Many employees have LTD (long-term disability) insurance as a benefit of employment. It is a very valuable benefit. However, many employees make the mistake of assuming it will pay benefits just because they are too sick to work.
Unfortunately, LTD does not provide benefits the way that health insurance usually does. Whereas virtually no one needs to consult an attorney before seeing a doctor or filing a health insurance claim, that is precisely what you should do if you are considering going out of work because of illness or injury and believe you will make an LTD claim. If you have STD (short-term disability) as well as LTD, then you should contact a lawyer even before you go out on STD.
You should see a lawyer before you go out of work when you expect to be filing an LTD claim to avoid pitfalls that can cause your claim to be denied. All of these claims are controlled by the insurance contract the employer purchased for its employees. These contracts are generally referred to as “the plan.” The plan, together with amendments and related plan documents, control the claim. In order to understand your rights, your chances of winning benefits, as well as your obligations under the plan, you must know the terms and conditions of the plan. You must know the answer to important questions, including but not limited to:
- What is the definition of disability, and does it ever change?
- How much will I be paid under the plan?
- How long is the elimination period?
- Will I be prevented from getting LTD benefits because of a “pre-existing condition”?
- Does the contract limit benefits to 24 months for my condition?
- How long can I be paid LTD benefits?
To get the answers you need, you should talk to an experienced attorney. Here at the Andalman & Flynn disability department, Elliott Andalman and Peter Casciano together have over 50 years of experience in this area and will assist you in answering the important questions listed above as well as provide other ideas for putting together a successful application for benefits.
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