Long Term Disability? What Employees Need to Know about the Benefits | Andalman & Flynn Law Firm
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Approved for Long Term Disability? What Employees Need to Know about the “Benefits”

Nov 10, 2021 | Disability Law, Long Term Disability

By Peter Casciano(301) 563-6685

Once approved for Long Term Disability, many issues and decisions can still arise. There are several common “benefits” associated with LTD benefits. The benefits are typically offered by the carrier once benefits begin.

One of those benefits can be a vocational rehabilitation program offered by the LTD carrier.

This brings about a dilemma for many folks. Participating in a carrier-sponsored rehab program may run the risk of generating evidence contradictory to the continued payment of benefits. However, some LTD annuitants take advantage of this program and use it as an eventual entry back into the workforce, which is, of course, the goal. When deciding whether to participate in the vocational rehab program offered by the carrier, one should consider the following questions: (1) are my medical symptoms ever likely to improve? (2) are my work restrictions incompatible with all work, or just my last occupation? (3) are my doctors OK with my participating in work rehab? A collaborative strategy discussion should occur between lawyer, client, and doctor when deciding if vocational rehabilitation is a good idea.

Another “benefit” often offered by the carrier after the LTD claim is approved the Social Security Disability (SSD) assistance.

The carrier will provide a social security disability vendor to assist you in filing and prosecuting your SSD appeal. The reason they do this is obvious because, for most folks approved for SSD, that means the value of the SSD benefit will reduce their LTD benefit. In other words, the carrier will be able to pay you less if you win SSD. However, one should be careful in deciding whether to choose to utilize this service. First, the carrier will often make specific mention of how their SSD attorney is free. While true, typically, the attorney fees you pay for an SSD attorney are not subject to the carrier offset. This means that by hiring a “free” SSD representative through the carrier, you are often not saving yourself any money.

Separately, the vendor suggested and paid for by the carrier to help with your SSD claim will sometimes provide confusing authorizations.

If you agree, the information that you share with your SSD representative will be passed directly to the LTD carrier. Therefore, one should be very cautious about this relationship. Generally, our advice is to pursue outside help from a qualified SSDI representative not connected to the LTD carrier.

Another aspect of LTD claims once they entered approved pay status are geographical restrictions.

Most LTD policies provide no geographical restrictions, allowing claimants to live anywhere in the country (and sometimes the world). This is important because many claimants will need to move after work and be approved for LTD benefits. The reason for this is apparent. Being on a claim for LTD benefits almost always means a reduction in income. It’s typical for folks to need to either downsize homes or move to a less expensive part of the country, or both. It’s important to review the details of the policy to understand if it places a geographical limit on you, and if so, where?

Connected to this issue is the fact that when moving homes, oftentimes, that means switching doctors.

There is no guarantee that the new doctor will issue the same findings as to the previous doctor. Moreover, sometimes they will have completely different opinions about your claim in general. Finally, the place where you are moving may never have a doctor specializing in the area of medicine important for you. These issues must all be considered thoroughly before pulling the trigger and making a move.

Separately, the elimination period can sometimes cause issues.

The elimination period is the time between stopping work and starting to receive your LTD benefits. If planned for properly by the employer, the STD policy and benefits should fit snugly within the LTD elimination period. If done correctly, there should be a very little gap in payments, if any. However, some employers don’t properly purchase the right length STD and LTD benefits. If that happens, the LTD elimination period will be longer than the max life of the STD benefits. In other instances, the employer does not purchase STD at all for the employees. The bottom line is that LTD benefits don’t begin until after the elimination period ends. Still, you must satisfy the definition of disability from the policy for the entire time. Understanding the interplay of these benefits once you stop working is critical to financial security.

Lastly, I want to mention health insurance because it is a common set of questions we receive after folks are approved for LTD.

Many people believe that because they are on claim file LTD, their health insurance through a company will continue as long as LTD is paid. This is simply not true. In fact, this happens very rarely. In my experience, it only happens if the employer has issued an internal guideline indicating they want to bear this additional cost for their employees. Health insurance and LTD benefits are complicated. For this article, I just want to say that many folks’ employment is terminated when LTD benefits, if not sooner. It is at the time of termination from employment that most health insurance benefits stop.

It’s very important to consult with an attorney to discuss this issue and health insurance benefit options other than employer-sponsored if the time comes for you to go onto LTD. Don’t hesitate to get in touch with me at any time if you have questions about this article or any other issues connected to LTD benefits.

About Andalman & Flynn, P.C.: Andalman & Flynn, P.C. serves clients throughout Maryland and the District of Columbia, offering compassionate, quality service and results-driven representation across a broad range of legal areas. With a concentration on disability benefits law and family law, the firm focuses on cases that impact the rights of everyone, and they are there for clients when responsive legal help is most critical. For more information about Andalman & Flynn, please visit http://www.andalmanflynn.com, or call 301.563.6685.


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