BRYANT LEGAL GROUP
Long-Term Disability Benefits
Chicago Long-Term Disability Insurance Attorneys
If you become disabled and are unable to work for an extended period, your long-term disability (LTD) insurance is supposed to replace a portion of your lost income and protect the standard of living you worked so hard to build. But in practice, that’s not always how it works.
Filing a long-term disability claim is often a complex and confusing process. Minor mistakes made during filing can lead to an unfair denial of long-term disability benefits. You will have only a limited time to appeal before losing your chance at obtaining your benefits. Even if you did nothing wrong, the insurance company may unfairly deny your disability claim and leave you in the lurch.
If you need help applying for long-term disability benefits, appealing a denied claim, or negotiating a settlement or buyout of your existing benefits, contact the Chicago long-term disability lawyers at Bryant Legal Group today. Our attorneys have decades of experience helping workers and professionals across Illinois get the benefits they deserve.
Our long-term disability attorneys can assist their clients with every aspect of their claims:
I have been using Bryant Legal Group several years now and they have been amazing. My attorney is Jennifer Danish and she has been a pleasure to work with. She is very professional, knowledgeable, and gets positive results for her clients. I would recommend her highly to anyone in need of a disability lawyer.
What Is Long-Term Disability Insurance?
Long-term disability is a form of insurance that is supposed to pay you a set percentage of your pre-disability income (up to a maximum monthly limit) if you are disabled and unable to work.
In most cases, long-term disability coverage is set to kick in once short-term disability coverage ends. Depending on the terms and conditions of your policy, LTD benefits may continue for a set number of years or until you reach Social Security normal retirement age, provided you remain unable to work.
There are two main types of long-term disability plans:
- Group disability insurance may be provided by your employer, similar to other types of employee benefits (such as health or dental insurance). These plans almost always are governed by a federal law known as ERISA.
- Individual disability insurance can be purchased directly from an insurance company if you are self-employed, an independent contractor, or have simply chosen to purchase additional coverage beyond employer-sponsored plans. Because individual plans are not covered by ERISA, the procedures and regulations for filing and appealing claims may be quite different from group policies.
Please note that long-term disability insurance is not the same as Social Security Disability Insurance. Bryant Legal Group does not handle standalone Social Security Disability claims.
Is My Condition Covered?
Claims related to most physical and mental conditions are covered by long-term disability insurance policies, including substance abuse. However, your LTD plan may limit or exclude coverage for certain conditions.
Generally speaking, you should be entitled to benefits under your long-term disability plan as long as the following conditions are satisfied:
- You can show that you have a medical condition that prevents you from working, under your insurance policy’s definition of disability.
- That condition is not explicitly excluded by your policy.
Related Article: Types of Disabilities Covered
Looking for Personalized Advice From an Insurance Lawyer?
Common Challenges Faced by Long-Term Disability Claimants
You or your employer pays your premiums every month. You expect your disability insurance to be there for you when you cannot continue to perform your occupation. But far too often, policyholders encounter obstacles that prevent them from getting promptly approved for the benefits they need.
Satisfying the Definition of Disability
Your insurance plan documents will define what “disabled” means under the plan. There are two broad definitions:
- Own occupation: you are considered disabled if you can no longer perform the duties of the job you held when you became disabled.
- Any occupation: you are considered disabled if you are unable to work any job to which you are reasonably suited—even if that job is much lower-paying and less fulfilling than your previous work.
Policyholders often run into issues when they disagree with the insurance company about whether their illness or injury qualifies them as disabled under the policy definition. Claimants often need to provide a substantial amount of medical records, vocational evidence, functional test results, letters of support, and other documentation to prove their claim.
It’s also not unusual for long-term disability policies to start out using an own-occupation definition of disability, then change to any occupation coverage after a set number of months or years (often two years). This can result in a sudden loss of coverage even if you are still unable to return to your original job.
