding ERISA and understanding this private world versus the Social Security, which is not really anywhere near as complex, even though it’s specific unto itself. But why should I have an attorney who’s really focused on the disability insurance side of handling these claims?
STEPHEN JESSUP: It really comes down to experience and understanding. It’s very niche area of the law. Some Social Security attorneys will dabble with it, try to help. But like you said, Social Security has certain criteria. Even when you read award letters, the judge goes through certain things. It’s like form language of what they need to do.
So it’s a very streamline, albeit very slow process. Whereas, on the private disability side, you are dealing with deadlines that are much sooner in time. Your legal rights are viewed completely differently.
I mean, in Social Security, you get to a point where you can at least have a hearing in front of a judge. If you end up in court in an ERISA employer-provided policy, you’re in federal court. You don’t testify. Your doctors don’t testify.
So the specialty that comes with the private disability side of it is so much different than the Social Security. It’s one of those things that even attorneys we’ve had refer cases to us after they started doing the work on it be like, this is so out of my wheelhouse. I tried to help this person, but they need to be with someone who really knows how to deal with what an insurance company is going to be looking for in order to prove your claim.
GREG DELL: Also, the Social Security, when a claim gets denied, it goes to a hearing officer. That’s not even an attorney. Whereas, in our situations, when your claim gets denied in a private disability, you first have to do an appeal, which goes back to the company, which is a mandatory requirement.
And Social Security, you’re appealing to– I don’t know who it is– a Social Security hearing officer. You can have an advocate that helps you. It doesn’t have to be a lawyer. Although in the private disability side, you can do an appeal on your own; although, we don’t recommend that. And we’ve done tons of videos to discuss how we can help you with an appeal and all the stuff that’s at stake in an appeal.
But in Social Security, you can just go ahead and have one of these advocates or do your own appeal. Of course, if a Social Security appeal is denied, they have a whole different type of system where then eventually, you’ll end up in federal court. But on the private side, if a claim’s denied, you end up in federal court with a federal judge, which is like the big leagues of disability claim for things being reviewed. The other thing that’s different is the Social Security disability lawyers have to run at such a high volume in order to make money. And many of them work with non-lawyers as well that they just don’t have the time to put into what’s involved in a private disability claim–
STEPHEN JESSUP: That’s very true.
GREG DELL: –and talk about how much time we put into our client’s claims in terms of working with them to help prove their disability.
The Proper Handling of a Disability Insurance Claim Requires a Lot of Time and Attention to Detail
STEPHEN JESSUP: I mean, going up to the point of litigation and lawsuits when we’re compiling for attorney fees awards, hundreds of hours can go into one single case. The appeal process in and of itself, they’re giving you 180 days to do an appeal. It’s not uncommon after everything’s done, the additional medical tests, and we want the drafting, you’re talking like 30- 40- 50-page documents at time, in addition to the exhibits.
So each case, there’s so much that goes into it. And when people appeal on their own imitative, the Social Security, and they lose, a lot of times, that lawyer can get involved. And they’re going to have their hearing, new evidence will be presented.
If you do your appeal on your own and you lose, no new information is coming in for an attorney when filing a lawsuit to be able to argue on your behalf. So it’s a matter of setting you up for success in it. And also, your private disability policy is almost certainly going to pay more than Social Security will. So there’s a bigger amount of money to be had there, so the stakes are higher.
The government is slow and overburdened with the sheer amount of cases, like you said. Where the private company’s concern is we’re going to be losing money because we’re paying as opposed to collecting premiums. So they have an incentive to really challenge every case that comes across their desk.
GREG DELL: The other thing is with the thousands of disability insurance claims that we’ve handled, we’re dealing with 40 different disability companies. Each company has their own multiple different versions of their disability policies much like car carriers offer multiple version– car manufacturers offer multiple different models of cars. Disability carriers do it the same way.
And Social Security, it’s one policy with one set of rules, and that’s it. Disability insurance is a whole other world. It’s like it comes out to be hundreds of different contracts. They’ve been written going back for 75 to 100 years disability insurance policy have been written– not that we have policies that are a hundred years old. But we do have policies that are 40 years old–
STEPHEN JESSUP: Yeah, they’re very old.
