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

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

Virginia ERISA Benefits Claims Experts

Each insurance company writes its own LTD policies, specifying which conditions qualify the policyholder for benefits and which are excluded. If you need specific coverage for a medical condition that runs in your family (and you’re afraid you’ll develop it), look for a policy that does not exclude it.

Qualifying Conditions for LTD Benefits in Virginia

Most LTD policies specifically list the conditions that are excluded from coverage. The policy may also have language that defines what a long-term disability is and the specific criteria the policyholder must meet to qualify as disabled under the policy.

Some of the most common exclusions for Virginia long-term disability policies include:

Pre-existing conditions
Mental illness or diagnosed mental health conditions
Nervous conditions or disorders
Injury or illness caused by substance abuse

These may not be the only conditions excluded by your policy, so check yours carefully.

Defining Long-Term Disability in Virginia

Each LTD policy offered in Virginia will have its own language defining long-term disability, but in general, it will read something like this: An impairment that is expected to result in death, or one that has lasted or is expected to last, for a continuous period of no less than a specific number of months.

The time period is usually at least six months. Many policies specify that the disability must have lasted at least nine or twelve months before LTD benefits are payable.

Common conditions that meet the qualifications of a long-term disability include:

Cancer
Cardiovascular disease or complications
Debilitating spinal cord or back injury
Chronic respiratory disease

Virginia Long-Term Disability Benefits

Long-term disability is intended to provide income for individuals unable to work due to a disability. Short-term disability benefits should cover the period from when the illness or injury prevents you from working until your LTD benefits begin.

Your income from LTD will be determined at the time you purchase the policy. LTD benefits are usually based on your average income for a specific number of years, like three or five, before you became disabled. You’ll receive a fraction of that amount, on average, about 60-70%.

Your LTD benefits may be subject to taxation in Virginia if your employer paid for the policy and paid its premiums. However, if you purchased the policy yourself with after-tax dollars, then the benefits shouldn’t be taxed.

Call Our ERISA Benefits Claims Experts

The attorneys at Capitan Law are dedicated to helping people seeking LTD coverage assert their rights to the benefits they’re owed. We can help you appeal a denied claim and ensure you are fairly treated. Call us today at (267) 419-7888 for a complimentary consultation.