How long term disability benefits work can be confusing. It is important to understand the various stages of your claim, when you will be paid, and what you need to prove at each stage to ensure you continue to get paid.
Elimination Period
Your LTD claim begins with the elimination period. During this time frame, which is typically the equivalent of your short term disability (usually 90 or 180 days), you must be found disabled from working in your own occupation. No LTD benefits are paid during the elimination period, but short-term disability benefits usually are paid.
Disabled from Your Own Occupation
The definition of disability for the first 24 months of benefits is disabled from your own occupation. This means, you have to be found disabled from working in your own occupation for the first 24 months.
The insurance company determines, based on your medical evidence and other non-medical evidence, whether you can perform your own occupation duties. If yes, then you are paid LTD benefits during your own occupation period.
You will still have to periodically provide updated medical and non-medical information to show you remain disabled throughout your own occupation period.
Disabled from Any Occupation
After the first 24 months of paid LTD benefits, the definition of disability changes from own occupation to any occupation. This means you have to prove you are disabled from working in any occupation, as defined in your LTD policy.
It is at this stage we most commonly see insurance company’s terminate LTD benefits.
Leading up to the change in the definition of disability, your insurance company will conduct an “any occ review.” This means they will request updated medical records, forms from you and attending physician statements from your treating providers.
The insurer will likely also conduct an occupational analysis to determine whether you are capable of performing any other occupations based on your qualifications, education and training as well as your medical restrictions and limitations.
If you are approved for LTD benefits into the any occupation period, you could receive benefits through the maximum benefit period. The max benefit period is typically age 65 or the normal social security retirement age (somewhere between age 65 and 67).
Once approved, not always approved. You are still required to periodically show you remain totally disabled under the terms of your policy. Unfortunately, LTD benefits are not guaranteed paid for the life of the insurance policy and work still must be done to ensure payments continue.
If you or someone you know are dealing with an LTD claim, contact one of our disability insurance attorneys today. We handle disability insurance claims at every stage and know how to handle insurance companies' tactics to deny a claim.
Help from a Lawyer with Expertise in Disability Insurance
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That focus means:
- All of our lawyers specialize in disability insurance claims;
- We have experience with every major disability insurance company;
- We have won important long term disability lawsuits.
Our disability lawyers can help you with:
- Submitting a disability insurance claim;
- Appealing a long-term disability denial;
- Negotiating a lump-sum settlement; or
- Filing a lawsuit against your disability insurance company.
Hiring an experienced disability attorney is important. Because federal law applies to most disability insurance claims, our lawyers do not have to be located in your state.
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