Whenever an illness or injury that did not occur while on the job leaves a person unable to work, a long-term disability insurance plan may provide much-needed income while they recover. As such, it is important to understand what types of benefits these plans may provide and potential hurdles that an applicant may face.
Louisiana long-term disability insurance benefits can provide essential income for people forced to miss significant time at work. However, applicants must still meet the requirements to begin the program and provide evidence to support their claims of continued disability. For more information, contact an experienced lawyer today.
The core prerequisite for any long-term disability insurance plan is that an illness or injury leaves a worker unable to earn a living. However, these plans will never cover an injury or illness endured while on the job. These incidents would instead be covered by workers’ compensation insurance.
Common examples of how a long-term disability may occur include but are not limited to:
In essence, a policyholder must simply suffer an injury or illness that prevents them from performing any work-related duty to be eligible for long-term disability insurance benefits. However, since many such conditions require intensive medical care to properly evaluate a patient’s loss of ability to work, working with an attorney to better understand how these benefits work in Louisiana may be key.
Every plan consisting of Louisiana long-term disability insurance benefits is unique. Typically, employers provide these plans as a perk or benefit to their employees, and employees are given the option to buy into the plan voluntarily.
Every plan will also have specific triggering terms that signal the issuance of benefits—for example, a requirement that an employee must miss somewhere between three and six months of work before receiving benefits. In essence, a worker must first exhaust all their options for short-term disability benefits before making a long-term disability claim.
In addition, plans may differ with regard to their definition of “disabled.” Some plans may state that a worker is disabled if their condition leaves them unable to work their old job, while others may label a person disabled only if they cannot work any job.
Finally, plans differ as to the amount of benefits provided under the terms of the contract, as well as regarding how long they will apply. In general, a long-term disability insurance plan in Louisiana will provide somewhere between 50 and 66 percent of a worker’s usual wages for a set maximum number of months. However, other plans provide this income for the rest of the worker’s expected working life up to the age of 65.
Because most long-term disability insurance plans are provided by employers, a set of federal regulations known as the Employee Retirement Income Security Act (ERISA) controls all appeal processes. In other words, ERISA regulates virtually all employer-provided benefit plans everywhere in the country.
Normally, a dispute over an insurance plan, including those addressing long-term disability benefits, is a matter for a court to decide. However, ERISA rules require an applicant to exhaust all insurance company internal appeals before asking a court to intervene. An attorney could help anyone looking to appeal a denial of long-term disability insurance benefits in Louisiana meet all the requirements ERISA establishes for their particular case.
Louisiana long-term disability insurance benefits can provide essential income in the case of an illness or injury. As long as this incident did not occur on the job, a worker can still collect income while being unable to work.
However, every policy is unique, and requirements for the length of disability, the period of benefits, and even the definition of disability will vary from policy to policy. An insurance lawyer could help you understand these policies and file appeals efficiently after a denial. Call today to find out more about your legal options.
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