When you are facing the possibility of not being able to work due to a catastrophic injury or serious medical condition, it can be a confusing and frustrating time. Your family depends on you for support and income, but what happens if you can not work? Medical bills can start to pile up, leaving the future uncertain. Many people make the wise choice to carry long term disability insurance through their employers, but it can be extremely disappointing when your claim for benefits is denied.
At the Law Offices of J. Price McNamara, we have spent years getting to know our clients and their unique situations. If you have been denied long term disability, call our team today.
Similar to an optional life insurance policy, long term disability plans are offered by employers to help employees who become unable to work for a long period of time. The plans generally provide a number of coverage options, based on how long you wish to be covered and what percentage of your salary you would need to get by in the event of a disabling condition.
Your employer’s long term disability plan is usually part of a cafeteria plan or group of options that you can choose from. Some long term disability plans are paid for by the employer, and in some cases, the employer may even pay 100% of the premiums up to a certain amount of coverage. In some plans, the employee must pay the premiums through payroll deductions.
To claim benefits, you must generally meet several requirements. These are:
What do terms like “disabled” and “unable to work” really mean? Unfortunately, this can vary from one contract to another, as there is no requirement that all policies be uniform.
Figuring out if you qualify for long term disability benefits will require you to review the policy contract. At the Law Offices of J. Price McNamara, we handle contract reviews for our clients, helping to clarify what is required and the sort of medical evidence you will need to meet that standard. Many Atlanta, GA employers use long term disability (LTD) benefits as a strong tool for recruiting and retaining employees, so it is only fair that the benefits be paid when people need them.
Most policies define disability as the inability to work in your profession or job. So, a disabling condition may be different for a brick mason and a clerical worker. Nevertheless, many policies now put caps on this definition, effectively increasing the requirement after 12 or 24 months. After that time lapses, to continue getting benefits you must show you are completely unable to work in any capacity.
In general, these types of policies will not cover pre-existing conditions. Unlike health insurance policies which currently must pay for pre-existing conditions, long term disability plans will not pay if you received medical care and treatment for the disabling condition in the 90 days prior to when coverage takes effect. There are limits to this, as some policies may only exclude pre-existing conditions for a year or two.
If you are unfairly denied compensation under your employer’s LTD benefit plan, call the Law Offices of J. Price McNamara today for a free consultation with an experienced disability lawyer who can help to review your case and look for ways to appeal the denial. Do not delay. Many policies have strict appeals procedures that must be met to preserve your rights.
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