Long-Term Disability Benefits: Important Info You Need to Know

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Long-term disability (LTD) insurance is a specific type of insurance policy that pays a percentage of your salary in cash benefits. These benefits are typically accessible if you are unable to work due to a disability. While each disability benefits plan is different, in order to be eligible for long-term disability benefits, you must generally meet the following requirements:

  1. have a covered disability under the terms of your policy; and
  2. be unable to work because of that disability.

Applying for Disability Benefits

Applying for long-term disability benefits can be challenging. Even if you were already approved for short-term disability, you will likely need to file a separate application for LTD benefits.

The first step in the application process generally involves reviewing your disability benefits insurance policy to determine what is considered a disability and what may be excluded. For example, many LTD policies exclude pre-existing conditions. In addition, you will need to determine whether your policy requires that you cannot work in “any” occupation or just in your “own” occupation.

The second step involves you requesting an application from your company’s human resources (HR) department or through an online portal.

Please note that, even though your company’s HR team can be a source of information, they are not a viable substitute for an experienced and knowledgeable ERISA disability benefits attorney. Why? Because only an attorney can properly advise you of your legal rights and develop a strategy to increase the likelihood of your disability benefits claim being approved.

As part of the application, you will need to provide an employee statement that describes your work history, educational background, and information about your disability. Your employer will also have to submit certain information, such as your hire date, job description, and job requirements. You will also typically have to sign an authorization that will allow the insurance company to request your medical records to determine your eligibility for benefits.

Denial of Disability Benefits Application

The LTD claim process is filled with potential pitfalls. An insurance company may deny an application for benefits for several reasons, including:

  • Insufficient medical evidence
  • Pre-existing medical conditions
  • Changed definition of disability after 24 months
  • Failure to meet the definition of disability under the plan
  • Missed deadlines
  • Paperwork errors
  • Other evidence that undermines your claim (which may come from an investigation into you or even your own social media posts)
  • Conflicting medical assessments

Speak to an Experienced LTD Benefits Lawyer

If you need assistance applying for LTD benefits, or your application was denied, then now is the time to speak to an experienced long-term disability benefits lawyer. They can assist you in putting together the appropriate supporting evidence and advise you on what you may need to do – or not do –  for your claim to be approved. If your claim is denied, they can help you understand the appeals process. This typically includes a requirement to file one or two administrative appeals before moving forward with a federal lawsuit.

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