If you are pursuing disability benefits and dealing with co insurers, It is best to work with an experienced and dependable Texas long term disability lawyer. They understand the complex process of obtaining your long term disability benefits.
These benefits are a financial cushion meant to safeguard employees when they cannot work for an indefinite period because of injury or illness.
First, all long-term disability insurance policies are not the same. Terms can differ, and even details in the letters from the insurer could have unclear details.
Therefore, it is best to consider working with an attorney to help you understand what the disability policy covers along with other related documents you might receive from your insurance provider.
The expected benefits from your LTD policy can amount to roughly 50% to 85% of your monthly wages, depending on the policy’s terms; Your lawyer will also let you know if the benefits are taxable.
At Ascend Disability, we have experienced attorneys and case managers who have helped hundreds of clients secure social security disability benefits.
If you are unable to earn an income because of an injury or illness that has lasted a year or more, Contact us today at (855) 445-9787
Let us be your solution.
What Is Long Term Disability (LTD)?
Long-Term Disability (LTD) insurance provides financial protection to employees and their beneficiaries when they are unable to perform their work duties due to an injury or illness.
Long term disability is anticipated to last more than twelve months and could potentially result in death or physical or mental impairment.
Ideally, the LTD policy assists with replacing a portion of the worker’s income when you are incapacitated and cannot execute your employment duties for some time.
The LTD policy can be governed by ERISA (Employee Retirement Income Security Act), which is a federal law. It can also be a private long-term disability coverage, individuals purchase to ensure they receive wage replacements.
Private or individual LTD insurance is best for self-employed individuals or those whose employers do not carry disability insurance.
Long-Term vs. Short-Term Disability
Short-term and long-term disability policies share similarities like tenure for receiving benefits, how much the policyholder will get, the “disability” definition, the costs of extra coverage, and any exclusions or limitations preventing the policyholder from getting benefits.
Though these two might have commonalities, they provide different coverage.
• Short-term disability insurance covers expenses associated with an injury or illness for a limited period (often lasting less than six months) while you are recovering. Sometimes short-term disability benefits can be paid for up to a year, depending on the policy terms, and the holder can get about 70% of their monthly wages.
• Long-term disability insurance ensures the policyholder enjoys an income replacement if their impairment or incapacitation lasts more than a year. Some LTD policies can cover medical treatment and rehabilitation. Moreover, long-term disability coverage can also see the policyholder enjoy the benefits even into retirement, depending on the insurance plan.
Long Term Disability Benefits
As mentioned earlier, individuals can get an LTD plan through their employer (ERISA) or as a Private LTD. Most disability plans have a 3–26 week waiting period; In the meantime you can qualify for short term disability benefits.
To qualify for LTD benefits, you must be deemed disabled as per the definition of disability under the SSA (Social Security Act). In short, your injury or illness is expected to last twelve or more months, or the condition could be terminal.
Most long-term disability policies replaces between 50% and 70% of their income. The disability plans have a waiting period of roughly 3–26 weeks, a time in which the policyholder can receive Short-term disability benefits before being eligible for LTD benefits.
You should know that insurance providers want to minimize the amount paid, for this reason it is important you have an experienced attorney on your side.
Call our Disability Lawyers today at (855) 445-9787 We will make sure you receive your benefits.
Requirements For Long Term Disability
All LTD plans require policyholders to satisfy one requirement: You must have a medical condition qualifying as a disability listed on the insurance policy. Furthermore, the policies have a waiting “elimination” period that starts when the policyholder sustains the injury or illness and ends when they get their benefits.
The requirements will differ depending on the plan. For an employer-sponsored (group) plan, there is no underwriting process. However, underwriting is mandatory for individual (private) LTD plans, and you must undergo a medical check.
Under the group plan, your employer pays a significant percentage of the premiums, while those in an individual plan purchase the long-term disability coverage with their after-tax incomes. Nonetheless, individual LTD policyholders enjoy tax-free benefits, while those in group plans must contend with taxable benefits.
The risk of pooling makes individual long-term disability policies less desirable because it makes them more expensive than group LTD plans. But on the other hand, individual plans are more robust and customizable, meaning policyholders can make them suit their needs, eliminating limitations regarding what benefits to receive.
An important thing to remember is a change of employment means that the policyholder voids the group LTD coverage, but those with individual policies can carry over their insurance plans when they change jobs.
What Medical Conditions Qualify for Long-Term Disability?
Some of the medical conditions that can qualify you to receive LTD benefits include:
- Stroke
- Fractures
- Lupus
- Cancer
- Brain injuries
- Major automobile accidents
- IBS, Crohn’s disease, diverticulitis, or other gastrointestinal illnesses
- Multiple sclerosis
- PTSD
- Cardiovascular disease
- Fibromyalgia
- Chronic fatigue syndrome
- Seizures and nervous system disorders
- Mental disorders like depression, anxiety, and bipolar
Please note that disabilities associated with any recklessness or negligence on your part, disqualify you from pursuing LTD benefits. An example would be causing an accident due to drinking and driving.
What Is the Long-Term Disability Process?
As we review the process of applying for long-term disability benefits, we will highlight the significance of having the right lawyer guide you.
If you sustained a disabling injury or illness and you have an LTD policy, you may be eligible for LTD. The process can be less daunting if you take the following steps.
Hire an Attorney
We highly recommend making this your first step after seeking medical care. It ensures you have expert guidance when starting the application process. It also improves the chances of approval; therefore, get in touch with our Texas long term disability lawyer the minute you are impaired and cannot do your job. The lawyer will guide you on what is required and ensure you avoid anything that will dent your chances of getting the benefits.
Notify Your Employer
The next thing will be notifying your employer of your condition and if it will make you not return to work even after the temporary leave granted to you to allow you to recover. Also, let your employer know that you will be seeking LTD benefits so that they can submit their statement to their insurance providers.
Seek Medical Care and Gather Medical Evidence
We highly recommend getting the process going as soon as your doctor or physician determines your injuries or condition is severe enough to keep you from executing your professional duties. It can be less than three months from when you were injured and stopped working. You will need medical evidence supporting your LTD application; thus, gather vital medical information speaking to the severity of your injuries or illness and other challenges during your treatment and recovery.
Review The LTD Policy’s Time Limits
Shift your focus to the insurance policy to analyze the time limits for filing your application. Your benefits could be denied if you fail to apply for the disability benefits within the stipulated time. Your lawyer will go over the policy and advise you accordingly.
Examine The Policy’s Definition Disability
You also should go through the policy to know the insurance provider’s definition of disability. Some LTD policies may require the policyholder to be partially disabled before benefits are paid, while others require the holder to be fully incapacitated. Your attorney at Ascend Disability Lawyers LLC will help you understand what is stipulated to ensure your condition meets the criteria.
Filing an Employee Statement
Most insurers require applicants to file an employee statement that includes the employee’s information, primary care physician, work nature, workers’ compensation details, and medical information. The employee statement must be filed within the stipulated time limits to avoid inconveniences.
Our lawyers will explore other benefit options worth considering as you seek compensation from your long-term disability insurance, including Worker’s compensation and Social Security Disability Benefits.
In all, we understand how frustrating this process can be, that’s why At Ascend Disability, we help get you the benefits you deserve. With years of experience dealing with disability compensation cases, we know how to get the job done.
Contact us today at (855) 445-9787!
