When an employee is injured or develops a serious illness that prevents them from working over a long period of time, they may be able to receive long-term disability benefits if their employer has a plan that covers them. Whether or not your policy will pay out in your situation will depend heavily on the terms of the policy.
The process of applying for long-term disability benefits tends to be unnecessarily cumbersome. Many folks find themselves running around in circles attempting to provide the insurance company with enough evidence to validate their claim. CJ Henry Law Firm, PLLC helps those in the often confusing and frustrating process of applying for long-term disability benefits. Please contact us to learn more about how an insurance claims attorney can help.
As your attorneys, we will review your policy and determine what you will need to prove in order to receive your benefits. Employers tend to provide such policies, but workers can also purchase them individually.
The language of the policy will provide a definition of what constitutes a “disability” under the plan. Some policies define disability in terms of not being able to do your current job. Other policies define disability in terms of not being able to do any job for which you are reasonably qualified and amounts to a significant portion of your past earnings. Many policies cover you in the event that you cannot do your current job for a period of two years and then revert into a policy that only covers you in the event that you can’t do any job. We can help you review your policy in order to determine what standard of proof you will need to receive benefits.
Missing a deadline gives the insurance company an easy reason to deny your claim. In some cases, there will be no way to file an appeal if you miss a deadline. In addition, insurance companies are suspicious of claims that were not filed immediately after a disabling injury occurred. It is always in your best interests to file the claim as quickly as possible after you become aware of the disability.
LTD policies will specifically exclude pre-existing conditions. This information is easily obtained through your medical records. But what constitutes a “pre-existing condition” under the policy? Generally, a condition is considered “pre-existing” when you have, at some point or another, received treatment for it.
In addition, there are several other conditions that are not covered by a disability policy. These include:
In this case, “acts of war” refer to engaging in open rebellion against the United States Government or, in the event that the U.S. mainland came under attack, the insurance company would not honor your claim. In addition, those who purchase LTD coverage and then join the military will probably not have coverage under their policy. Lastly, acts of terrorism are not covered under these types of insurance policies.
Most insurance policies will not cover acts of war regardless of the type of insurance covered. If you are afraid that an act of war could imperil your fiscal solvency, you can elect to purchase separate coverage. Most people in the U.S. do not have “act of war” insurance policies.
Before you begin receiving benefits, the LTD insurance policy will make you exhaust sick time, vacation time, and all other paid leave. This also includes short-term disability. In addition, you will be required to apply for SSD which will lower the amount of money your LTD policy is required to pay out.
Any claim you make in order to cash in on the policy will need medical evidence to support it. Insurance companies are typically stingy when it comes to paying out these claims, so the more evidence that you can generate, the better off you’ll be.
Your insurance claims attorney can handle the process of submitting your claim to the insurance company. In addition, we will make sure that you have enough evidence to prove your claim. If your claim is denied unfairly, we can recover damages from the insurance company. We will also manage your appeals and, if necessary, we will take your claim before the court.
At CJ Henry Law Firm, PLLC, we have successfully advocated for a number of clients under LTD policies. Contact us to learn more.
