The road to recovery from a long-term disability (LTD) is difficult enough without the added stress of navigating the system. When you have become disabled and are no longer able to work, you may find yourself needing to rely on your long-term disability plan. Unfortunately, it’s not uncommon for insurers to work to deny or minimize the benefits provided to those who rely on them.
Injuries sustained in a car accident, motorcycle accident, or other injury scenarios may even result in disability so severe that the injured person is unable to file the claim personally. In these cases, it is often especially important that families who are seeking benefits to care for their loved ones have the support and advocacy of a long term disability lawyer who understands long-term disability claims. This advocacy is even more crucial if the initial claim resulted in a denial.
What Is a Disability Insurance Claim?
Long-term disability benefits are generally available when someone is unable to work after they have reached the end of the following:
- Short-term disability insurance
- Sick leave benefits
- Employment insurance benefits
Most LTD policies are provided by employers, and some are purchased by individuals themselves. There are a few key characteristics of LTD plans that will determine whether you are eligible for benefits in the first place:
- Definition of disability: Believe it or not, different plans cover disabilities quite differently. In fact, the definition of disability even varies from plan to plan, including within the same company.
- Eligibility tests: There are a few different types of eligibility tests insurance companies will use to determine if you qualify for long-term benefits. These eligibility tests are part of the larger picture of the nuts and bolts of receiving LTD benefits.
- Qualifying period: Policies that provide long-term disability benefits specify how much time must have passed before you can receive LTD benefits. This period is usually between 90 to 180 days, but it depends on the specific policy.
- Coverage amount: Long-term disability benefits are not equal to the pay you were receiving before your injury. Generally, people who receive benefits from an individual disability insurance claim can expect to receive between 60-85% of their previous salary.
When Should You File an LTD Claim?
While you may have a period of time during which you do not yet qualify for LTD benefits, many plans will allow you to file and get the claims process started before this period is up. By being proactive in filing a claim as soon as you are able, you have a better chance of not having gaps in the benefits you receive.
Some of the conditions for which people file long-term disability claims include:
- Chronic pain
- Orthopedic injuries
- Spinal cord injuries
- Brain injuries
- Psychological illness
- Chronic conditions/illnesses
Understanding the ins and outs of what is allowable under each plan can be difficult, even when you are not dealing with the pain and stress of being injured. Speaking with a lawyer who is experienced with LTD claims can help you understand your specific policy better and come up with a plan to maximize your benefits and reduce gaps in coverage.
When Should You Hire a Long-Term Disability Lawyer?
You do not have to wait until you are fighting a denied LTD claim to seek legal help. Not only can a lawyer help you better understand your policy, its requirements, and what you can expect from receiving LTD benefits under that policy, but a lawyer can help you stay focused on building a strong case for LTD when the process seems less than smooth.
Even if you have not yet been denied, if you are getting a sense that qualifying or receiving benefits under your long-term disability plan seems more complicated than it reasonably should, you might consider calling a lawyer. Hiring a lawyer can help you make sure that you are staying on top of your own deadlines, paperwork, and any other requirements in order to build the strongest claim possible.
For example, your policy may have rehabilitation care requirements written in complicated legal language that you thought you were meeting but have fallen short of because of understandable confusion. Having someone on your side who is looking out for insurance company tricks can be helpful.
What Can You Expect From the LTD Claim Process?
Your application for long-term disability will ask you to provide detailed information about your injuries and your inability to work your “own occupation.” You will likely be asked to provide a number of documents as medical evidence. This evidence might include:
- Your official diagnosis
- Your treatment records
- Laboratory test results
- Physician statements
In addition, you may be asked to provide statements from your employer along with personnel records, and you will likely be asked to provide a personal statement and evidence of previous short-term benefits that you have received related to your injury.
If your claim is denied, then one of the benefits of having a long-term disability lawyer to advocate for you is having someone who can present your case in a more streamlined fashion that really tells the full story of your injury and the time and resources you will need to recover.
How Can Derek Wilson Help?
Because I worked for insurance companies in the past, I understand what insurance companies are looking for in the way of a strong claim. I will focus on presenting your claim for long-term disability insurance benefits in a more holistic way that meets the requirements of your specific policy.
If I see holes in the evidence, I can help to arrange additional medical assessments that demonstrate the full scope of your situation. These additional medical assessments include making sure that invisible injuries are given the treatment they deserve, too.
Call us at 855-769-0418 or get in touch online to schedule a free consultation. We are committed to always having your best interests in mind in order to help you and your family stay focused on healing.