Whether you have only been receiving long-term disability benefits for a short time or years, receiving notice of termination can be shocking and quickly turn into panic. Will you still receive the disability benefits you count on to pay your bills and keep your family financially afloat?
Suppose you were let go from your job after being approved for ERISA long-term disability benefits. In that case, you need to know that you have rights. You should also know what happens to your benefits after your termination. Working with an experienced ERISA attorney is usually the best way to get answers to your questions and the help that you need.
Long-term disability benefits provide wage replacement of 50 to 70 percent of your earnings before your injury or illness. It typically isn’t available for pregnancy, injuries that heal relatively quickly, or minor illnesses.
This benefit is for people with long-term injuries and debilitating illnesses that prevent the employee from returning to work for months or even years.
Sometimes, an employee can receive long-term disability payments until they reach retirement age or until they can go back to work. The waiting period for a long-term disability may be as long as three to 26 weeks.
Frequent reasons for receiving long-term disability benefits include:
- Lung cancer
- Other forms of cancer
- Back injuries
- Mental health issues
- Heart disease
- Multiple sclerosis
- Parkinson’s disease
- Peripheral neuropathy
- Kidney disease
- Blindness or vision loss
- Deafness or hearing loss
- Chronic pain
- Chronic fatigue
- Qualifying long-term injuries
Applying for ERISA Long-Term Disability
If your employer or the insurance company denies your ERISA disability benefits application, you may have a difficult time appealing to the court. To avoid even having to go to court over the matter, you must submit a thorough and complete application.
The following steps can help you.
- Read your policy: Get familiar with your policy and what it does and doesn’t cover. Obtain a copy of the Summary Plan Description, as well as the actual insurance policy. Under ERISA, a federal law that governs disability plans provided by employers, you have the right to get copies of these documents after you give a written request to your plan’s administrator.
- Understand the associated deadlines: Long-term disability claims involve multiple deadlines that you will be required to meet. Your policy should detail these deadlines. Take the time to familiarize yourself with them, including how long you have to file an appeal. Sadly, not meeting deadlines can mean that you won’t be eligible to receive the disability benefits you otherwise were entitled to receive.
- Identify the date your disability began: Identifying this date is crucial. It will determine all other relevant dates in your claim, such as when you are required to file a proof of claim and when your payments should begin. Carefully review your policy to identify how it defines a disability. This will assist you in determining the actual date that your insurance plan classifies you as disabled.
- Obtain copies of your medical records: You must know what your medical records say about your condition. This is the same information the insurance company will use to determine if they should approve or deny your claim. Medical records must contain objective proof of disability. For example, objective proof can include an MRI for back problems or a Mental Residual Functional Capacity form completed by your psychiatrist for bipolar disorder or depression.
- Carefully select your last day of work: The last day you worked, also known as LDW, is an essential date. Obtain as many records and documents as possible in support of your disability before you stop working.
- Talk to an attorney: Applying for and obtaining long-term disability benefits isn’t a simple process. It’s wise to enlist the help of a well-versed disability lawyer. It’s helpful to have an attorney on your side as soon as you know you will be applying for disability benefits.
Do You Have Job Protection While on Long-Term Disability?
Unfortunately, receiving disability benefits doesn’t protect your job. On the contrary, many employers terminate a disability claimant’s employment after they receive long-term disability benefits for a while. Employers are motivated to make this move if they decide that it’s unlikely the disabled employee will come back to work in the foreseeable future. They may also say that they need to fill the employee’s position to justify terminating an employee getting long-term disability benefits.
However, the circumstances are much different if an employer fires an employee who intends to apply for long-term disability benefits. Section 510 of the Employee Retirement Income Security Act of 1974 (ERISA) permits an employee to sue their employer if they terminated the employee intending to interfere with the employee’s right to benefits. This law also gives employees the right to file a lawsuit against the employer if they retaliate against them for attempting to access employee benefits, including long-term disability benefits.
Is Your Termination Legal?
Employers can still terminate employees who are receiving disability payments. However, federal and state laws prevent them from firing disabled employees in some situations. Suppose you suffered a stroke and suffered partial paralysis. If you qualify, you may be approved to receive long-term disability benefits. Because you have a partial disability, you can still go to work, but you can’t perform your job adequately as you did before your stroke. Because of your inability to complete your work tasks, your employer decides to fire you. Is your termination legal?
Unfortunately, there’s not a clear-cut answer. It depends on the state or federal laws that prohibit the wrongful termination of disabled workers. If these laws apply in your case, you can file for damages. When it comes to this unlawful termination, the fact that you’re receiving long-term disability benefits shouldn’t matter. If your employer wrongfully terminated you, the fact that you received disability benefits doesn’t mean the employer was right or wrong.
However, some employers are more likely to fire disabled workers who can only work part-time and can’t perform as they once did. They may also be likely to fire those who receive long-term disability, so they don’t have to keep paying on their claim.
Laws Protecting Disabled Employees
Fortunately, several laws protect disabled employees from being terminated based on their disability.
