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It’s easy to take our health for granted, until it’s gone. Suddenly, tasks that used to come as naturally as breathing - driving to work, walking up the stairs, sitting down without pain - can feel like scaling a mountain. According to the CDC, approximately 1 in 4 US adults are dealing with some form of disability. Many long-term disabilities require constant medical care and treatment - doctor visits, physical therapy, and medication can become a regular part of your routine.
Whether your disability stems from a demanding job, a sudden accident, or a devastating illness, it can affect everything from your physical abilities to your relationships and psychological well-being. Beyond these challenges, losing your ability to earn an income can leave you uncertain about your future. A long-term disability policy - bought individually or provided by your employer - can be a financial lifeline in this situation, covering necessary housing, food, and medical costs.
If your long-term insurance company has unjustly denied or terminated your claim, having an experienced long-term disability lawyer on your side can make all the difference. Our long-term disability attorneys specialize in navigating complex legal processes - and have helped thousands of clients secure the disability benefits they deserve. While you focus on your well-being, we will use our knowledge of disability law to ease your financial struggles. As you prioritize your health, we will prioritize your rights, and fight tirelessly to obtain the long-term disability benefits you need.
Understanding Long-Term Disability and Disability Law
Long-term disability insurance is a type of insurance policy that provides financial assistance to individuals who are unable to work due to a disabling illness, injury, or condition that lasts for an extended period. The fundamental aim of long-term disability insurance is to substitute a part of an individual's income that they lose due to an inability to work. For those who find their employment abruptly interrupted by a debilitating health condition or accident, these benefits are critical. They alleviate financial stress by covering essential expenses like housing, food, and medical care, allowing individuals to focus on recovery without the added burden of financial insecurity.
How Do Long-Term Disability Benefits Work?
Long-term disability insurance policies can be either purchased individually or provided by employers as part of a comprehensive employee benefits package. The coverage and benefits provided by a long-term disability policy vary considerably depending on the specific terms of the policy, including the percentage of income replacement, the waiting period before benefits begin, and the duration of benefits.
The benefits of a long-term disability policy typically include a percentage of your pre-disability income, with percentages commonly ranging from 50 to 70 percent. However, the onset of these benefits depends on a predetermined waiting period (commonly known as the elimination period), which can range anywhere from 30 to 90 days - or longer. The duration of the benefits once they begin varies widely depending on the specifics of the policy, and can last a few years, up until the policyholder's retirement age, or even for life.
It's important to understand that long-term disability insurance is a different entity than Social Security Disability Insurance (SSDI), a government-run program that provides financial assistance to individuals unable to work due to a disability. While the two are separate, note that some long-term disability policies may require the individual to apply for SSDI benefits in addition to their long-term disability claim. Typically, long-term disability insurance comes in two primary forms: "Own Occupation" and "Any Occupation."
This type of policy is broad in its definition of disability. It pays benefits only if you are unable to work in any occupation your education, training, and experience qualify you for. For example, if you were a surgeon who developed a hand tremor and cannot continue your current employment but can still work in some other capacity, such as a teacher, this policy wouldn't provide benefits.
This category of policy is designed to provide benefits if you become unable to perform the duties of your specific, current occupation due to a long-term disability. A unique aspect of this policy is that, unlike an “any occupation” policy, it will continue to provide benefits even if you’re capable of working in a different occupation. Finally, while this policy provides more comprehensive coverage, it tends to be more expensive.
What Defines Eligibility for Long-Term Disability Benefits?
Eligibility for long-term benefits typically depends on the severity and duration of your disability, as well as your ability to perform either your current job or any other type of work. You can expect an in-depth analysis and evaluation of your medical evidence, work history, treatment records, and functional limitations. These are all important factors that influence eligibility. To apply, you must send your long-term insurance provider specific documents and information to support your case for long term disability benefits. While the exact requirements may vary depending on your policy and provider, below are some of the most common items you may need to provide:
Claim Forms - these detail your personal information and job details, and describe the nature and extent of your disability.
Medical Records - comprehensive medical records are crucial. These must include your diagnosis, treatment, medications, and prognosis from your medical providers detailing the nature and extent of your disability.
Physician Statements - letters or reports from your treating physicians that explain your health condition, functional limitations, and reasons why these limitations prevent you from working.
Work History and Job Description - detailed accounts of your past employment, including job titles and duties.
Income Documentation - proof of your income before the onset of disability, typically in the form of pay stubs, W-2 forms, or tax returns.
Independent Medical Examinations (IME) - reports from medical examinations conducted by a doctor selected by the insurance company to objectively assess your health status and ability to work.
