Washington Residents – Get Assistance from Expert Long-Term Disability Insurance Lawyers

While Capitan Law is not licensed to practice in Washington courts, our long-term disability lawyers assist disabled Washington citizens with ERISA-governed disability insurance claims. As discussed in more detail below, ERISA is federal law. If you have a claim that is governed by Washington law, please contact a local attorney licensed to practice law in your state to assist you with that matter.

Facing a non-work-related injury or illness can threaten your financial stability. Let Capitan Law, your experienced long-term disability insurance lawyers, guide you through the application process of disability insurance via your employer’s ERISA-governed policy. Be aware that this process is complex, with insurance companies often attempting to minimize or deny benefits owed.

Our long-term disability attorneys will defend your rights, collate necessary evidence, and strive for the benefits you deserve. We offer free consultations, so call us at (267) 419-7888 today.

About ERISA and Long-Term Disability Insurance

The Employee Retirement Income Security Act of 1974 (ERISA) typically governs long-term disability insurance plans provided by employers. That means if your employer pays for part or all of your disability coverage, you must follow the rules and procedures set forth by ERISA. The benefits that are provided by your LTD insurance policy will replace a portion of your income for an extended period, which is generally determined by your plan and the nature of your disability. As mentioned above, these claims can get complex. An ERISA benefits claim attorney will provide knowledge and experience to guide you through the process.

Each policy varies slightly in its definition of disability, but in general, to be eligible for benefits, the injured individual must be unable to perform the duties of their own job. After some time, eligibility for benefits may change and may stipulate that the individual cannot complete any work at any job due to their disability.

Differences between LTD Insurance and Workers’ Compensation

The main difference between long-term disability and workers’ compensation is that LTD benefits provide a partial-wage replacement for someone who becomes injured while doing something unrelated to their work, while workers’ comp is for job-related injuries and illnesses. If you are injured at work, you may still be able to apply for disability insurance benefits depending on the specific language contained in your policy. However, if you are eligible for both types of benefits, LTD benefits are usually offset by any benefits received through the workers’ comp claim.

Both insurance policies can come from your employer; however, not all businesses in Washington have a legal obligation to provide long-term disability to their employees. If your employer does not offer LTD insurance, you may have purchased your own individual disability plan and paid the monthly premium. It is also possible to have a policy you purchased yourself and one provided through your employment relationship. If you sustain an injury or get sick, you’ll be able to collect benefits based on your policy type. The attorneys at Capitan Law can help you understand the options available to you and are well-equipped to help you navigate these complex issues.

Disabilities Qualifying for LTD Benefits

LTD policies typically cover severe medical conditions that prevent you from maintaining your previous work schedule. These disabling conditions can include autoimmune diseases, back and spine injuries, mental health disorders, and many others.

Filing a Long-Term Disability Insurance Claim

Immediately file a claim when an injury or illness impedes your work. First, file a short-term disability claim; when these benefits end and your disability persists, your LTD benefits can commence. Start the process early to resolve any claim denials or delays promptly. We are happy to assist you in the long-term disability application process.

Common Reasons for Claim Denial

LTD claim filing is complicated, with any errors potentially leading to denials. Common reasons for denial include discrepancies in the definition of disability, missing medical records, procedural errors, inconsistent information, bad faith by insurance, and lack of understanding of rare medical conditions.

Appealing a Denied Claim

You can appeal a denied long-term disability claim. Under ERISA, you must file the appeal within 180 days from the denial notification date. At Capitan Law, we understand the appeals process and will help you through each necessary step.

Long-Term Disability Laws in Washington

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.

Contact our ERISA Benefits Claims Experts

At Capitan Law, we comprehend the urgency of receiving LTD benefits. We work tirelessly to protect your rights and ensure fair treatment during the claims process. If you’re unable to work in Washington, call us at (267) 419-7888 for assistance with filing for benefits.