Though you would never want anything this unfortunate to happen with you, it is still good to be prepared. Long term disability insurance is the best preventive solution in this context as it pays monthly benefits if you are unable to work due to medical reasons.
While this form of insurance definitely has you covered, you cannot expect to secure the benefits easily. As a matter of fact, applying for disability benefits and getting an optimal amount can be time-consuming and frustrating.
Insurance providers will do everything possible to deny the claim or at least, minimize the value of compensation that you get. You can follow some tips and guidelines to simplify the process and get the compensation you deserve. Let us list them for you.
Understand your long term disability policy
Basically LTD coverage is of two types- group coverage through the employer and individual policy. Whichever policy you have, you need to understand its clauses before filing for a claim. Go through the policy documents carefully and pay attention to the following aspects in particular:
Definition of disability:
The law does not provide a standard definition of disability though insurers generally define it as an inability to perform your occupational duties due to illness or injury.
When you file a claim, you need to prove that you cannot continue at your current position due to a disability. Some policies may define long term disability as the inability to perform any job rather than just the current one.
The clause mentioned in your policy decides whether you are covered under the definition of disability.
While there are some conditions that come under the scope of LTD policies, you cannot claim compensation for the disabilities caused by pre-existing conditions.
Similarly, conditions such as drug abuse, alcoholism, attempted suicide and disabilities caused by the commission of a crime are not included in the coverage. Disabilities caused by mental or nervous conditions may also not get the LTD benefits or have them only for a limited period.
Disability policies give stringent time limits regarding filing your initial application and subsequent appeals. Not adhering to these deadlines means that insurers may deny your claims. So it is best to apply with all the required paperwork within the time allotted.
The policy may also have an elimination period, generally 3-6 months, between the time disability first occurs and the time you start getting the payments. Normally, the elimination period coincides with the short-term disability policy, which means that there is no gap in coverage.
Gather sufficient medical records as well
While you need to know your policy well enough, there is also a need for having sufficient medical records to prove the disability. Proper supportive documents are a must to get the amount that is rightfully yours. To start with, you need to show that you are undergoing regular medical treatment for the condition causing disability.
Obviously, the insurer will expect you to prove that you visit a primary care physician and specialists on a regular basis. This rule applies to both physical and mental conditions. Supportive evidence such as tests including X-rays, CT scans and MRIs can make your case even stronger.
The statement of your doctor is vital when it comes to proving work-related medical limitations. Get a detailed letter that states how the impairment limits your ability to work.
Be prepared to counter the insurance company
Even if you have a genuine long term disability case, the insurance company will do everything to avoid paying up the compensation. So it is better to be prepared to counter them. The best approach would be to hire a seasoned long term disability lawyer to handle your case and negotiate with the insurance company. You can check out https://www.preszlerlaw-ns.com/ to see how these experts can help.
Lawyers who specialize in this field will generally know the measures that insurance companies often take to disavow claims. These can range from alleging incomplete medical documentation to stating that you are not fully disabled to show that you are still capable of doing similar work. They may even prove that you are not disabled by having you evaluated by their panel doctor.
Filing for social security disability
When you get approval for LTD benefits, you will also have to file for Social Security Disability benefits. In fact, your insurance company would want you to do it and even arrange a disability attorney to represent your case. This is because they can actually offset the amount you get from social security against the monthly LTD payment.
On the other hand, if you are getting LTD benefits due to a workplace injury, you may also have to file for workers’ compensation. In this case, the worker’s compensation you get will offset the LTD benefits. Therefore, following through these claims, as the case may be, is important if you want to get your LTD benefits.
other valuable tips:
Social Security Disability: 7 Things You Might Not Know
Injured and Out of Commission? 3 Ways to Pay the Bills if You Can’t Work
Taking the right approach will probably do the job of getting you the long term disability claim you should. At the same time, you should seek expert help from a specialist lawyer to improve your chances. If the claim is initially denied, you should not lose heart but file an appeal. You can rightfully get one or even two levels of administrative claims with this form of compensation. It is best to hire a lawyer at this stage if you haven’t done so initially.
A skilled and experienced lawyer can help you by gathering all the significant evidence that makes your case stronger. Still, if you fail to get a favorable verdict even after filing a subsequent appeal(s), you must file a case in the federal court. A long term disability claim is your right, more so because you have been contributing to the insurance and would expect them to cover you in return.
Image Credit: long term disability claim by Pixabay
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