Washington employers are not required to provide long-term disability (LTD) policies for their workers. State employees may enroll in long-term disability insurance offered by their state employer if they wish. Many private employers offer this optional plan for employees as part of their insurance benefits.
If your employer doesn’t provide LTD options, or if you don’t like the terms of the plans it offers, you can purchase your LTD policy through an insurance company.
Insurers offering plans in Washington cannot have terms in the policy that conflict with the federal ERISA law.
Washington Eligibility for Long-Term Disability
Each insurance company has specific conditions for LTD qualification, as well as listed conditions that are excluded from coverage. Furthermore, a carrier may have a few different LTD plans with different terms and conditions, so what is excluded from a lower-priced plan may be included in one with higher premiums. If you know a specific condition runs in your family, you may want to seek a policy that covers disability caused by that condition.
Qualifying for LTD Benefits in Washington
Each LTD policy will define what conditions qualify as a long-term disability. Even if your condition isn’t specifically excluded, you still may be denied coverage based on the insurance carrier’s definition of disability. If your claim is denied, speak with an experienced Washington disability claims lawyer who can help you appeal the denial.
Commonly excluded conditions include:
- A pre-existing condition
- Nervous disorders
- Mental illness
- Substance abuse-caused disease
The Definition of Long-Term Disability in Washington
The verbiage of your policy may vary, but in general, a long-term disability can be defined as “an impairment that lasts, or is expected to last, a minimum of 12 consecutive months that prevents a person from working.” Some LTD policies have a minimum duration of 12 months, but some pay benefits for years or until the policyholder reaches retirement age.
Conditions that could meet the definition of a long-term disability include:
- Cardiovascular complications
- Cancer
- Debilitating back or spine injury
- COPD
Washington Long-Term Disability Benefits
LTD insurance provides income for disabled individuals who are unable to work. It’s usually about 50-70% of the person’s salary. The salary used as the basis for this calculation will be specified in the policy document. It could be a monthly or yearly salary for a specific period of time before the policyholder becomes disabled.
Some policies have provisions for “own occupation” disability or “any occupation” disability. In an “own occupation” policy, you could receive benefits if you’re disabled from performing the tasks of your particular profession. In an “any occupation” policy, you only get LTD benefits if you cannot work in any job at all. Some policies start with a specific period when the “own occupation” definition of disability applies but then switch to any occupation after a defined period.
Washington has no state income tax, but your LTD benefits could be subject to federal taxation. If your employer paid the premium, you could pay tax on your LTD income. If you paid the policy and premium using your post-tax money, your benefits shouldn’t be taxed.
Speak with an ERISA Benefits Claims Expert
At Capitan Law, we understand the urgency you feel when you file your LTD claim and the frustrations you feel when it’s denied. Our legal team can help you file an appeal and ensure you’re treated fairly. If you cannot work in Washington due to a disability, call us at (267) 419-7888 today for assistance in getting the LTD benefits you paid for.
