Located in Norco, LA, and built in the 1980s, the Valero St. Charles Refinery is one of the newest oil refineries in the United States.
With over 600 people under their employ, Valero ranks safety as their foundation for success.
Though Valero claims to have received the highest plant safety recognition by the U.S. Occupational Safety and Health Administration (OSHA), accidents in this hazardous industry, unfortunately, can and do happen.
If you’ve been injured or can no longer work because of a disability while working for Valero St. Charles, you're probably covered under an ERISA group disability plan.
Getting your benefits, though, isn't always easy.
The majority of long-term disability (LTD) claims are denied the first time and applications are often written in such a way to solicit a denial.
Going against the big insurance companies is challenging at best. They have deep pockets and maintaining their bottom line is their number one priority.
Following These 5 Steps Can Help You Win Your LTD Appeal Against Valero St. Charles:
1. Meet Your Deadline(s)
If your long-term disability (LTD) insurance benefits have been denied you will typically need to file an appeal within 180 days of the denial.
Write down any and all dates listed in your denial letter.
Failure to meet a deadline is a sure way to sink your claim. Use this time to gather evidence!
What the insurance company may not tell you is that the internal appeal is your last opportunity to add evidence of your disability to the official record.
If you miss the deadline to file your appeal, your best evidence will not be allowed in court.
2. Get a Copy of The Insurance File
So, what exactly are you trying to prove to your LTD insurance company?
That’s an important question and one not completely answered in your denial letter.
The denial letter will tell you some reasons why your claim was denied but won’t get into specifics.
To get the full story, you’ll need to get a copy of your administrative file.
The insurance company’s administrative file contains detailed information about why your claim was denied.
In it, you will find the actual reports from their reviewing doctors explaining exactly why they don’t believe you are disabled, as well as any surveillance or other information used to deny your claim.
Your LTD insurance company will not provide you with this file unless you ask!
Once you have it, however, you and your attorney are in the best position to support your claim with factual evidence by having your doctor(s) and specialists specifically address the issues cited in your claim denial.
3. Talk to Your Doctor About Your Disability Claim
Let your physician and specialists know that you are filing for long-term disability and that a doctor from your LTD insurance company may contact them.
Ask your doctor to write a letter describing your limitations in detail.
Also, ask for letters from any qualifying specialists such as your physical therapist.
Be sure that your medical record is complete and all the necessary tests, CT scans, MRIs, etc. have been done.
Review what your doctor said in the insurance company’s file. This may help you to understand why your claim was denied.
Discuss your findings with your doctor and have your doctor draft another letter responding to these issues.
Remember to always be honest with your doctor about how you feel, the level of pain you are experiencing, and the extent of your limitations.
Saying you feel “fine”, even if you’re having a “good day” is not helpful to your claim and does not give your doctor a full understanding of your disabling condition.
4. Know That You are Probably Going to be Under Surveillance
Be aware as you go about your daily activities like going to the grocery store or walking your dog.
The long-term disability insurance company will probably hire a private investigator to catch you doing activities that your disability should prevent you from doing.
If your disability claim was denied because you were caught on camera, you may want to consider hiring a local long-term disability attorney.
An experienced LTD lawyer will be in the best position to explain that the five minutes you were filmed having a “good day” are not indicative of your disability as a whole.
Also, be aware that your social media accounts will probably be monitored as well.
Until your claim is settled, you should refrain from posting pictures that make you look non-disabled or portray you doing non-disabled activities.
Depending on the circumstance, it can sometimes be difficult to prove that an old photo isn’t recent.
Because comments about your disability may be taken out of context, all correspondence about your limitations should only be between you and your doctor.
5. Talk to an Experienced Local Attorney
Although you can appeal your long-term disability claim denial on your own, be aware that the deck is stacked against you.
The big insurance companies have very deep pockets and can afford to hire teams of experts, doctors, and outside counsel to go against you, an individual.
They use the fact that you may be vulnerable due to an illness or injury to their advantage, hoping that you will give up and accept their denial.
If your LTD insurance claim is denied, you should contact a local attorney as soon as possible.
Working with an experienced attorney familiar with LTD rules and procedures will give you the best chance to win your appeal and secure the long-term disability benefits you deserve.