Americans With Disabilities Act (ADA)
Under the ADA, employers with at least 15 employees must provide their disabled employees with reasonable accommodations. Sometimes called “productivity enhancers,” reasonable accommodations are changes or adjustments in the work environment that make it so a disabled employee can still effectively perform their job duties to the same extent as possible before they suffer a disability. However, such changes can’t cause the company undue hardship.
To accommodate employees with disabilities, employers can:
- Install ramps or modify the workplace layout
- Provide assistive technologies, such as screen readers and videophones
- Offer the employee a more flexible schedule or update their job requirements
Suppose an employer provides reasonable accommodations and the employee still can’t do your job as their employer expects them to. In that case, the employer can legally dismiss them. They can also dismiss the employee if no reasonable accommodations exist that can assist with the employee’s disability.
Family and Medical Leave Act (FMLA)
The purpose of FMLA is to assist employees with balancing their work and personal life. This law gives certain employees up to 12 weeks of unpaid, job-protected leave.
What is a job-protected leave?
With job-protected leave, you can take a leave of absence for as long as 12 weeks. During this time, your employer cannot terminate you. However, if your leave becomes longer than 12 weeks, the law no longer covers you, and you can be legally let go from your position.
FMLA applies to:
- Businesses with at least 50 employees
- Public agencies
- Elementary and secondary schools (both public and private)
Employees who have worked for their current employer for at least 1,250 compensable hours over the last 12 months are entitled to take an FMLA leave. The Fair Labor Standards Act (FLSA) is used to identify compensable hours.
However, not every illness or event qualifies for FMLA.
This job-protected leave must be for:
- Birth and care of a newborn child
- Placement of a child for foster care of adoption
- Caring for an immediate family member, which includes a spouse, child, or parent who has been diagnosed with a severe health condition
- When you can’t work due to a severe health condition
Those who qualify for FMLA but still face termination can file for reinstatement or file a claim for damages from the employer.
Disability Leave Laws by State
Each state enacts its own laws regarding employee medical leave. Some of them are even better than FMLA.
Employees in California receive a minimum of 30 days of paid sick leave every year. They also receive one hour of paid leave for every 30 hours they work.
Under Florida laws, you can maintain your former position as long as you go back to work before your allowed leave ends. You can also transfer to a different position with similar benefits, pay, and status.
For additional information about your state’s sick leave laws, reach out to your state’s Department of Labor and a seasoned LTD and ERISA attorney.
What Happens to Long-Term Disability Benefits Upon Termination?
The answer depends on the specific disability insurance policy. Suppose an insurance company pays for your disability benefits. In that case, your employment status most likely won’t impact your long-term disability benefits. However, if your employer pays them, then your disability payments may stop.
Whether employer-paid disability benefits will continue after termination is dependent on the terms of the applicable disability plan.
Disability benefit administrators must take into account the claimant’s medical status at the time their employer lets them go, even if an employee is fired for cause. An administrator can’t legally deny a disability claim just because the employer terminated the claimant’s employment. The only way they can is if the disability plan includes explicit terms to the contrary.
Keep in mind that there are also other instances when the insurance company can legally stop your benefits. When this happens, it’s typically because you don’t meet the definition of “disabled” any longer. The insurance company can also cancel your benefits if you don’t cooperate with their requests for information.
Do Disability Benefits Continue Upon Termination?
Rarely, a long-term disability policy will expressly state that employees aren’t eligible for disability payments if the employer terminated their employment with good reason. Whether or not your disability policy contains this language will dictate if a for-cause termination causes the employee to stop getting long-term disability benefits.
It’s also worth noting that your termination will also impact your health insurance coverage. Employer-sponsored healthcare benefits usually cease on the last day of the month in which the employee was let go unless the employee elects to continue coverage via COBRA. This might cause problems with your long-term disability claim since employees need continued proof of their disability to keep receiving their disability benefits.
Therefore, if financially possible, keep getting medical treatment even if you don’t have employer-sponsored healthcare benefits anymore. You might also qualify for discounted health coverage via https://www.healthcare.gov/ in addition to COBRA.
Did Your Employer Terminate You While Receiving Disability Benefits? Call a Skilled Disability Attorney Today
It’s crucial to read your policy plan thoroughly both when you obtain the plan and if you are experiencing changes to your employment or benefits. Even still, if you have questions about disability benefits and termination of employment, don’t hesitate to get in touch with a skilled employee benefits attorney or ERISA law firm since these matters are quite complex.
You can still qualify for benefits even after losing your job. You may also have a cause of action against your employer if they terminated you to stop you from accessing your disability benefits.
Following graduation from Loyola Law School in New Orleans in 1990, Price McNamara served as a Federal Judicial Law Clerk to the Honorable John M Shaw, Chief Judge, United States District Court Western District of Louisiana.
Mr. McNamara founded J. Price McNamara ERISA Insurance Claim Attorney, and began putting his past experience to work for the injured and disabled clients he now represents against the insurance companies in personal injury and long term disability and other insurance disputes in both federal and state courts