6 Legal Tips For Understanding Your Long-Term Disability Policy

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Long-term disability insurance is intended to provide an income stream to people who are suffering from any disability and are unable to work. As per recent research, it was found that a majority of claims get approved, however many legitimate claims are often denied. This is because these claims lack a few important details.

Had they been submitted differently, they would have got approved. Thus, to ensure that you do not go through the hassle of applying for the insurance claim, again and again, this article will talk about the important information that you must include to increase the chances of your LTD claim being approved.

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1) Obtain The Required Forms

Applying for LTD generally requires a significant amount of paperwork, beginning with documents issued by the insurance company. These are generally provided by your employer, but you may also request them explicitly from the LTD insurance provider. The forms are generally made up of three distinct documents: one for you to fill, one for your employer to fill, and one for your physician to fill.

2) Read The Benefits Pamphlet

Your benefits booklet will talk about the available coverages, such as extended health benefits, life insurance, short- and long-term disability insurance, etc. The brochure will give you an overview of what the policy entitles you to, as well as basic information like how the benefit is calculated, the waiting period, and other specifics.

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3) Review The Policy

The benefits’ brochure is only a summary. The policy will be lengthy and contain certain terms that are difficult to understand. You will need a long-term disability lawyer to translate the legal terms into layman’s language.  If these words like ‘Exclusions, exceptions to exclusions, all-source maximums, direct offsets, indirect offsets provisions’ etc. apply to your claim, consider contacting an LTD attorney.

4) Review The Entire Application Before Submitting

Few LTD forms are denied because a box was not checked, a date was entered incorrectly, or a sickness or injury was described incorrectly. Before you enter any information, ensure that you understand the question, and before submitting, ensure to double-check every detail that you have entered.

5) Complete the Application Form Sincerely and without exaggeration

Insurance contracts, particularly LTD contracts, need both parties to be honest to each other.. If you are caught in a lie or the LTD approver accuses you of being dishonest, your insurance claim will most likely be denied. Only when all information is consistent and can be verified, you can overturn a denial.

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6) Concentrate On Your Weaknesses

The focus of disability claims must be on functional constraints and limitations. Regardless of the importance of diagnosis, LTD insurance approvers are far more concerned with function, or the reason you are unable to work. Talk about what prevents you from carrying out your job responsibilities. Instead of saying, “I am unable to work because of back pain,” you could say, “Back discomfort prevents me from lifting more than 10 pounds, sitting for more than 30 minutes, and standing for more than 15 minutes.” Furthermore, the side effects of the drugs are causing me to lose focus and concentrate when operating heavy machinery.”

The time when you have to deal with long-term illness or sudden disability is something that stresses a lot. During such a time, something that comes as a sign of relief is the disability claim. You can file for the claim and enjoy the benefits that come along. To do so, you need to follow a few steps and then navigate the process to check the status.

Steps To File For Long-Term Disability Claim

Below mentioned are the steps you must follow to file for long-term disability claim:

  • Notify Your Employer

When you are suffering from long-term disability, applying for a leave from work becomes mandatory. After consulting the rest tenure with your doctor you should convey the same to your employer. Your employer will ask for certain documentation to be sure about your condition. Under the Family and Medical Leave Act, employees are eligible for short-term and long-term leaves along with some added benefits.

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  • Review The Policy For Information

Time is everything, and the same is not different when you want to obtain disability benefits. You should review both your short-term and long-term disability insurance policies to be sure about the time limit to file applications. If the claim was denied sometime ago, it needs to be appealed again. Keep in mind that missing deadlines may result in the denial of benefits and in some cases forfeiting the right to appeal.

If required, you can also reach out to a disability attorney who will help you with the legalities of the procedure. Also, they will ensure that no important deadlines are missed.

  • Know What Is The Definition Of Disability In Your Policy

Different insurance companies have different definitions of disability. That said, the terms will vary from the perspective of policies, employers, and also the policy itself. Hence, it is mandatory to obtain a copy of the policy pertaining to your employer and you. Also, when you speak with your HR about obtaining disability benefits, they can help you with the required information.

Within the policy, you need to navigate to the section where disability is defined. Some policies may state that the employee will have to stop working before the disability benefits are paid. Under other policies, only a partial definition of disability may be met, where the employee will be allowed to work, maybe on a part-time basis, and also pursue disability benefits.

If you are not able to understand the terms of your policy’s definition of disability, you may seek help from experienced attorneys that specializes in disability cases.

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Filing for disability benefits is confusing and at times people may not be able to take all the required steps. This is why professional help exists. The long term disability insurance is designed for employees so that they can seek protection when it’s needed the most. Experts will help you understand how coverage and claim works and how you can obtain the benefits.