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Top 10 Long Term Disability Questions
Here is a list of frequently asked questions you might have about Long Term Disability. If you would like specific answers that relate to your unique situation, simply contact our Arizona disability law firm for a FREE CONSULTATION.
Can I apply for Short Term Disability or Long Term Disability benefits with your Firm?
If you have a short term or long term disability benefits policy through an employer or that you purchased privately with an insurance carrier, such as Cigna, MetLife, Liberty Mutual, Broadspire or the like, we can help you with the process of applying and understanding your coverage.
How do I apply for Short Term Disability and/or Long Term Disability benefits through my employer?
The application documents are available through your employer’s Human Resources Department or you can request them through the insurance carrier your policy is with. Before applying for disability benefits, it is always in your best interest to have an experienced attorney focused on disability insurance law review your policy to fully understand your coverage and how to start the process for the best possible outcome.
Can I work while receiving Short Term Disability and/or Long Term Disability benefits?
Some plans will allow a person to work while receiving Short Term Disability and/or Long Term Disability benefits. This is dependent on the terms of your employer’s plan, if it is a group policy, or the terms specified if you purchased an individual policy. Typically working while receiving disability benefits could negatively impact your claim because of the way these plans define disability. Working can provide basis for the insurance company reducing or denying your benefits.
My Long Term Disability benefits claim was denied. Why did this happen?
Insurance companies deny or terminate claims for many reasons. One common reason is the purported failure to meet the definition of “disability.” Many Long Term Disability policies have changes in the definition of “disability” after 24 months of benefits, requiring you to be disabled not just from your “own occupation,” but from “any occupation.” The insurance company will frequently “cherry pick” your medical records, even retain an “independent” medical reviewer to build evidence against you, despite the fact that you’ve never been personally evaluated by that reviewer. Although the road ahead can seem difficult, don’t give up on disability benefits you rightfully deserve. Insurance companies often count on you not fighting your benefits, thus saving them from paying you for the months – and often years – of benefits to which you’re entitled. We’ve secured millions of dollars in benefits for our clients and can help you too.
Can the insurance company rely on other doctors’ opinions besides my own doctors?
To best answer this question, we would need to review your policy documents and look at your particular claim. But it is very common for the insurance company to hire independent doctors to conduct reviews, and they are allowed to do it generally. They do not have to defer to your treating providers, although their failure to do so is definitely something that we address all of the time. Under the federal law that governs most of these benefits, the standard is whether the insurance company’s reliance on the independent reviewers over your treating providers was reasonable, and there’s a lot that goes into this analysis.
Should I apply for SSDI?
In most circumstances, the answer is yes. Under most employer sponsored disability plans, you’re required to apply for Social Security Disability benefits, assuming you are eligible under Social Security’s rules. Most plans and group disability policies allow the insurance company to reduce your monthly benefits amount by the amount you receive in Social Security Disability benefits. This is so the insurance company can reduce its financial liability and the amount it pays you each month. There is little downside to applying for Social Security Disability benefits if you are qualified; doing so can protect your retirement and qualify you for Medicare. If you don’t apply for Social Security Disability benefits, know that the insurance company may have the right to reduce your Long Term Disability benefits by what you would otherwise receive in Social Security Disability benefits. Our firm can help you apply for SSDI and fight the insurance companies for the LTD benefits you deserve.
The insurance company claims they can deduct the amount I’m receiving in SSDI from my monthly LTD benefit amount. Can they do that?
We would need to see your policy documents to verify whether they have this right, but most of the time, they are allowed to do it. It’s a very common offset found in disability policies. If you have your policy, there is a section typically about deductible sources of income or that is commonly called other income benefits. The information would be in there if you want to verify whether they have the right. However, if you have not been awarded SSDI benefits yet and you have been denied disability benefits, then the insurance company might be precluded from collecting offsets from you. That would be a separate issue to discuss down the road.
Should I resign from my job if I need to go out on disability?
No. Don’t resign, enter into a severance agreement, or make any retirement decisions without first fully understanding your plan/policy documents. Any resignation or severance agreement may impact your eligibility for disability benefits, and there are ways to end employment while still protecting your disability benefits. Contact our attorneys who specialize in Long Term Disability policy/plan document review.
Can I submit a claim for private disability benefits if I was injured at work?
The answer depends on your policy. With respect to disability benefits through a private or employer-sponsored policy, disability benefits may be reduced by “other income,” which could include workers compensation. You should make sure to pursue any worker’s compensation options available to you if you have been injured at work. We focus exclusively on disability benefits law for residents in Arizona and often work in conjunction with attorneys specialized in other areas of law and can provide excellent referrals.
Does the law require my employer to provide me with private disability coverage?
No. But if an employer decides to offer disability insurance, then usually, the federal statute ERISA governs those disability insurance benefits. Because disability benefits are not a requirement of employers to provide in the workplace, employers are generally allowed to draft or purchase coverage as they see fit. ERISA does not mandate that certain types of disabilities must be covered, or how much of a monthly benefit an employee should be provided. For example, employers can exclude certain disability from coverage, such as mental nervous conditions, or adopt very strict criteria for obtaining benefits. For this reason, if you have coverage through your employment, it is imperative to obtain and fully understand your plan/policy documents to determine the particulars of your coverage.
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