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

While Capitan Law is not licensed to practice in Michigan courts, our long-term disability lawyers assist disabled Michigan 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 Michigan 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 Michigan 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 Michigan

Long-term disability (LTD) insurance provides a partial wage replacement if the policyholder becomes ill or disabled to the point where they cannot work (or must work limited duty) for a long period of time. There is no state law that defines how long “long-term disability” is; each Michigan insurance carrier sets its own regulations for how long someone must be disabled before their disability is considered long-term. For the most part, though, LTD plans define a long-term disability as one that lasts more than six months.

All LTD plans sold in Michigan must comply with federal ERISA requirements, providing a minimum amount of coverage for the insured. It’s not mandatory for employers to offer LTD insurance options, although many do. If your employer doesn’t offer an LTD policy, you can purchase your own through an independent insurance carrier.

If you become disabled and have LTD coverage, then you can file a claim, either working with your employer, if they provide the benefit, or through the insurance agent that you purchased the policy from.

Benefits Eligibility for Michigan Long-Term Disability

Each plan sets its own eligibility requirements, but for many:

You must be employed full-time.
Your disability must meet the plan’s definition of disability.
You must have worked for your employer for a specific length of time (usually six to 12 months).
You must provide medical proof of the disability.
Your disability must not be one excluded from coverage (such as a pre-existing condition).

The wage replacement benefits are intended to provide you with a portion of the wages you were earning prior to becoming disabled. Most plans stipulate how they calculate your wage, such as your average wage for the 12 months prior to you becoming disabled or your three-year average. You likely won’t receive 100% of what you were earning before the disability, as most plans pay between 60-70% of your pre-disability wage.

Most plans have a waiting period before you can begin collecting benefits. In addition, if you have a pre-existing condition or your disability is specifically excluded in your plan’s language, then your claim may be denied.

How Do Michigan Long-Term Disability Laws Define Long-Term Disability?

There is no state law defining the exact length of a long-term disability. LTD carriers in Michigan define a long-term disability with varying lengths of time, although most consider a disability to be long-term if it keeps the insured from working for more than six months.

Many plans have an unlimited duration, with the most generous offering benefits until the insured is eligible to file for Social Security retirement benefits. Other plans may have a shorter duration, anywhere from two to ten years.

Other Considerations Regarding Long-Term Disability Laws in Michigan

The IRS may assess federal income tax for benefits you receive if your employer paid for your premiums as part of your employee benefits. However, if you purchased your own plan or if you paid for all of the premiums of an LTD plan offered by your employer, then you shouldn’t have to pay federal taxes on any payouts.

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 Michigan, call us at (267) 419-7888 for assistance with filing for benefits.