At some point in their careers, a large minority of workers suffer from unexpected illnesses or injuries that prevent them from returning to their jobs either for lengthy periods of time or permanently. As much as 25 percent of today’s workers in their 20s will suffer from debilitating conditions at some point in their lives. Long-term disability insurance offers a safety net for workers so that they can have financial protection in case they are disabled and unable to return to their jobs.
Long-term Disability Insurance Explained
Long-term disability insurance is a type of coverage that can provide monthly benefits payments that replace a percentage of your former income if you are disabled. You may receive this coverage as part of your benefits package through your employer, or you may purchase it separately on your own.
Long-term disability insurance is available to protect your income if an injury, accident or illness prevents you from working for a lengthy period of time. The insurance has several different coverage and benefit options, allowing you to choose the protection that will work best for your needs and security. It is important for you to understand the options so that you make certain that you will have the level of protection for as long as your disabling condition might require.
It is important to note that long-term disability insurance has multiple coverage and benefits options that must be chosen at the time that you purchase your policy. In order to get the best protection, you might want to avoid blindly purchasing the cheapest policy because it may be insufficient. Instead, you should look for features that could make the difference if you later need to seek benefits.
Long-term disability insurance is available for varying durations. The cheapest policies have very short durations and should be avoided. Instead, you should look for a policy that provides you coverage for a minimum of five years and preferably up to age 67. You will also want to choose own-occupation coverage instead of any-occupation coverage. Own-occupation coverage provides you with benefits as long as your disability prevents you from returning to your former position. Your benefits will not be cut off simply because you are later able to return to working in a different type of occupation.
It is also a good idea to choose residual benefits as an option. This offers disability benefits if your condition partially disables you, reducing your ability to work more than part-time. A cost-of-living rider may also be desirable as it will provide for adjusting the amount of your benefits payments according to inflation. The coverage and benefit options that you choose along with other factors will be used to determine the annual cost of your premiums. Generally, you might expect to pay between 1 and 3 percent of your annual gross income for long-term disability insurance if you are male and between 2 and 4 percent if you are female. Read more about Long Term Disability Coverage.
In order to apply for and receive benefits from your long-term disability insurance coverage, there are several requirements that you must first meet. If you do not have the residual benefits rider on your policy, then your condition must have left you totally disabled. If you do, then your disability must have rendered you partly disabled and unable to work at your own occupation for more than part-time. Your doctor’s written opinion is of paramount importance. He or she should write a statement about how your condition impacts your ability to complete the functions of your job. You will likely need to submit other types of medical evidence, so it is important for you to continue seeing your doctor while your benefits application is pending.
Most policies require that you had full-time work, which is defined as at least 30 or 35 hours per week, prior to your injury, illness or accident. There is also an elimination period, which may be anywhere from 30 days up to one year during which time you will not receive benefits after your disabling condition occurred. You will also want to check your policy carefully to make certain the illness or condition that you have is not one that your policy specifically excludes from coverage. If you have a pre-existing condition that was worsened by your job, your policy may have an exclusion period for coverage of up to one year after it caused you to become disabled. Read more about Long Term Disability Requirements.
You should expect the application process to take between four to six weeks. In order to apply, you will need to submit the application, documentation of your income and a signed release that authorizes your insurance company to obtain copies of your medical records. After you submit the documents to your insurance company, you should be contacted to schedule a phone interview and a paramedical examination.
On the date of your exam, a technician will complete a home visit, take your blood and urine samples and measure your vital signs, height and weight. The results will be sent to the insurance company. Your phone interview will be conducted at the scheduled time. You should be prepared for the questions by getting copies of what to expect from your insurance broker. You should make certain that you have your doctor’s contact information handy in case you need it during the phone interview. The interviewer will ask you questions about your health condition and your lifestyle.
The next step will either be the submission of your information to underwriting for final approval, or the company may instead request that you submit to a functional capacity evaluation or an independent medical examination. It is a good idea to talk to your long-term disability lawyer before attending either an FCE or an IME – we have helped countless clients through this process, and would be honored to do the same for you. Companies often use these types of assessments to provide them with reasons to deny your claim. If your case is sent to underwriting for approval, you should expect to be notified of its approval within two to four weeks. If you are denied, you will receive a denial letter in the mail.
What if a Claim is Denied?
Even after you have long-term disability coverage, your claim may be denied once you attempt to use those benefits. There are several common reasons why this can happen. When a long-term disability claim is denied, you should contact us immediately. Our team of experienced attorneys at Osterhout Berger Disability Law has helped more than 30,000 individuals receive their disability benefits .
If you find yourself facing a denied long term disability claim, we’re here to help.
Let Us Help You Get the Benefits You Deserve
Schedule a free confidential consultation about appealing your denial by calling us toll free at 1-866-438-8773. If you prefer, you can fill out our intake form, and an experienced lawyer will contact you to schedule an appointment. With offices in both Pennsylvania and Florida, and handling cases nationwide, we’re here to help.