Frequently Asked Questions

If you aren’t sure whether or not you need a lawyer, or even if you’re pretty sure you can handle it on your own, I encourage you to give our office a call and we’ll set up a free initial case review. At BenGlassLaw, we ONLY accept cases if we are confident we can add value and will never pressure you to hire us if we don’t think you need to.

A big determining factor in whether or not you need a personal injury attorney for your situation is the severity of your injuries. If you’ve only suffered minor injuries, your accident case probably won’t be worth more than a few thousand dollars. 

We have plenty of resources to help you handle a case on your own or decide if our team is the right fit for you: 

• How to Settle a Car Accident Claim Without a Lawyer
• The Essential Duties of A Car Accident Lawyer

After being injured in an accident that wasn’t your fault, your focus should be on recovery and not on figuring out how your medical treatment is going to be paid.

In Virginia, the answer depends on factors like the type of accident that caused your injuries (a car accident, dog bite, slip and fall, etc.), as well as your health insurance, MedPay coverage, and who was at fault. 

Virginia’s contributory negligence laws can bar you from receiving compensation if you’re even 1% at fault. Understanding insurance and how the accident happened is key. Having an experienced personal injury attorney on your side can help navigate this process.

Read more about how medical bills are paid after car accidents here.

Since 1995, Allstate insurance company has been sending a letter to people injured by its policy holders.

The letter, entitled “Do I Need an Attorney?”, makes the following claims:

• Claims are settled faster when a lawyer is not involved.
• Lawyers charge a percentage of the recovery plus expenses, but if you settle with Allstate you keep the entire amount.
• Victims can hire a lawyer at a later date if they are not satisfied with Allstate’s offer to settle your case.
• Victims can negotiate a settlement with Allstate first, then hire an attorney and insist his fee be based only on the amount recovered above the Allstate offer.

Make no mistake about it, Allstate is not looking out for your interests.  The insurance industry’s own statistics demonstrate that it costs the insurance company an average of $9,000 more per claim when an attorney is involved for the injured person.  The truth is that you should never settle a personal injury claim without consulting with an attorney.  We never charge a fee for meeting with injured people and answering all of their questions in order that they can make a fully informed decision as to whether to hire an attorney who will be looking out for their rights.

No insurance company is going to spend the time to discuss with you, in an unbiased fashion, the following topics:

• The reasonable value of your case when compared to similar cases.
• Why delaying the settlement of your case is sometimes in your best interests.
• The availability of other types of insurance payments to pay your bills, including medical payments, health insurance, worker’s compensation, and the relationship between each.

Allstate’s letter does not tell you that in some instances, you must pay a portion of what you get from Allstate back to another insurance company. Nor would you be advised by Allstate’s letter that some of these additional sources of funds require you to give prompt notice of the claim to the entity involved. Whether you should seek additional medical care and what medical specialist might have insight into your particular problem. Time and time again we have heard from clients that insurance adjusters tried to make them believe that it was the insurance company’s decision as to whether you should see a medical specialist. How your settlement with the insurance company may affect other claims arising out of the accident, including medical malpractice claims and claims against other defendants. Release of your automobile accident claim may be argued to be a release of a doctor’s negligence, even thought the doctor does not operate on until much later. Whether you should, as Allstate will request, give authorization to the insurance company to obtain all of your medical records and wage information. Do you even know what is in those records? Irrelevant entries in medical charts may be used against you if the case does not settle.

You may hire a personal injury lawyer at any time. That’s your right. But there are points in the accident case settlement process where a lawyer may not have the legal ability to help you. 

There are two points in the accident case process where everyone, lawyers included, are pretty powerless to do anything. The first is when the statute of limitations runs out. For Virginia, that’s two years.  If you’ve waited that long, even the best Fairfax personal injury lawyer may not be able to help you obtain a settlement. 

The next event that may reduce a lawyer’s ability to assist you is when you’ve already signed the settlement release. In a typical settlement release, the fine print prohibits you from taking any further legal action against the insurance company or the defendant. 

