A nurse whose medical condition prevents them from working long shifts on their feet may still be able to perform sedentary work. A skilled tradesperson who can no longer lift, carry, climb, or safely operate equipment might theoretically be able to perform another type of job. For disability insurance purposes, that distinction can determine whether benefits continue or stop.
The Milwaukee disability lawyers at Hawks Quindel, S.C. help workers understand how their disability policy defines their ability to work and challenge insurance companies when valid claims are denied or terminated.
For Milwaukee County workers in manufacturing, healthcare, skilled trades, public employment, and other demanding careers, the difference between being unable to perform your own occupation and being unable to perform any occupation can become one of the most important issues in a long-term disability claim.
Reach out to our Milwaukee disability team to learn more about your unique circumstances and which benefits may be available to help you through this challenging time. Call our Milwaukee office today at (414) 271-8650 for a free case screening.
Securing Disability Benefits Rightfully Owed to Wisconsin Workers
Why Choose Hawks Quindel, S.C. for a Milwaukee Disability Insurance Claim?
Founded in 1959, Hawks Quindel, S.C. has represented Wisconsin workers for more than 60 years. Our team includes more than 30 attorneys, allowing lawyers in different worker-side practice areas to coordinate when disability insurance overlaps with another claim or workplace issue. We represent individuals seeking benefits—not insurance companies or employers.
Attorney Tim Maynard handles disability matters for Hawks Quindel, S.C. in Milwaukee. His practice includes short- and long-term disability claims, and he is recognized as a Super Lawyers Rising Star, is a member of the National Employment Lawyers Association, and is top-rated on Avvo.
Our approach begins with the policy. We determine what the insurer requires you to prove, examine the medical and occupational evidence, identify weaknesses in a denial, and prepare the claim or appeal around the issues that actually control eligibility.
Disability insurance claims require more than proof that you have been diagnosed with a medical condition. The evidence must establish how your limitations satisfy the definition of disability in your particular policy. We know how to gather that evidence and present a strong claim on behalf of our clients.
How Does Employer Disability Insurance Work?
Many Milwaukee-area workers receive disability insurance through employee benefit packages. This is common across large manufacturing operations, health systems, skilled trades, professional workplaces, and other major employers throughout Milwaukee County and the North Shore.
If you have employer-provided disability insurance, the plan documents—not an informal explanation from HR—establish your rights under the plan.
Those documents address issues such as the definition of disability, the amount of income the policy replaces, how long benefits can continue, exclusions and limitations, claim procedures, and appeal requirements.
Many policies begin with an own-occupation definition and later change to a more demanding any-occupation standard. If your insurer is approaching that transition or has already used it to terminate your benefits, we can help you learn more about Own Occupation vs. Any Occupation Disability Benefits and explain your options.
There is also an important distinction between the claims discussed here and Social Security Disability. This page focuses on employer-provided and privately purchased disability insurance, long-term disability denials, and ERISA appeals. If you need SSDI or SSI benefits from the federal government, visit our Milwaukee Social Security Disability Lawyers page instead.
Hear From Our Clients
“happy with our settlement”
Bill Parsons and Brook Tylka and the rest of the staff from Hawks Quindel were very helpful with our case. They kept me up to date on the progress of my claim from the very beginning. After our first conciliation, we felt very confident we had the right attorney to...
“a practice someone can trust”
Hawks and Quindel are an amazing law firm to deal with. It’s a scary time and everyone there puts you at rest that they have your best interest at heart. They never make you feel like you are bothering them and they kept me in the loop with answers before...
“thoroughness, patience, and insight”
I can’t praise Aaron Halstead and Connor Clegg enough for their work on my legal matter. I especially appreciated their thoroughness, patience, and insight. They were always responsive to my questions. They helped me navigate a challenging workplace issue and obtain a good outcome. I would and do recommend them.
“highly recommend seeking the services of this firm”
During this very difficult time, the staff at Hawks and Quindel kept me reassured and informed every step of the way. I had the pleasure of working with Attorneys Jessa Victor and Brook Tylka. Jessa, Brook, Matt, and Hadley, thank you for all of your hard work, professionalism and compassion!...
