Long Term Disability Frequently Asked Questions

Disability insurance provides an injured or sick worker income replacement while they are out of work. The amount of income replacement workers receive will vary. Depending on the policy, you may receive partial or full income replacement. It is very common for short term disability policies to pay a greater percentage of your income than long term disability insurance policies.  Most Group Long Term Disability Plans pay 60% of a person’s pre-disability earnings (sometimes those benefits are taxable, and sometimes they are not).

It is a fact of life that some injuries and illnesses last longer than others. Long-lasting injuries and illnesses will affect a worker’s ability to work in the long term. Long term disability insurance provides income replacement for this extended period of time.

Disability insurance policies will differ. Determining how long you can expect to receive long term income replacement will depend on your policy.

One significant difference between short-term vs. long term disability is the length of time a condition lasts. Certain injuries, like a broken limb for instance, take a relatively shorter time to heal. Once a worker recovers, they can resume their duties at work. In the meantime, a worker may receive short-term disability benefits to make up the loss in income. These benefits can last anywhere from 3 months to 1 year, depending on the injury.

Other conditions, like arthritis for example, will not heal in a definite period of time. Some conditions will never go away completely. This means that a worker will be unable to perform his or her job duties for an extended or indefinite period of time. If you have a private disability policy or an employer-sponsored group long term disability insurance, you will apply for the LTD benefits while your short term benefits are being paid. In these cases, you  should seek out a long term disability attorney to help recover long term disability benefits. Long-term disability benefits may last anywhere from 1 year to decades, and usually pay until your regular retirement age.

Unlike short-term disability benefits, long term disability claims take longer to process. Workers who file a short-term disability claim will have a brief wait period, called an elimination period.

Workers who file for long term disability benefits will wait out a longer elimination period. This can last anywhere from 3 to 9 months, and the elimination for group long term disability plans is the same period of time that an employer’s short term disability benefits pay

For this reason, you should check to see whether you qualify for both kinds of policies. In some cases, workers can receive short-term benefits while they await a decision on their long term disability claim. You should also work closely with a disability lawyer when filing for long term benefits. Having your claim denied after waiting so long may be disastrous to your finances.

So, what exactly should you do if your claim gets denied? Fortunately, a denial does not mean the end of the world. If you are making a claim under your employer’s group disability plan, you will have the option to appeal the insurance company’s denial. Many appeals result in winning the benefits previously denied. The disability lawyers at Tucker Disability Law encourage you to seek help to do this, however. The appeals process is just as difficult as the initial filing process, but it actually has more technical and has more legal traps. For example, there are requirements to get expert reports submitted during the appeal, and if you fail to do that, you will never be able to introduce those expert opinions in court if your appeal is denied.  Working with a disability attorney is your best bet for successfully appealing a denial.

ERISA is a federal law which governs employee  benefits that were obtained through an employer group plan. Whether you pay for the coverage or your employer give it to you, ERISA applies to most group benefit plans.  ERISA affords you some protections, but also imposes some technical limits and rules on you.

When filing for long term disability benefits, it is extremely important to know whether your policy is subject to ERISA. Disability policies that are subject to ERISA undergo a specific form of litigation that is distinct from state-sanctioned litigation. Because ERISA is a federal law, ERISA disability claims are litigated in the federal court system. Additionally, a policy that is subject to ERISA will also have a specific appeals process. This appeals process prohibits introducing new evidence after a denial. For these reasons, it is important to work with an ERISA attorney to secure your benefits.

While unfortunate, it is not uncommon for an insurance company to delay their decision on a claim. This often leads to the insurance company breaching the deadline required of them. In such instances, filing a lawsuit is not only possible, but encouraged. This is because a lawsuit may change the standards a court applies to your case. In many cases, this creates an advantage for claimants.

Those attempting to secure their disability benefits face a tough battle. The process is difficult, and insurance companies will do their best to deny you coverage. Even when a claim is approved, a worker may still see their benefits reduced or terminated. In most cases, it is in your best interest to hire a disability lawyer who can navigate these pitfalls.

If you are currently unable to work because of a health condition, then you may be wondering how you can afford a lawyer. We recommend that you look for a disability attorney who takes this into account. Many law firms will make special provisions for disabled workers.