If you sign the release and incur additional medical expenses that were not accounted for in the settlement, you typically have no legal recourse to file an additional claim. 

However, I’m going to go ahead and say it doesn’t hurt to ask an attorney for help if you’re facing these or any other situations throughout your accident case. Sometimes, when you’re settling your case on your own it’s best to get a definite ‘yes’ or ‘no’ when you have questions about your case, and lawyers like me can provide that advice. 

No decent injury attorney will turn a potential client away without offering an opinion or guidance on an accident case. Whether you’ve just been in the accident and have yet to take action or you’re nearing settlement, it never hurts to seek the opinion of someone who’s dealt with cases such as yours.

A notice of dismissal without prejudice means that you can refile your case if you act within certain time deadlines. Generally, if you have not already filed a similar “notice of dismissal” in your case before, (also known as a “non-suit”), you will have 6 months within which to refile your case.

This can be tricky, however, and you should promptly consult with an experienced attorney in your area if you are in this situation.

Insurance companies live on a different timeframe than the insured. Sometimes, they will rush you to settle. Or, they are making you wait for your settlement. Both of these games are tactics to either settle your claim before you hire an attorney, or to make you wait so you will accept their first offer.

The insurer is fully aware that you are in a financial bind and that you have medical bills piling up, while at the same time you are unable to work. They know that you need the money and the longer they delay your claim, the better the odds that you will accept a low settlement.

Of course, delays are not always “tactics.” Insurance companies are large corporations with many different levels of management. You may just be waiting for the insurance company to make their decision on a complicated claim, and it is taking some time.

Keep in mind, you have two years from the date of your accident to file a personal injury claim. Typically, we recommend completing your medical treatment before settling with the insurance company. During that time, you will be responsible for paying your medical bills, so be sure to submit any claims to your health insurance company. You can also make arrangements with the hospital to make monthly payments on your medical bills until you have your settlement from the insurance company.

If your health insurance is paying your medical bills, check your health insurance contract for a subrogation clause. Some health insurance policies require you to pay back the health insurance company for your medical bills once you reach a settlement for your car accident.

Finally, car accident claims can take a long time. It may be months or years before your claim is settled by the insurance company. Some cases will go to trial, so you should be prepared to wait on your settlement

If your claim is being ignored or delayed, consult with a personal injury attorney. Most attorney consultations are free, and the attorney will let you know if your case is simple and straightforward, or complicated enough to require an attorney.

If you’ve been injured as a result of someone else’s negligence, you’re entitled to compensation for the losses you’ve suffered. In other words, the personal injury claim is meant to “make you whole,” balancing out what’s been taken from you. Potential damages include:

• Medical expenses (including those you’ll likely need in the future, such as ongoing physical therapy)
• Lost wages (including future lost wages and reduced earning capacity—for example, if you have to switch to fewer hours or lower-paying work)
• Reasonable compensation for non-economic losses, such as pain and suffering, emotional trauma, disfigurement, or loss of relationship with a loved one.

In rare cases, you could also receive punitive damages above and beyond the damages meant to compensate you for losses. These might be in play if the responsible party acted with extreme recklessness or malice—think drunk driving or excessive speeding.

Before you and your attorney appeal an ERISA disability claim, you need to gather documents from: 

Your employer. Often claims are denied because there is a dispute over whether you can perform your job duties with your disability. It is helpful to have a description of your job provided by your employer that you can review and compare to the description of your duties in your disability claim. “Sedentary” jobs are notorious for generating disability denials, but “sedentary” may not cover the full scope of your duties. 

Your doctor. How your doctor interprets your disability and your ability to work is critical for your appeal. You probably already have your doctor’s support, but the insurance company may disregard or overlook your doctor’s input on your disabling condition. 