GREG DELL: –because most policies, many policies have lifetime benefits paid to age 65. People buy these policies in their early 20s in the beginning of their careers or when they start working. So we have seen hundreds of different disability policies. And the nuances are so– they’re so minute that if you don’t understand what’s going on there, you can really put a client in a compromised position.
The other thing that where lawyers who don’t do this work get in trouble is with time frames. And talk about those, even if it’s ERISA or the policy, why it’s so important to comply with these frames?
STEPHEN JESSUP: Strict deadlines. ERISA, especially, when they see you have 180 days file an appeal, if you submit it on 181– and I’ve seen cases where people have done that. And the insurance company says had 180 days. You didn’t file it on time. We’re not accepting it.
And right there, your legal rights are done. You can’t pursue beyond that time frame on it. Statute of limitations, as well. Most policies, private policies, are governed by the state it was delivered in. ERISA usually has three years from proof of loss.
At least now, with the new regulations, the insurance companies are advising the exact date by which a lawsuit has to be filed. And if you don’t within that time frame, that’s that. There’s nothing that can be done.
We get calls frequently throughout the year of people like, three or four years ago, my insurance company denied my case, and I want to take a look at it. And you could be like, you have a great case. You could have gotten something or whatever the case may be, but you did it to within that time.
So these timelines are a lot of times for courts black and white, because in the ERISA federal court system, it’s very– it’s busy. And this judge it may be looking at your case isn’t just handling ERISA cases like a Social Security judge is only doing those. They’re doing complex criminal and civil cases as well. So if they get something across their desk on a statute of limitations, that’s a no-brainer just to kick the case out. So you have to be very, very conscious of the frames.
Not to mention in the private disability world, since it does usually have a quicker turnaround with an insurance company having to make a decision, whereas Social Security usually know you’re in it for a long time before you’re going to have a decision. There’s a lot more, in my opinion, added stress for the person to try to get this done quicker because they’re not working. They’re not working. So the frames, making sure the insurance company’s abiding by the time frames. Everything’s numbers and everything’s paper trails when it comes to these policies.
GREG DELL: Yeah. And Social Security, if you screw up a date or something, or you miss a deadline, you can reapply. I mean, a woman called me yesterday and goes, well, I just got approved for Social Security. It’s been seven years. I ignored my private MetLife claim. Can I do something now?
And I was like, no, you basically had three years, usually give or take. I’ve seen five or six, but not seven years. We just can’t– there’s nothing we can do in that situation to try to bring that claim. Now, if she had been paying premiums and had her own policy, then maybe it’d be a different standard. But you cannot not just reapply like you do in Social Security.
The Disability Insurance Companies Have More Resources and Provide a Higher Level of Claim Review
And that the thing is with the Social Security, it’s kind of like you get what you pay for. The stakes are a lot higher in a private disability claim. These insurance companies are billions and trillions of dollars in assets. And they have a lot more resources, which is another thing, where there is a lot more scrutiny I believe on the private side in the disability insurance benefit claims than what you see on the Social Security side where they’re– whoever they’re finding to look at claims, they don’t have the resources that these insurance companies–
STEPHEN JESSUP: Yeah. You’re going to talk with private investigators. There’s surveillance background searches, sending you out to multiple doctors, IMEs, all this stuff. Their pockets are very, very deep.
GREG DELL: Yeah. So you have to be even more prepared in terms of bringing these claims. So complete differences what we want you to understand in terms of when you’re looking for a disability attorney, because a lot of people go on Google or any of the search engines, and they put in disability attorney.
STEPHEN JESSUP: And it’s almost always Social Security and disability.
GREG DELL: And they read lots of articles and things like that. And they come up with these Social Security Disability-type things. But those standards are completely different and don’t apply to disability insurance.
And for the people that are searching disability insurance attorney, that’s what we do. That’s what we do on a nationwide basis and have been doing that for over 30 years and have become one of the premier the country who do this and have a reputation with every disability company for being able to proactively and proficiently represent our clients.
So what we’d like to do for you is we encourage you, no matter what stage you are at with your disability insurance claim, to give us a call at either the phone number at the bottom of the screen or go to our website a diAttorney.com, submit a free consultation. And what we’d like to do is review your claim, which could be review your disability policy, review a denial letter if that’s where you’re at. We’ll provide you with an immediate free consultation and opinion as to how we can help you.
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