Suffering a debilitating injury can be overwhelming but when you are faced with having to prove that your disability fits squarely into a certain definition to receive insurance benefits, it can be even more disheartening. However, there are attorneys who can help you evaluate your injury to determine whether it should be defined as a long-term disability.
Defining long-term disability in Louisiana depends on several different factors that involve a legal as well as a medical analysis of the facts. Because of the complexity of this process, working with an attorney for a thorough analysis may be helpful.
The definition of long-term disability is slightly different depending on the terms of the governing insurance policy. While the precise definition of long-term disability can vary, there some common standards.
Many policies will consider an individual to have a long-term disability when they are unable to perform their most recent job. However, other policies define a long-term disability as the inability to continue working in any position that would be appropriate given an individual’s training, education, and experience.
The conditions that qualify for long-term disability coverage will vary depending on terms of the controlling policy. Common claims for long-term disability are based on the following types of medical conditions:
Unfortunately, some disabilities, although debilitating, are specifically excluded from an insurance policy’s definition of a long-term disability. Pre-existing conditions, meaning those that were discovered, diagnosed, or treated prior to the beginning of the coverage are usually not covered. Making a determination of whether the disability at issue was pre-existing will depend on the individual facts and circumstances of each case.
If an individual’s medical condition is mental in nature, coverage will likely be limited. Anxiety, depression, and dementia are examples of mental conditions that may result in limited coverage. Conditions related to alcoholism or substance abuse may also have limited or no coverage under long-term disability insurance.
Individuals seeking long-term disability coverage will need to have medical records to substantiate their claim. Any medical tests, evaluations, or reports will be helpful to establish the existence of a long-term disability as defined in a policy. A legitimate disability without sufficient supporting evidence may not be recognized.
Long-term disability benefits are not paid out immediately after a diagnosis. There is generally an elimination period imposed before the insured can collect long-term disability. The individual must remain disabled and unable to work for the duration of that period. Elimination periods vary by policy, but typically last between three and 12 months. If the insured no longer meets the definition of a long-term disability at the end of the elimination period, they may not be entitled to receive benefits.
Long-term disability insurance ends upon the occurrence of certain events including:
If you have questions or concerns about whether your injury or medical condition is a long-term disability as defined in your insurance policy, a knowledgeable attorney is here to help. They can review your claim to help determine your options.
To schedule a meeting with one of a well-versed Louisiana attorney to discuss your long-term disability, call today. A lawyer can work with you in defining long-term disability in Louisiana to help clarify whether your injury qualifies.
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