“my case was won”
From our first phone call with Donnie Malchow, we knew we'd found the right person to help us. I had filed for disability and been denied. He was willing to walk beside us and thoroughly explain the entire process (lasted over a year and a half) and expectations (gave us...
“I would wholeheartedly recommend HQ”
I had another law firm representing me on a non-compete, and when it became clear that I needed new representation, I reached out to Hawks Quindel. Aaron Bibb took my case and he represented me extremely well to an agreeable resolution of the case, and costs were extremely reasonable and...
“went above and beyond”
Attorney Halstead and his team went above and beyond to not only win my case, but because of certain circumstances I had going on, they did everything they could to help and rush the settlement through. They were always quick at responding to emails and phone calls with questions I...
“I highly suggest this firm”
I can't imagine using any other firm after having Hawks Quindel, they were so knowledgeable and experienced but yet so down to earth to talk with. They kept me informed every step of the way and always answered when I had a question. What a staff, so many great people,...
“empathy, intelligence, and professionalism”
I reside in New Mexico but drove a semi-truck coast to coast for an unscrupulous trucking company out of Wisconsin. This logistics company harassed, bullied lied and discriminated against me, keeping my earned wages, and leaving me in a financial hole. Devastated I called and left a message for the...
“people treat you like family”
Top notch law firm Jacob and Natalie were my 2 attorneys that represented me on both of my cases? They did a fantastic job. Speaking up for me as they do for thousands of people and especially the little guys down-to-earth, people treat you like family, these people are godsons.
“Way beyond my expectations”
Many thanks from my family to all of you at the firm!!! Hawks Quindel, S.C. is the only place I would consider for LTD, disability, SSDI, ERISA, EEOC, DRoW legal help!! Jessa Victor and her team got me all the answers and results when I didn't think it was possible!!!...
“His team were patient and professional”
I had the pleasure of being represented by Aaron N. Halstead, Shareholder, on my discrimination case. His team were patient and professional. I would highly recommend this firm for the professionalism and efficiency for working through my case.
“If there were 10 stars”
If there were 10 stars I would give them that. There are not enough words to express my gratitude for Aaron, Ben and their team. I felt strong with them behind me. Exceeded expectations is an understatement.
“wonderful to work with”
I had mauve she was wonderful to work with! She helped me with my long battle to get SSI and SSDI. Which thankfully I now have! She's a delight and really helps boost anyone's confidents.
“Extremely knowledgeable”
I had an incredible experience regarding my workers compensation case with Jakob Feltham! It was my first workers compensation case (*or first case ever), and I didn't know anything about the legalities surrounding my issue, or what I was entitled to? Jake Feltham had ALL my answers, and made it...
“I’m happy with the work they did”
They were extremely responsive and good at communication throughout the process. They were accommodating of my disability and explained things well, taking time to answer all my questions. I'm happy with the work they did. Felt like I really had people on my side during a confusing and difficult time.
“consistently responsive and professional”
My recent experience with Hawk Quindel, and in particular with John Leppanen in the Milwaukee office. He, was extremely valuable. The support/intake staff responded quickly to my initial inquiry, and John was responsive and made time soon after our initial contact to begin work on my case. John was able...
“the best lawyers, trustworthy”
Excellent people, the best lawyers, trustworthy, always seeking the best results in the shortest possible time. I highly recommend them.
“Very Helpful”
Eze the intake coordinator was awesome, very helpful and connected me with the right people to help with my situation! Thank you Eze!
“Had My Back”
In 2010, I returned home from my second deployment. In 2012, I was told by the VA I couldn’t return to the job I was working at. It is now 2019, and through 7 years of needing legal representation, Hawks had my back through 3 separate issues: short term disability,...
“Best Decision”
I really don’t know how to put this in words to express how happy, satisfied, and really just overwhelmed with a sense of justice being handed out on my behalf. This big corporate work comp insurer treated me wrong, but before I decided to give up I contacted Hawks Quindel,...
