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

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

When we talk about long-term disability laws in New York, there’s one critical factor to keep in mind: the Employee Retirement Income Security Act, or ERISA. ERISA is a federal law that sets the standards for how long-term disability insurance works nationwide. Even though each state, including New York, might have its own regulations, those laws must comply with ERISA guidelines. ERISA preempts state and local laws.

But there is one key area where New York stands out from the crowd: It’s one of just five states that require employers to provide short-term disability insurance. This requirement is a testament to New York’s dedication to supporting its workforce during tough times.

Who Qualifies for Long-Term Disability Benefits in New York?

In New York, the insurance companies typically determine who qualifies for long-term disability benefits, not the state or employers. This is because employers, including government agencies, pick their own insurance providers, and these insurers set the standards.

The good news for most full-timers: If your employer offers long-term disability insurance, chances are you qualify to acquire an LTD policy. But what if your workplace doesn’t have this perk? Don’t worry. You can buy an individual long-term disability insurance policy to ensure you’re covered.

However, not all health issues make the cut. Some conditions, like certain mental health disorders, soft-tissue injuries, or conditions without clear diagnostic tests, might not always qualify for long-term disability benefits. If you have concerns about whether your illness or injury qualifies as a long-term disability, you can review your policy with a knowledgeable attorney.

Definition of Long-Term Disability in New York

While the concept of “long-term disability” might seem straightforward, its definition varies depending on the insurance company. In New York, although individual insurance providers set the criteria for eligibility, there are common threads to be aware of.

Most insurers define a disability as “long term” if it’s expected to last a significant duration. Typically, this means a minimum of six months. However, some insurance plans are more stringent, requiring the disability to last a year or even longer before the policyholder can claim any benefits.

But what about cases where the disability is dire but might not fit neatly into a six-month or one-year timeframe? Most insurers cover terminal disabilities if the prognosis suggests the condition might not last as long as their usual requirements.

Long-Term Disability Benefits in New York

The benefits available through a long-term disability policy vary widely among insurers and employers. However, most plans typically include the following benefits:

Waiver of Premium: It can be stressful to think about premium payments while dealing with a disability. Hence, many policies include a waiver of premium provision, which means you won’t have to pay policy premiums while receiving disability benefits.
Income Replacement: The cornerstone of any long-term disability policy is its promise to replace a portion of your salary if you become disabled. Typically, this amount ranges from 50 to 80 percent of your pre-disability earnings.
Cost-of-Living Adjustments (COLA): Inflation can erode the purchasing power of a fixed income. To counteract the effects of inflation, some policies include COLA benefits that adjust your disability payments over time.

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