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

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

At the intersection of federal and state regulations concerning disability benefits lies the Employee Retirement Income Security Act (ERISA). Established in 1974, ERISA is a federal law governing most private industry pension and health plans, including long-term disability insurance plans.

A key feature of ERISA is its “pre-emption” power, a principle signaling that ERISA’s regulations take precedence over state-specific rules, even those crafted by Tennessee lawmakers. This ensures that individuals across the U.S., whether from the Smoky Mountains or sunny California, are under a consistent set of standards when it comes to long-term disability insurance.

Eligibility Requirements for Long-Term Disability in Tennessee

In Tennessee, as in other states, the insurance companies are generally the ones who set the eligibility rules for long-term disability. This is because employers and government agencies can select their preferred insurers, and these insurance giants establish their own eligibility requirements.

While eligibility criteria differ across insurance providers, a common thread exists: Most full-time employees are eligible to purchase a long-term disability policy if their employer offers them. So, if you’re a full-time worker in Tennessee and your employer offers long-term disability insurance, as long as you purchased or opted for the employer-provided long-term disability insurance, you can tap into those benefits should the need arise.

Tennessee’s Definition of Long-Term Disability

The term “long-term disability” might seem straightforward, but it has specific connotations when it comes to insurance policies and coverage in Tennessee. Typically, for insurers to classify an injury or illness as a long-term disability, it must be expected to keep you completely off work for a minimum of three to six months. For instance, 90 days is the minimum waiting period for Tennessee public employees. Some insurers stretch this timeframe even further, requiring the disability to last for at least a year before recognizing it as “long-term.”

However, some insurance providers make exceptions for terminal health conditions. In such cases, they’ll provide benefits even if the condition might not span the stipulated extended period.

It’s also essential to be aware of exclusions, as insurers don’t cover certain disabilities. Some conditions commonly excluded from disability coverage include self-inflicted injuries, disabilities arising from riots or wars, and those resulting from criminal activities or substance abuse.

Long-Term Disability Benefits in Tennessee

Given the discretion employers and insurers have in shaping these policies, there can be considerable variation in the benefits offered. But while the specifics can differ, most policies include a handful of similar benefits, including:

Replacement Income: These policies provide a significant portion of the disabled employee’s salary (typically between 50-70 percent), ensuring financial stability despite being unable to work.
Cost of Living Adjustments (COLA): To account for inflation and rising living costs, some policies offer COLA, ensuring that benefits maintain their purchasing power over time.
Waiver of Premium: Some insurers waive premium payments while the individual is receiving disability benefits.

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