We represent individuals with long-term disability claims through all stages of a claim for disability income benefits, which includes the disability application process, denial of disability benefits, appeals, legal actions to recover disability benefits and the negotiation of lump-sum policy buyouts for individuals that are currently being paid disability income benefits.
What is Long-Term Disability Insurance?
Long-Term disability insurance (often abbreviated to LTD coverage or LTD insurance) is meant to provide workers with a monthly benefit payment if an injury or illness keeps them from receiving a paycheck. The payments from an LTD policy are meant to serve as a safety net and cover essential living expenses for a period of time, known as the benefit period, that can vary by policy, but typically runs 2, 5, or 10 years, or until retirement age. These policies often have a waiting period which is the amount of time after getting coverage before an individual can file a claim. This type of insurance typically comes with an elimination period which is the amount of time between an injury and when a claim can begin being paid – these typically range from 30 days to two years, with three to six months being the average period length. A more extended period for elimination can lower the deductibles paid but may extend the amount of time it takes to collect insurance benefits.
What is the Difference Between Workers’ Compensation and Long-Term Disability Insurance?
Many people may confuse workers’ compensation claims with LTD claims. While there is some overlap in insurance coverage types, the primary difference is when the disability coverage kicks in. Workers’ compensation claims apply when someone is injured on the job, while LTD benefits begin whether someone is injured or becomes ill regardless of whether they are at work or not.
Different Types of Disability Insurance
There are several different types of long-term disability insurance claims that include group disability insurance, private disability insurance, and association disability insurance. Group long-term disability insurance is the most common type of disability insurance policy that people have. This type of insurance is provided through an employer along with other group benefits such as health insurance, life insurance, vacation packages, and retirement benefits. You can ask your human resources department about the LTD plans available through your company if you are unsure if you have coverage. If you do not have coverage through your employer, you can secure an individual policy that is paid for directly out of pocket. You can also look to purchasing a long-term disability plan through an association you may belong to.
Different long-term disability policies have various eligibility requirements such as preexisting conditions being exclusionary, full-time work requirements, requirements to file for Social Security Disability Insurance benefits (SSDI) when filling an LTD claim, and a requirement that you file for Workers’ Compensation along with your claim for disability insurance. Some policies are also known as “own occupation” policies which means you qualify for disability if you can no longer execute the duties of your own job, rather than “any occupation” policies which mean you are only disabled if you cannot execute the duties of any job that you are reasonably qualified for.
Do I Need a Lawyer for a Long-Term Disability Insurance Claim?
Navigating through the process of having a long-term disability claim approved can be daunting. It is quite common for valid disability insurance claims to be challenged by insurance companies. These insurers look at every disability claim with the ultimate goal of returning the disability claimant to work as soon as possible, with as little fair and just compensation as possible.
Regularly, disability companies will engage the services of their own physicians to review medical records and a disability claim file and render an opinion that a claimant is not disabled. Furthermore, different insurance policies may each have a different definition of disability which can be used to claim that you may only suffer from a partial disability that impacts your benefit when, in fact, you are entitled to maximum benefit payments.
Let us help you make sure that your claim is processed fairly, and for you to get what is rightfully yours. It is critical to speak with an attorney during the application process. Long-term disability policies are governed by a federal law called “ERISA”. Under ERISA, if a long-term disability claim is denied, you must file a lawsuit in federal court. The federal court will only consider evidence contained in the claim file. Thus, it is critical that the proper documentation is submitted to the insurance company prior to the denial of a claim. Otherwise, it will be difficult to reverse a denial at the federal court level.
If you are applying for long-term disability benefits, contact the attorneys at Dross Berman LLC for a free consultation to better understand your rights.