Many employers provide their workers with long-term disability coverage to protect them in case of illness or injury. But if you’re thinking about applying for long-term disability benefits, the process can be more challenging than you may think.
At Petro Law Firm, our experienced Birmingham AL LTD lawyers can help. We’re not afraid to stand up to insurance companies and demand justice. In this article, we explain the essentials of a long-term disability claim, and how you can strengthen your claim from the very start.
Do I Qualify for Long-Term Disability?
Because long-term disability claims involve insurance benefits, you’ll need to carefully examine your employer’s current LTD plan before you file a claim. Each insurance plan includes different terms, conditions, and definitions of disability. The easiest way to review these terms is by requesting a copy of the Summary Plan Description (SPD); if you need help understanding the SPD’s language, contact an experienced LTD lawyer.
One of the most important things to understand about your long-term disability plan is how it defines disability. Generally speaking, most plans include one of two definitions:
- Own Occupation: You must prove that you are unable to perform your own occupation or job.
- Any Occupation: You must show that you are unable to do any type of work on a full-time basis.
This analysis requires an intensive review of your medical conditions, limitations, training, education, and other factors. Because this information is critical to the strength of your claim, it’s important to thoroughly review it before applying for long-term disability benefits.
Reviewing Plan Documents
You’ll also need to review the plan documents to determine whether your claim is excluded or limited for any reason. For example, some policies exclude pre-existing conditions or limit the amount of benefits you can receive for mental health issues or addiction. There may also be a waiting period before you become eligible for LTD benefits.
Understanding the strengths and weaknesses of your claim in advance can help you build your best possible case — and gives you time to identify and collect important evidence that can strengthen your claims.
How Do I File an Application for Long-Term Disability Benefits?
When you apply for LTD benefits, you’ll need to provide the insurance company with a great deal of information. First, you’ll need to complete a series of forms that outline your medical conditions, limitations, and the places you’re treating. Make sure you provide accurate and honest information on these forms — the insurance company will use any inconsistencies and errors against you.
The insurance company may also ask for information from your doctors. They may even send you to a one-time medical examination — although this doctor may be protecting the interests of the insurance company more than anything.
During this phase of your claim, it’s important to provide as much information as possible to the insurance adjuster. Your attorney may want to send comprehensive copies of your medical records to the insurance company, ensuring that they have all the information they need.
Next, the adjuster will review your information and issue a decision. If they approve your long-term disability benefits, you should start receiving a monthly check. If they deny your LTD claim, you have the right to appeal — and you should immediately consult with your LTD lawyer about your options.
Beware of Insurance Company Surveillance Tactics
After filing a long-term disability claim, you can feel like the insurance company is watching your every move. In fact, many insurers use surveillance to monitor claimants and look for fraud.
This surveillance can occur in real life and online. So be careful to live within your restrictions and try not to overexert yourself — the insurance company could be watching. You should also make your social media accounts, like Facebook and Instagram, private.
However, surveillance is sometimes more subtle. For example, an adjuster may ask to come to your house for an interview. During this meeting, the adjuster may study your house, looking for evidence that you’re doing more than you claim. If you’re not comfortable dealing directly with the insurance company, it’s best to consult an attorney who can guide you through the claims and appeal process and help you protect your rights.
For Questions About Applying for Long-Term Disability Benefits
To learn more about applying for long-term disability benefits and preparing a claim, contact Petro Law Firm. We will meet with you, learn about your conditions, and help you build a plan that focuses on getting you the benefits you deserve.