Witness Statements - statements from colleagues, family members, or friends who can attest to the impact of your disability on your daily life and work capacity.
Legal and Financial Documentation - documentation demonstrating the financial impact of your disability, as well as any relevant legal records, such as workers' compensation or Social Security Disability claims.
The insurance company may also require regular updates and medical examinations to ensure you continue to meet the policy's definition of disability.
What’s the Difference Between Short Term Disabilities and Long Term Disabilities?
Short-term and long-term disabilities differ in several key aspects, including the benefits provided, the duration of the disabilities they provide these benefits for, and the elimination periods before the benefits go into effect. Short-term disability insurance is particularly helpful for individuals who require temporary financial assistance during their recovery from an injury or illness, while long-term disability insurance serves as a safety net for those facing more prolonged periods of disability that may have a significant impact on their earning capacity. Understanding the differences between short term and long-term disabilities can help you make an informed decision about your insurance needs and prepare for anything that might suddenly disrupt your working years.
Short-term disabilities are temporary conditions that limit your ability to perform their job duties for a limited period. These disabilities most often result from non-work-related injuries, illnesses, or medical procedures that require time for recovery. Short-term disability insurance provides partial income replacement, usually covering 60% to 80% of your pre-disability income. The elimination period for short term disability benefits ranges from a few days to around two weeks. The duration of these disability benefits is generally limited to a few weeks or months, with most policies capping the benefit period at three to six months.
Long-term disabilities, on the other hand, are chronic conditions or severe injuries that prevent you from working for an extended period, from several years until retirement age. Long-term disability insurance offers replacement of 50% to 70% of your pre-disability income. These benefits have a longer elimination period, ranging from 30 to 90 days or more. However, the duration of long-term disability benefits can potentially last several years, up to your retirement age, or even for the remainder of your life, depending on the specifics of the policy.
It's important to note that many long-term disability policies include an elimination period that overlaps with the duration of short-term disability benefits, which helps to bridge the gap between the two types of coverage. By having both short-term and long-term disability insurance in place, individuals can ensure they have a comprehensive safety net to rely on should they face a disabling condition that affects their ability to work and earn an income. If you have further questions concerning the difference between the two, or need help contesting a rejected claim, contact our lawyers for more information.
Common Long-Term Disabilities
A variety of disabilities can qualify for long-term disability (LTD) benefits, from physical injuries to mental health conditions. Our long term disability lawyers can clarify your specific LTD claim qualifies for benefits under disability law. The most common disabilities covered under most long term policies include:
Chronic kidney disease
Peripheral artery disease
Degenerative disc disease
Chronic back pain
Mental Health Conditions:
Major depressive disorder
Severe anxiety disorders
Traumatic brain injury
Spinal cord injury
Amyotrophic lateral sclerosis (ALS)
Chronic obstructive pulmonary disease (COPD)
Type 1 diabetes
As this is nowhere near a complete list, it’s important to consult with an attorney to assess your LTD claim and verify the treatment and proper documentation you need to support it.
Workers' Compensation and Long Term Disability Benefits
Workers' compensation is a form of insurance that provides financial support to employees who suffer work-related injuries or illnesses. In some cases, workers' compensation may provide disability benefits for those facing long-term disabilities. Our long-term disability lawyers can help you understand the relationship between workers' compensation and long-term disability benefits, and ensure you receive the support you deserve.
Workers' Compensation Claims
Workers' compensation claims come into play when an employee is injured or becomes ill due to a work-related cause. The benefits from these claims are designed to cover medical expenses, lost wages during recovery, and, in certain cases, vocational rehabilitation services. In instances where the injury or illness results in a long-term or permanent disability that prevents the individual from returning to work, workers' compensation may also provide long-term disability benefits. However, the process to qualify for such benefits can be complex and often requires substantial evidence, including detailed medical documentation. Our team of long-term disability lawyers can assist you through this process, ensuring your claim is as strong and comprehensive as possible. If you're dealing with a long-term disability you received at work, your attorney can help you file a workers' compensation claim. They will ensure your claim is accurately documented and submitted, improving your chances of receiving benefits under workers' compensation law.
Coordinating Long-Term Disability Benefits and Workers' Compensation
The coordination of long-term disability (LTD) benefits and workers' compensation can be a complex process. Many LTD insurance policies contain provisions for an offset, meaning the amount you receive from your LTD benefits may be reduced by the amount you receive from workers' compensation. This is designed to prevent you from receiving more than 100% of your pre-disability income. Our experienced long-term disability lawyers can help you navigate this difficult process and help you understand how these benefits interact. Most importantly, your attorney can help you maximize your total benefits. Whether you're dealing with a workers' compensation claim, a long-term disability claim, or both, your disability attorney will protect your rights and ensure you receive the full range of benefits you're entitled to.