“Highly Recommend”
The attorneys at Hawks Quindel worked tirelessly on my behalf. They were transparent at every step of the way, and answered any questions I had directly and in ways that someone without a legal background could easily understand. Although I would highly recommend them to anyone who is potentially facing...
Does Your Employer Decide Whether You Receive Disability Benefits?
Frequently, no. An insurance company or plan administrator evaluates the claim and determines whether the evidence satisfies the policy.
Your employer's human resources department can provide information about your benefits, but HR does not replace the policy and should not be treated as the final authority on what the plan covers.
This distinction becomes especially important after a denial. Before assuming HR's explanation is correct—or that an insurer's decision is final—we can review the actual plan documents and denial letter to build a strong response and protect your rights.
Why Are Long-Term Disability Claims Denied?
An insurance company can agree that you have a medical condition while disputing whether it prevents you from working under the policy's definition of disability. Denials frequently depend on questions such as whether the medical evidence adequately documents functional restrictions, whether the insurer believes the employee can perform their occupation, or whether a policy limitation or exclusion applies.
An insurer may also rely on a medical review conducted by a physician who did not treat you, surveillance or other information about your activities, or a vocational analysis identifying work it believes you can perform. A denial letter should explain the basis for the decision. That explanation gives us a starting point for the appeal.
The right response is not simply to submit the same records again and ask the insurer to reconsider. A strong appeal identifies the reason for denial and develops evidence that addresses it directly.
How Long Do You Have to Appeal an ERISA Disability Denial?
The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that governs many employer-sponsored disability benefit plans and sets the rules for how claims and appeals must be handled. A claimant generally has 180 days to appeal a long-term disability denial under an ERISA-governed plan.
ERISA generally requires claimants to complete the plan's administrative appeal process before pursuing a claim for denied benefits in federal court. Missing a required appeal deadline can prevent you from taking the claim to court.
The 180-day period is not simply a filing window. It is the time available to investigate the denial and build the administrative record, including:
- Obtaining and reviewing the insurer's complete claim file.
- Gathering updated medical records and detailed treating-provider opinions.
- Developing functional or vocational evidence that responds to the insurer's reasons for denial.
Waiting until the deadline is approaching can leave too little time to develop this evidence properly. If you have received an LTD denial, contact our disability attorneys promptly rather than treating the 180-day deadline as time you can afford to lose.
Why Is the Administrative Appeal So Important?
An ERISA appeal is not just an informal request for a second opinion. It can determine the evidence available if the dispute eventually reaches federal court.
A concrete first step is to obtain the insurer's claim file and compare it with the denial letter and the policy. The file can show which medical records the insurer reviewed, what its medical consultants concluded, which occupational information it considered, and what evidence influenced the decision. Our attorneys can then identify what the record lacks.
For example, a physician's note stating only that a patient "cannot work" may be less useful than a detailed explanation of how long the person can sit, stand, walk, concentrate, use their hands, lift heavy objects, or sustain activity throughout a workday. Those restrictions can then be compared with the actual demands of the occupation.
The administrative appeal is the opportunity to put that evidence into the record—not merely argue that the insurer reached the wrong conclusion.
Is Your Disability Plan Governed by ERISA?
ERISA governs many employer-sponsored disability plans, but it does not apply to every policy. Governmental plans and qualifying church plans are exempt. Disability insurance purchased individually rather than through an employer is also ordinarily outside ERISA.
The distinction matters because ERISA and non-ERISA claims follow different legal rules and can provide different remedies when benefits are wrongfully denied.
Milwaukee County includes substantial private-sector and public-sector workforces, so you should not assume that ERISA applies simply because your disability coverage is connected to your job. Our ERISA vs. Non-ERISA Benefits guide explains these differences in greater detail.
What Happens When the Definition of Disability Changes?
Some long-term disability policies initially pay benefits when a medical condition prevents you from performing your own occupation. After a specified period, the policy can switch to an any-occupation definition. That transition can prompt an insurer to take a fresh look at a claim it has already approved.
Consider a worker who spent decades in a physically demanding occupation. The medical evidence may clearly show that returning to that work is impossible. Under an any-occupation standard, however, the insurer can focus on whether the claimant has the physical capacity, education, experience, and transferable skills to perform another occupation that satisfies the policy. That makes vocational evidence increasingly important.