Your disability insurance provider. Most people don’t know this, but you can and SHOULD request your claim file from your insurance company. You should know and understand why the insurance company denied you, and you will want to review their “evidence” about your claim. Bring this with you when you meet an attorney. It will help the attorney understand why you were really denied when reviewing your claim. 

If you are thinking about filing for short-term disability benefits: 

We should talk about that before you stop working. This is especially true if you are not a traditional W-2 employee, for example if you: 

• Own a business 
• Make money on commission 
• Are a health care provider 
• Are a C-Suite professional 

This is why we offer paid consultations with our highly experienced disability attorneys. We will review your disability policy, talk about your medical issues and chat about your job or occupation. You will walk away from that call or meeting with a definite plan of action. If you pay us a consultation fee and later hire us to handle an appeal, your consulting fee is credited against any future fees that we earn.

If you are on claim and have questions, but we don’t currently represent you: 

You have two choices: 

• Have a short, free call with one of our non-attorney disability specialists. They are often able to get your questions answered about processes and procedures. They do not give legal advice. 
• Schedule a paid consultation with Damon Miller or Ben Glass (contact us and we’ll set this up for you).

If your claim has been denied: 

Send us your denial letter as soon as you get it. We will review it and give you a detailed strategy for moving forward. This service is free, but you must act promptly. The insurance company only gives you a limited time to appeal or their decision is permanent. Upload your denial letter securely here or email it directly to our team at disability@benglasslaw.com.

When disability insurance benefits are denied, the insurance company has to tell you WHY. Then you can appeal their decision, giving your reasons and supporting evidence for why they are wrong. When they evaluate your appeal, they are supposed to – by law – only consider the original reason they had for denying your claim and your arguments against that. If they decide you are right, you win – that’s the law.

Unfortunately, whether insurance company appeals managers don’t know the law or don’t care, sometimes they will do something incredibly frustrating – they will say “okay, you were right about ABC. But now your claim is denied because of XYZ.” This is called “changing the reason for the denial.” It is against the law, and it happens all the time. When it does happen, your only recourse is to file a lawsuit. This is why we say you MUST have an experienced attorney who understands disability insurance law (called ERISA) on your side from Day 1.

We have a client who was injured in an auto accident that left him with traumatic brain injury and a host of problems associated with that. He had a disability insurance policy with his employer, and the policy paid benefits for many years. One day, out of the blue, he got a letter from the insurance company (let’s call them Aetna) saying that his benefits were denied because his medical records showed he was disabled due to Chronic Pain Syndrome, and his policy limits coverage for Chronic Pain Syndrome to two years – which had long since passed. We appealed, submitting letters from his doctors and medical records showing that Chronic Pain Syndrome was just ONE of the effects that lingered after the car accident – and his true disabling condition was Traumatic Brain Injury (which had no coverage limitations). The insurance company denied the appeal, but not because they disagreed about the Traumatic Brain Injury diagnosis. They denied the appeal because they said they reviewed the records again and found that actually, he was not disabled at all!

This is an insurance company that simply got tired of paying the claim. Of course, that’s not allowed, but it happens all the time. We have filed a lawsuit, and we are confident we will win (judges do NOT like to see this kind of monkey business from insurance companies).

For a deeper dive, here’s the case law supporting the “no new reason for the denial” rule:

When an insurer changes the basis for its denial during the appeal process – whether during the administrative review or judicial review – that opportunity is lost. See Thompson v. Life Ins. Co. of N. America, 30 Fed. Appx. 160, 163 64, 2002 U.S. App. LEXIS 3390 (4th Cir. 2002) (unpublished) (remanding to the district court where insurance company changed the reason for its denial of benefits during judicial appeal because allowing insurer “to raise a new basis for denial would deprive (the claimant] of the procedural fairness guaranteed to claimants under ERISA”). Also Glista v. Unum Life Ins. Co. of America, 378 F.3d 113, 130 (1st Cir. 2004) (remanding to the district court with instructions that the insurer be held to the reason articulated during its internal claims review process since the insurer “violated ERISA and its regulations by relying on a reason in court that had not been articulated to the claimant during its internal review”).

