LTD Benefits & What To Expect 

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Long Term Disability

Long term disability policies usually have two distinct definitions of disability. The initial term, called “Own Occupation,” measures your disability by your inability to do the occupation you were doing before becoming disabled. That period is usually 24 months. To continue LTD benefits after that term, you must meet a more stringent definition of disability referred to as “Any Occupation,” which means not being able to work in any job you may be qualified for based on your training, education, or experience. Fortunately, there is usually an earnings component to the Any Occupation definition, meaning that whatever job the insurance company claims you can do, you must be able to earn 60-80% of what you were earning. In other words, if you were a computer programmer earning $100,000 per year, but could do a customer service job, if you can’t earn $60,000 or more doing that job, you are still considered disabled. 

Most disability insurance policies require claimants to also file for Social Security Disability benefits within 12 months of disability.

This may seem hard to understand since premiums were paid for the insurance company to pay benefits in the event you become unable to work. A group LTD policy through an employer typically cost you or your employer $20-$50 per month or less. If you bought a private individual LTD policy, it likely costed hundreds or thousands of dollars per month. Most employer-sponsored LTD plans have a provision where the insurance company can offset every dollar you and your children receive from Social Security Disability from the benefits the LTD insurance policy pays you.

Filing for SSD is a complex process as well. We have attorneys and legal teams focused on each of these practice areas. With so much at stake, it is smart to have one local firm working together to stop delays and denials of benefits you need and deserve. 

The insurance company may seem like your friend in the beginning, but keep in mind they are a big business focused primarily on their profit margin. The longer they pay out benefits, the less profit they can make. When your disability keeps you from being able to work longer than the initial period, insurance companies will do all they can to find ways to deny your benefits.  

Video surveillance is a common tactic disability insurance companies use to terminate or deny benefits. They do this to try and catch you functioning in ways you said you couldn’t. So be mindful of this when you have doctor appointments, go grocery shopping or even take out your trash. Be careful of social media as you can be sure it will be monitored closely with the same intent.  

If you’re receiving disability benefits, it may be easier to close social media accounts and avoid being included in posts by others. Even if you keep your settings extremely private, they can find ways to see posts that could incriminate you by connecting with your friends and family who may not realize who they are.  

Other tactics include random calling to try to interview you off guard, repeated paperwork and other requests that may even seem harassing. But if you refuse to complete forms or comply with their requests, they will use this as grounds to deny your claim. Disability insurance carriers are known to claim forms were not received on time or at all, so it always good to track all correspondence in a way you can prove by the deadlines the insurer sets. 

Need Help with Your Long Term Disability Matter?

Wondering how to appeal your long-term disability insurance claim denial?

Don’t give up or do it yourself. That’s what your insurance company expects and works towards. Why? Because it works in their favor if you do. Know your rights and get the help of an experienced ERISA lawyer that knows what it takes to develop an effective LTD appeal.