If you receive notice that the definition of disability is changing, do not wait for a termination letter to investigate what the new standard requires. Understanding the policy before the transition gives you an opportunity to address the evidence proactively.
Can an Insurer Terminate Benefits It Has Already Approved?
Yes. Long-term disability insurers can periodically request updated proof that a claimant continues to meet the policy's requirements.
A benefits termination can follow a change in the policy's disability definition, a medical review, new vocational findings, or an insurer's conclusion that the evidence no longer establishes the required limitations. Receiving benefits for months or years does not eliminate the need to continue documenting your condition.
If payments suddenly stop, we should promptly review the termination letter. An ERISA-governed termination can trigger the same administrative appeal requirements and strict deadlines that apply to an initial denial.
What If the Insurance Company Offers to Buy Out Your Disability Policy?
Some claimants who are already receiving LTD benefits are offered a lump sum in exchange for ending the insurer's future payment obligations. A disability contract buyout is different from simply receiving benefits early.
You are generally giving up future rights under the policy in exchange for a negotiated payment now. Evaluating the offer requires looking beyond the dollar amount to the value of future benefits, the duration of coverage, policy terms, possible offsets, and what rights the release requires you to surrender.
Do not assume the insurer's offer represents the full value of the remaining claim. Our guide to Long-Term Disability Settlements and Contract Buyouts explains the issues you should consider before accepting a lump-sum offer.
How Can Our Disability Attorneys in Milwaukee Help?
A disability insurance dispute can involve medical evidence, occupational analysis, contract language, federal benefits law, and procedural deadlines simultaneously. The attorneys at Hawks Quindel, S.C. help claimants determine what their policies require and build evidence around those requirements.
Depending on the stage of the claim, our work can involve:
- Reviewing plan documents
- Analyzing denial letters
- Obtaining claim files
- Developing medical and vocational evidence
- Preparing administrative appeals
- Negotiating appropriate disability settlements
- Pursuing litigation when necessary
Our Wisconsin disability lawyers also recognize when another benefit program creates an issue that should be coordinated with the disability claim.
Frequently Asked Questions About Milwaukee Disability Insurance Claims
Should I apply for long-term disability before my short-term benefits end?
You should review your LTD plan before short-term disability benefits expire. LTD policies can impose their own claim requirements and waiting periods, and beginning the process early can reduce the risk of an avoidable gap or missed requirement.
What if my doctor supports my disability claim, but the insurer still denies it?
A doctor's support does not require an insurer's approval of a claim. The medical evidence must demonstrate restrictions and limitations that satisfy the policy's definition of disability. An appeal should address why the insurer rejected or discounted the treating provider's evidence.
Can I receive Social Security Disability and private disability insurance at the same time?
Yes. A person can qualify for both, although an LTD policy can reduce its payment based on SSDI benefits. If your primary issue is applying for or appealing federal disability benefits, our Milwaukee Social Security Disability attorneys handle those claims.
Do I need an attorney before my disability insurance company makes a decision?
You do not have to wait for a denial to contact our team. We can become involved earlier when the policy is difficult to interpret, the insurer requests extensive documentation, an own-to-any-occupation transition is approaching, or another benefit program affects the disability claim.
Talk With the Milwaukee Disability Lawyers at Hawks Quindel, S.C. Today
A disability insurance policy is supposed to provide income protection when your health prevents you from continuing to work. When an insurer denies that protection, terminates benefits, or questions whether you remain disabled, the attorneys at Hawks Quindel, S.C. can help you understand the policy and determine what to do next.
Founded in 1959, our worker-side firm has spent more than 60 years advocating for Wisconsin workers and individuals. From our Milwaukee-area office in Glendale on the North Shore, our disability attorneys serve clients throughout Milwaukee County and southeastern Wisconsin.
Contact Hawks Quindel, S.C. at (414) 271-8650 or visit our office at 5150 N Port Washington Rd, Suite 243, Milwaukee, to begin the intake process and learn whether your matter qualifies for a free case screening.