Posted on Wednesday, September 15th, 2021 at 6:57 pm
You’ve thought about what retirement might look like someday, but you always believed that you alone would make that call. Suddenly, because of an injury or other medical condition, you just can’t work a job with significant physical demands anymore. You’re experiencing frustration, confusion, and concern about what your future looks like. You can probably seek coverage under you’re the long-term disability policy you bought through your company, but you don’t know the first thing about how to apply for it, what it covers, how long it will take to get in place or how much you can count on it to provide for your family.
The experienced long term disability attorneys of Capitan Law understand your pain and your priorities. We can explain how to pursue coverage under your long-term disability policy and help you improve your chances of getting the best possible outcome.
How Does Long Term Disability Coverage Work?
The Social Security Administration reports that one out of every four working Americans will become disabled before retirement age. With those odds, you need to have long-term disability (“LTD”) coverage in place. Although the outcome of any LTD claim is controlled by the specific facts surrounding the injuries/condition of the individual pursuing coverage, there are some general guidelines that apply to all LTD claims:
- The terms and conditions of the LTD policy will be the single biggest factor in determining the total award for which you may qualify.
- There will be some period of time that must elapse (known as the “elimination period”) to establish that your disability is truly a long-term problem rather than a temporary setback.
- Specialized medical evidence will be required to document both your current diagnosis and your prognosis for further progression of your condition.
What Is an Elimination Period?
The elimination period refers to the amount of time between when you apply for benefits and when the payment of your benefits begins. Very few LTD policies start paying benefits on the day or week after you first become disabled. Depending on the time period specified under the LTD policy, you may have to wait 90 or even 180 days to receive benefits after the injury occurs or your medical condition is definitively documented.
What Happens Next?
LTD coverage is not automatic after you report a disabling injury or other medical condition to your LTD carrier. You have to aggressively pursue benefits available under your LTD policy. The average LTD claim takes nearly three years to fully resolve, so you should get started as soon as possible.
You must first complete and submit a detailed application, together with supporting medical records. After that, the LTD insurer usually will:
- Have its own medical experts scrutinize every aspect of your medical records to identify potential grounds for denying or limiting your claim
- Request additional documentation in piecemeal fashion to purposely extend the period of time during which it has your claim “under review”
- Demand that you submit to independent medical evaluation by physicians or other medical providers on the insurer’s paid staff
While no LTD attorney can (or should) guarantee any specific outcome in any particular period of time, at Capitan Law, we have handled hundreds of LTD cases against the biggest LTD insurers in the marketplace, and we know what it takes to get the benefits you qualify for to start flowing sooner rather than later.
What Other Factors Affect How Long My LTD Claim Will Take?
There are several other considerations that can impact the time it takes to perfect your LTD claim. Some of those factors are:
- The duration and severity of the symptoms supporting your current LTD claim
- Any prior short-term disability or workers’ compensation claims on the same job
- Whether your treating physicians and other caregivers cooperate promptly and completely as needed to support your LTD application
What if the LTD Insurer Denies My Claim?
Unfortunately, there is a substantial likelihood that the insurer will deny your first application for LTD benefits. The claim administrators who perform the initial assessment of your application often routinely deny deserving claims even where the evidence of disability appears to be clear.
The appeals process rules also favor LTD insurers, making reversal of an LTD claim denial very challenging and time-consuming. You usually only get one shot at an appeal, and the odds are already stacked against you. Having an experienced LTD attorney like the lawyers of Capitan Law on your team could make the difference between obtaining benefits or walking away empty-handed.
Why Choose Capitan Law?
The attorneys at Capitan Law have dedicated their professional careers to helping workers like you whose plans and dreams have suddenly been affected by an unexpected work injury or other medical condition. Call us today at (267) 419-7888 or contact us online to put our extensive experience and relentless advocacy to work for you.