ERISA and Long-Term Disability Claims
The Employee Retirement Income Security Act (ERISA) is a federal law that governs employer-sponsored benefit plans, including group long-term disability insurance policies. Thankfully, our attorneys have considerable experience navigating ERISA's complex regulations. Your disability attorney can assist you in appealing your LTD claim under ERISA.
Understanding ERISA Claim Requirements
ERISA imposes specific requirements for filing an LTD claim. These include strict deadlines for claim submission, extensive supporting documentation, and exact adherence to all prescribed claim procedures. Missed deadlines or incomplete paperwork can and will lead to claim denial. However, our attorneys are excellent at handling ERISA-specific requirements. Your attorney can guide you through this intricate process, ensuring that all requirements are met in order to improve your chances of receiving a claim approval under ERISA law.
Navigating ERISA Appeals
If your long-term disability claim is denied under ERISA, it's not the end of the line. You have the right to file an appeal, after which the insurance company has 45 days to respond, plus an additional 45-day extension in special circumstances. If the appeal is denied, you may be able to take legal action against the insurance company. Your disability attorney will assist you with filing a lawsuit against the insurance company in federal court.
This lawsuit may seek damages that include disability benefits, reinstatement of benefits, payment for past benefits, and legal costs. While the case could proceed through litigation to a trial, the majority of cases are settled before they reach the trial stage. Regardless, your attorney is fully prepared to defend your rights all the way to the courtroom.
Our attorneys stand ready to assist you in meeting all necessary appeal deadlines, gathering additional supporting evidence, and representing you throughout the challenging appeals process. Your attorney will help you draft a comprehensive appeal letter that addresses the reasons for your denial and presents a compelling case for reversal of the decision. Our attorneys will guide you with compassion and expertise through every step of the ERISA appeals process.
Social Security Disability and Long-Term Disability Benefits
Social Security Disability Insurance (SSDI) is a federal program that provides disability benefits to those who qualify. In some cases, individuals may be eligible for both SSDI and long-term disability benefits. Our long-term disability attorneys can help you understand your eligibility and coordinate benefits between these programs.
SSDI Eligibility and Application
Our long-term disability lawyers can help you determine your eligibility for SSDI and assist you in the application process. They will ensure your application is accurate and complete, improving your chances of being approved for SSDI benefits.
If your SSDI application has been denied, our long-term disability attorneys can help you appeal the decision. They will represent you throughout the appeals process, ensuring you have the best chance of obtaining the SSDI benefits you deserve.
No Long Term Disability Policy? Apply for Social Security Disability.
Even if you don't have a long-term disability policy, there are other options available to you if you are unable to work due to a disability. In the United States, one such option is Social Security Disability Insurance (SSDI). This federally funded program is designed to supplement the incomes of those whose limitations prevent them from gainful employment.
While applying for SSDI can be a complex and challenging process, our Social Security Disability team has extensive experience in this area and is willing to guide you through every step of the process. We can help you understand the SSDI program, determine your eligibility, assist you in gathering the necessary documentation, and represent you effectively if you need to appeal a denial of benefits. Our team has a proven track record of securing benefits for clients who have struggled to obtain them on their own. We are committed to fighting for the financial support - through one means or another - you need to continue your life.
The Benefits of Hiring a Long Term Disability Attorney
Dealing with insurance companies and their complicated processes can be an intense and frustrating experience. Our long-term disability lawyers have worked with insurance companies and understand the tactics they may use to deny or minimize your disability claim. Having legal representation on your side has a host of immediate and long-term benefits. If you choose Wettermark Keith to represent your claim, your long term disability lawyer will:
Your lawyer will handle all communication with insurance companies on your behalf, ensuring that your rights are protected and your claim is accurately represented. Our disability lawyers are skilled negotiators who will use their knowledge of disability law, insurance policies, and the insurance industry to advocate for the maximum benefits you deserve. This can ease your stress and allow you to focus on your recovery and well-being.
Your lawyer will help you collect and present the necessary evidence to support your disability appeal. This may include medical records, expert opinions, and work evaluations, all of which can strengthen your case and improve your chances of success.
Your lawyer will represent you at your appeal hearing, presenting your case in the most persuasive manner possible. Their experience and expertise in both disability law and the courtroom can make a significant difference in the outcome of your appeal.
