How Long-Term Disability Benefits Work
Long-term disability coverage is essentially the “private insurance” version of Social Security Disability Income (SSDI) in that it operates as a wage replacement for those who are rendered incapable of working for an extended period of time due to their disabling condition. Long-term disability benefits are often offered through one’s employer, but it is not uncommon for such benefits to be obtained independently through an individual plan.
If you are making a long-term disability claim, you are likely suffering from a serious and debilitating condition, and as such, an insurer’s failure to grant long-term disability benefits can be particularly damaging from both a financial and emotional standpoint. Disabled policyholders who can no longer work — and who have also had their claims denied by their insurer — may find themselves stuck in a difficult situation at the crossroads of insurer greed, incompetence and administrative issues. When pursuing a long-term disability claim, it’s therefore vital that you work with a qualified Chicago long-term disability attorney who can provide the necessary assistance you need.
What Makes Long-Term Disability Coverage Unique?
Long-term disability benefits are rather simple to understand. Unlike short-term disability benefits, long-term disability benefits are intended to provide an income for an extended period of time to those who have been rendered incapable of working due to their qualifying, disabling condition. This income may be percentage-based (i.e., you receive 50 percent of your wages as long-term disability benefits), or may be a specific amount (i.e., you receive $3,000 per month per the language of the long-term disability policy) that is not actually related to your wages. In any case, long-term disability benefits are paid out for a period of at least a year, and up to age 65, depending on the plan.
For example, one plan may offer higher benefits and have a very broad definition of “disability,” but last for only five years, while another plan may offer lower benefits and have a stricter definition of “disability,” but last until retirement age.
Long-term disability benefits are intended to last for a sufficiently long enough time to serve as adequate compensation for the wage loss of the claimant. Given that the overall benefits payout tends to be higher than short-term disability benefits (due to the lengthier period of time during which benefits are paid out), you are more likely to encounter insurer roadblocks when making a claim for long-term disability benefits.
Complete Disability — Definitions May Vary
What constitutes a qualifying “complete disability” depends on your particular coverage. As a general rule, however, a disability in the context of long-term disability benefits is any condition that renders you incapable of working at your current job — stricter definitions are occasionally encountered, so be sure to confirm the language of your policy with a qualified Chicago long-term disability attorney here at Bryant Legal Group, P.C., before making a claim for benefits.
Some long-term disability insurance plans have a list of automatically qualifying conditions. For example, your insurance plan may include certain debilitating immune system conditions, such as Lupus. If you qualify under one of the listed conditions, then it will be quite difficult for the insurer to justifiably challenge your claim for benefits.
Regular Updates Are Necessary
Each plan has a regular schedule for updates. Further, benefits recipients are required to update the insurer whenever there has been a significant change in circumstances that may influence the long-term disability benefits at issue. This is what is referred to as the insureds’ duty to provide continuing proof of loss. For example, if you have recovered from the disabling condition enough that you can return to your job, you will have to update the insurer so that they can terminate the benefits. Failure to report could result in various penalties. It is irrelevant whether your plan lasts for five years or until retirement age — if your condition is no longer disabling, then you cannot receive benefits.
Contact Us Today to Speak With an Experienced Chicago Long-Term Disability Attorney
If you have recently become disabled or are already suffering from a disabling condition and have had your long-term benefits claim denied by your insurer (whether the coverage is through your employer, or independent of your employer), it’s important that you consult with an experienced long-term disability attorney for guidance. Your attorney can help you gather necessary evidence and repackage your application for benefits, challenge decisions made by the insurer through the appeals process, and potentially sue and recover damages on your behalf for wrongful denial.
Here at Bryant Legal Group, P.C., we have successfully advocated on behalf of disabled claimants for many years, helping policyholders obtain the long-term disability benefits to which they are entitled. We understand that in the wake of a disabling condition, claimants are likely to feel overwhelmed and under pressure. To that end, we work closely with our clients and keep them updated on developments throughout the engagement process.
Call (312) 561-3010 today to speak with one of our long-term disability attorneys. We look forward to assisting you.