This is a question I hear, or a fact pattern I see, all the time. An award of social security disability (or SSD) benefits ALWAYS has an impact on your LTD claim. Allow me to explain the two ways in which it can affect your claim:

At a very basic level, winning SSD benefits is a sort of verification of your status as disabled. It is another independent organization concluding that you are, in fact, disabled. This doesn’t mean your LTD claim is safe, or will never be rejected/denied. Insurers love to overlook SSD awards. But it IS proof that another entity felt the evidence indicated disability. Obviously, SSD and your insurer use different standards in judging disability. However, by operation of law in many cases, your insurer cannot arbitrarily disregard the fact that you have been awarded SSD benefits. This is a good thing.

On a financial level, it has serious implications for your LTD claim. The VAST MAJORITY of disability insurance policies have “offsetting income” provisions (or the like). These provisions state that income from certain other sources offsets what your insurer pays you. SSD income is ALWAYS specified. What happens is best explained by example. Say AETNA/Hartford/UNUM/etc are paying you $2,000.00/month BEFORE you get SSD. All of a sudden, you get a letter from SSD saying you have been awarded benefits in the amount of $1,000.00/month going back 6 months. They pay you $6,000.00 (for the past 6 months), and they say you will get a check monthly for $1,000.00.

By the contract with your insurer, your insurer will now pay you $1,000.00/month ($2,000 – $1,000 = $1,000). This is good for many reasons. Most importantly, it diversifies your income and protects you in the event that one of your benefits is cut off. However, what about the fact that you were awarded “back-benefits” for the past 6 months?

You will owe that money back to your insurer. The award of back benefits means your insurer should have been paying you $1,000.00 less each month for the past 6 months. They will want that money back (when they realize it).

Which brings me to the advice: When you receive an award of SSD benefits, DON’T SPEND THAT CHECK!!! It is highly likely you will owe the majority of it, if not the entirety of it, back to your LTD insurer. Spend it, and the trouble starts.

Of course, in such a circumstance, speak with an attorney. Like I said, I see this issue all the time. I know how to negotiate a “repayment of overpayment” agreement that serves to help keep you on claim.

About once a month we get contacted by an employee who is out of disability but is being offered a severance package to leave the company. The question arises: what about my disability claim with the company’s disability insurance company?

The answer is that your disability claim may well end with the signing of the agreement if you are not careful. It does not have to be that way.

In almost every situation your disability claim is being managed by a big insurance company. (Aetna, Unum, MetLife.) What we see happening is that your employer’s corporate lawyers draft boilerplate severance agreements which purport to extinguish “all claims” you may have against the company.

Whether or not your employer INTENDS to extinguish your disability claim, you can bet that the disability insurance company’s lawyers (different from your company’s lawyers and, frankly, with no allegiance to your employer at all) will argue that your disability claim is over.

Here’s the consumer tip:

Just call us. We’d be happy to review your severance agreement and give you the right advice – for a flat fee. 

You have run into two major problems with these group long term disability insurance policies. First, you discovered that yes, most require a repayment if you are later awarded social security disability benefits. Yes, you will likely have to repay your disability company, even though they have now terminated your benefits!

The second major discovery you made is that these companies that the disability insurance company send you to for a “free” representation in your social security disability claim are working for two “masters,” you and the company that hired them. Unfortunately, we’ve seen a lot of dubious practices carried about by these “we’ll get your social security benefits for free” companies the disability companies send people to.

So, unfortunately, you have seen the worst of these disability companies. Benefit denial followed by a request that “you pay us back out of your social security benefits.”

Each contract is different, and you should consult with an experienced disability company in your area to see what you can do about your benefits.

When your long-term disability insurance has been denied, you almost always have the option to appeal the decision. But it’s crucially important that you get it right—because it may be your only chance and there’s a deadline to do so.