While insurance companies often employ complex strategies to deny or reduce disability benefits, your lawyer will help you navigate such tactics so you come out on top. In addition, your lawyer will identify and challenge any unfair practices or policy interpretations, ensuring your rights under the law are upheld.
Your lawyer can provide expert advice to guide you through the complex process of filing a disability claim. They can explain the complexities of your policy, explain the full extent of your coverage, and advise you on the best course of action based on your unique circumstances.
The process of claiming long-term disability benefits can be emotionally draining - especially when dealing with a debilitating condition. Our attorneys understand the draining nature of this process. Your lawyer can not offer you not only legal assistance but emotional support and guidance as well.
When filing a disability claim, deadlines and details matter. A single misstep can delay your benefits or result in immediate denial. Your lawyer can help you avoid these pitfalls by ensuring that your claim is filed correctly and on time. They can guide you through the paperwork, help you understand the fine print, and ensure you meet any and all deadlines.
Our Long-Term Disability Attorneys Can Streamline Your Claims Process
Working with our long-term disability attorney or lawyer can significantly improve your chances of securing the benefits you need. This support is critical to successfully navigate the complex and often challenging landscape of disability claims. If your initial LTD claim is denied, contact our attorneys. We will evaluate the reasons for the denial in order to craft a persuasive appeal.
Our team of attorneys specializes in disability claims, with a considerable knowledge base and practical experience in the field that equips them with the skills necessary to navigate the world of disability law, insurance company protocols, and complex benefit programs.
Your attorney can help you understand the nuanced terms and conditions of your insurance policy, help you gather any necessary medical and employment documentation, and ensure that your application is complete and convincing, increasing the likelihood of its acceptance. Our main goal is to alleviate your financial worries, lift the burden of complex legal processes and maximize your chances of securing your LTD benefits. From filing your disability claim to appealing a denial, our long-term disability lawyers are here to provide expert guidance and representation.
Who is Wettermark Keith?
Wettermark Keith, with offices located throughout Alabama, Tennessee, and Florida, has an excellent reputation as one of the most accomplished personal injury firms in the country. Our reach is not only regional but includes a diverse range of practice areas, including premises liability law, personal injury cases, auto wrecks, trucking wrecks, insurance dispute claims, nursing home abuse, medical malpractice, on-the-job injuries, social security disability, and veterans’ disability claims, to name just a few.
At Wettermark Keith, we believe in taking cases personally. Our purpose is to practice with care and compassion- to tell our clients’ stories and make their voices heard. We do this by building strong relationships based on constant communication and an unwavering dedication to truth and trust. You should never wonder what’s going on with your case. We will keep you in the loop and represent you as if you are family- because to us, you are.
Contact Wettermark Keith for a Free Consultation
If you are facing a long-term disability and need assistance with your disability claim, contact the compassionate and experienced long-term disability lawyers at Wettermark Keith. If your long term disability benefits have been denied, we offer a free, no-obligation consultation to discuss your case and help you determine the best course of action going forward. If you call us or fill out the free case evaluation form on our website, our team will get back to you as soon as possible. Reach out to us today and let us help you secure the disability benefits you deserve.
Long-Term Disabilities - Resources and Support
At Wettermark Keith, we understand that dealing with a long-term disability goes beyond the legal aspects of your case. Our lawyers and staff are committed to guiding you toward resources that might help you manage the challenges of living with a disability.
Frequently Asked Questions
There are various reasons your claim may have been denied, including lack of sufficient medical evidence, discrepancies in your application, or the insurance company's determination that you are not "disabled" according to your policy's definition. Our attorneys will help analyze your denial and determine the best course of action.
Yes, you can appeal a denial of your long-term disability benefits. However, the appeal process can be complex, so we recommend you hire an experienced attorney to guide you through it - and significantly increase your chances of a successful outcome.
An attorney can gather and present necessary evidence, negotiate with the insurance company on your behalf, provide expert legal advice, ensure your claim is filed correctly and on time, and represent you at any hearings - or all the way to the courtroom, if necessary.
The time frame to appeal a denial can vary depending on your insurance policy. Typically, you have 180 days from the date you received the denial letter. Our attorneys can help ensure you meet all important deadlines.
If your appeal is denied, you may have the option to file a lawsuit in federal court. Our experienced attorneys can advise you on the best course of action and represent you through every step of the process.
Wettermark Keith operates on a contingency fee basis, meaning you will never pay your lawyer by the hour or out of pocket. If your attorney is unable to win your case, you will not be charged. We choose to operate this way for the sole benefit of our clients - we want to see you obtain the long term disability benefits you need to continue your life.