When you’re unable to work due to an injury, illness, or chronic condition, the last thing you want to do is wait for disability insurance benefits. Unfortunately, many short-term and long-term disability policies contain “elimination periods” that must pass before you can receive compensation.
What Is an Elimination Period?
Under most disability insurance policies, you must wait a period of time before the insurer will pay out your benefits. This waiting period is called the elimination period.
Most short-term disability policies have an elimination period of between 0 and 14 days. Long-term disability policies have varying waiting periods, but 90 days is the most common. You can also purchase LTD insurance with a much shorter or longer elimination period.
Many long-term disability experts compare an elimination period to a health insurance deductible, which is the amount of money you must pay before your insurance company starts to cover your health care. When you purchase health insurance, a policy with a larger deductible typically will give you a lower monthly premium. However, you’ll have to pay more money out-of-pocket for your care until your spending exceeds the deductible.
Similarly, in the world of private disability insurance, a policy with a longer elimination period will have cheaper monthly premiums. However, if you become disabled, you’ll have to wait longer before the insurer starts paying your short-term or long-term disability benefits.
Where Can I Find My Policy’s Elimination or Waiting Period?
When you purchased your long-term disability policy, you may not have paid much attention to the elimination period. However, this period becomes incredibly important when you need to file for disability insurance benefits. You can find your policy’s specific elimination period in both the Plan Document and the Summary Plan Description (SPD).
Both the SPD and Plan Document are highly technical documents. If you have a hard time reading and understanding them, you should call an experienced disability insurance lawyer. At Bryant Legal Group, we offer free consultations, and we can help you understand your policy’s precise terms and conditions. Then, we can help you build a legal strategy that focuses on both your long-term and short-term needs.
Should I Wait to Apply for Disability Benefits Until the Waiting Period Expires?
Many people assume they cannot apply for long-term disability benefits until their insurance policy’s waiting period expires. This is incorrect. Elimination periods are not “probationary periods” that prohibit you from filing a claim. Instead, you should apply for LTD benefits as soon as you meet your plan’s definition of disability, even if you won’t receive a check for a couple of months.
Our disability lawyers suggest this strategy for a few reasons. First, it takes time to process disability claims. You’ll need to fill out a variety of forms, the insurance company will request medical records, and the insurance adjuster may even schedule you for an independent medical examination with one of their company doctors. This process can easily take a few months. By the time the adjuster makes their initial decision, your policy’s elimination period may be complete.
Second, many long-term disability plans have accumulation clauses, which let you combine periods of disability over an accumulation period (typically a year).
For example, suppose you suffer a heart attack and cannot work for 45 days while you recover. You return to work for a month or two, but your fatigue, shortness of breath, and other symptoms make it too difficult. Your cardiologist takes you off work again and suggests that you apply for long-term disability benefits. If your policy has an accumulation clause and a 90-day elimination period, you’ll only have to wait 45 days before you can receive benefits (90 days – 45 days of disability = 45 days).
Finally, if you have a chronic, recurring health condition and already qualified for LTD benefits once before, your policy may waive the elimination period in subsequent claims. For example, suppose you have relapsing-remitting multiple sclerosis. In the past, you had to take a year off of work due to the severity of your symptoms. During this time, you received long-term disability benefits. If you still have the same insurance plan and you experience a significant MS flare, your elimination period may be waived.
- Related Article: Disability Insurance in a Nutshell
Will I Automatically Get Disability Benefits Once My Waiting Period Ends?
No. There’s a lot more to your long-term disability plan than just an elimination period. Your LTD policy includes a vast number of terms and conditions. Before you qualify for long-term disability benefits, you’ll need to satisfy them all.
Here are some of the most important policy requirements you’ll need to look out for.
How the Plan Defines “Disability”
Most LTD policies define disability in one of two ways. If you have an “own occupation” plan, you’ll need to prove that you cannot perform your actual job. However, most LTD plans are “any occupation” plans. That means you’ll need to convince the insurance company that you’re unable to do any type of work.
Limitations on Pre-existing Conditions
If you have an employer-sponsored disability insurance policy, it may include additional limitations and waiting periods if you have a pre-existing condition. For example, many group long-term disability plans will not cover a pre-existing or chronic condition if you reported symptoms in the six months before you enrolled in the plan and file a claim within 12 months of enrollment.
Other insurance policies may exclude or limit coverage of certain conditions, like mental illness, addiction, and self-inflicted injuries.
- Related Article: Pre-existing Conditions and LTD: 4 Things You Need to Know
For How Long Will I Get Long-Term Disability Benefits?
Again, it’s important to read your long-term disability plan’s documents, like the Summary Plan Description. Most LTD policies will cover you until you reach retirement age or can return to work. However, insurance companies are for-profit businesses, and they often try to terminate their claimants’ disability benefits.
If you’re receiving long-term disability benefits and the insurance company schedules you for an independent medical examination (IME), the company may be building a case against you. IME doctors frequently find that disabled claimants’ abilities have “improved.” IME doctors make these findings because that’s what they’re paid to do.
If you’re concerned about an upcoming IME or suspect you’re under surveillance, call a disability insurance lawyer right away. You need to start building your legal claims and preparing for a fight.
Bryant Legal Group: Illinois’ Trusted Long-Term Disability Firm
At Bryant Legal Group, we help people across Illinois with their private and employer-sponsored disability insurance claims. If you have questions about your long-term disability claim, contact us today. We’ll help you understand your policy’s requirements, suggest ways you can strengthen your disability claims, and educate you about your rights.
To schedule your initial consultation with our team, call us at 312-667-2536 or complete our online form.