We understand the intense pressure to act quickly, but firing off a quick “I appeal” letter is about the worst thing you can do for your long-term disability claim.

The most important next steps are to:

1. Read the denial letter very carefully
2. Plan your appeal
3. Write an appeal letter that connects all the dots

We always urge anyone who’s been denied their long-term disability benefits to consult with an experienced long-term disability lawyer like our team here at BenGlassLaw. Our consultations are free and we offer a free denial letter review where our experienced team will deny your letter and give you personalized feedback for your next steps.

Read more about your next steps here.

The reality is that insurance companies regularly and wrongfully deny short-term and long-term disability claims for many different reasons. But that’s where our team at BenGlassLaw can help you.

We’ve been doing this since 1995 and the most common reasons for denial that we see are:

1. You don’t file your claim on time
2. Poor documentation
3. The pre-existing condition exclusion
4. Your doctor doesn’t support your claim
5. Social Media
6. Your employer purchased a mediocre long-term disability policy
7. You weren’t kind to the claim’s adjuster

If you’ve been denied, use our free denial letter review service or contact us for a free consultation.

There are certainly some advantages to hiring an experienced long-term disability lawyer near where you live, although the reality is that ERISA long-term disability is a niche legal practice, so the odds of finding a highly experienced attorney for your case can be more rare.

The good news is that, due to ERISA regulations, you don’t actually have to live physically close to your attorney to hire them, or for them to represent you in court! When you’re starting your search for a long-term disability lawyer, you should focus on their experience and if they’re a good fit for you, rather than their locality.

Although our team is based in Northern Virginia and files more long-term disability appeals and lawsuits than any other firm in the Mid-Atlantic Region of the US (Source: Pacer, the official government site for Federal Court lawsuits), our team has won benefits for people all across the United States since 1995.

If you’ve been denied your benefits, call us for a free consultation or upload your denial letter to our free denial letter review service.

Before you and your attorney appeal an ERISA disability claim, you need to gather documents from: 

Your employer. Often claims are denied because there is a dispute over whether you can perform your job duties with your disability. It is helpful to have a description of your job provided by your employer that you can review and compare to the description of your duties in your disability claim. “Sedentary” jobs are notorious for generating disability denials, but “sedentary” may not cover the full scope of your duties. 

Your doctor. How your doctor interprets your disability and your ability to work is critical for your appeal. You probably already have your doctor’s support, but the insurance company may disregard or overlook your doctor’s input on your disabling condition. 

Your disability insurance provider. Most people don’t know this, but you can and SHOULD request your claim file from your insurance company. You should know and understand why the insurance company denied you, and you will want to review their “evidence” about your claim. Bring this with you when you meet an attorney. It will help the attorney understand why you were really denied when reviewing your claim. 

If you are thinking about filing for short-term disability benefits: 

We should talk about that before you stop working. This is especially true if you are not a traditional W-2 employee, for example if you: 

• Own a business 
• Make money on commission 
• Are a health care provider 
• Are a C-Suite professional 

This is why we offer paid consultations with our highly experienced disability attorneys. We will review your disability policy, talk about your medical issues and chat about your job or occupation. You will walk away from that call or meeting with a definite plan of action. If you pay us a consultation fee and later hire us to handle an appeal, your consulting fee is credited against any future fees that we earn.

If you are on claim and have questions, but we don’t currently represent you: 

You have two choices: 

• Have a short, free call with one of our non-attorney disability specialists. They are often able to get your questions answered about processes and procedures. They do not give legal advice. 
• Schedule a paid consultation with Damon Miller or Ben Glass (contact us and we’ll set this up for you).

If your claim has been denied: 

Send us your denial letter as soon as you get it. We will review it and give you a detailed strategy for moving forward. This service is free, but you must act promptly. The insurance company only gives you a limited time to appeal or their decision is permanent. Upload your denial letter securely here or email it directly to our team at disability@benglasslaw.com.