Policy Exclusions
Long-term disability policies often include limitations and exclusions regarding covered conditions. For example:
- Coverage for pre-existing conditions may be excluded if those conditions were present before the policy’s effective date or during a specified look-back period.
- Coverage for disabilities related to mental health issues (e.g., depression, anxiety, post-traumatic stress disorder) or substance abuse may be limited to a shorter benefit period, such as 24 months.
- Conditions involving subjective or self-reported symptoms (e.g., fibromyalgia, degenerative disc disease, chronic fatigue syndrome) may have stricter requirements for objective medical evidence and/or be limited to a shorter benefit period.
- Disabilities that result from workplace injuries are typically covered under a worker’s compensation claim. Your long-term disability coverage may not apply or only pay a partial benefit.
Complex Procedures and Tight Deadlines
Filing claims and appeals is often complex and confusing, with each insurance company and plan having its own set of rules. It’s easy to make mistakes if you don’t have an experienced long-term disability attorney helping you.
Furthermore, group policies governed by ERISA require policyholders to go through the insurance company’s administrative appeals process before filing a lawsuit in federal court—and the court can only consider evidence that was previously submitted as part of the administrative appeal. That means it’s critically important for claimants to put together an expansive, comprehensive claim file, often in just a few months before a tight deadline.
- Related Article: 5 Essential Questions You Should Ask a Disability Insurance Lawyer
Our Settlements and Verdicts
After our client’s disability insurance benefits were improperly terminated, we negotiated a $1.6 million settlement for him.
Our medical practice team recovered $500,000 for a physician group when an insurer failed to properly reimburse them for their services.
We collected $440,000 in unpaid disability insurance benefits for our client and got her LTD benefits reinstated by proving she was disabled from any occupation.
How to File a Claim for Long-Term Disability Benefits in Chicago
If you’re planning to file a disability claim under a long-term disability insurance policy, we strongly encourage you to retain legal counsel with an experienced Chicago disability attorney. When we are retained to represent individuals at the early filing stage, we work with them to provide the best possible evidence in support of their claim early on, and we make recommendations about what to avoid in the process.
At Bryant Legal Group, we usually recommend starting the process by requesting a copy of your current long-term disability insurance policy. This document will include all its requirements and procedures and explain how quickly you must submit your claim, what type of proof of loss the insurance company requires, and how disability is defined.
Most insurance companies administering long-term disability claims require you to complete an initial set of forms. The forms usually include:
- Insured’s claim (claimant statement) form;
- Employer’s claim form or statement;
- Authorization form that lets medical providers, financial institutions, and government agencies disclose information to the insurer; and
- An attending physician statement.
If you become sick or injured, the insurance company may make it very difficult for you to collect the benefits you are due. Rather than help you navigate your claims, the adjuster may give you misleading information or delay paying your claim.
The filing process can be fraught with pitfalls. The Chicago long-term disability attorneys at Bryant Legal Group understand insurance companies’ tactics to delay payments and deny coverage, and can help you overcome these obstacles.
Related Article: Applying for Long Term Disability Benefits in Chicago
Why You Need an Airtight Claims File
It is important to ensure every piece of evidence is submitted during the claims filing process. If the insurance company denies coverage and the dispute ends up in court, you are generally precluded from adding any new information to your file.
If you provide incomplete records and evidence, the insurance adjuster is probably going to deny your long-term disability claim. Insurers have no incentive to award disability benefits in “close” cases where it is likely that the claimant has a disability, but the record is not sufficient to objectively support such qualification. They will deny reasonable claims without adequate documentary evidence.
Our attorneys know how to build a claims file that will give you the best chance of getting the long-term disability benefits you deserve. We draw upon decades of industry knowledge to collect and assemble the most persuasive evidence for your case, including MRIs, CT scans, and other medical tests and vocational evaluations.
While you might manage the process on your own, you run the risk of making a mistake that could cost you your benefits. If you’ve already filed a claim on your own and had it denied, time is running out on your chance to appeal, and you will likely only have one opportunity to add the evidence you need to support your case.
When you work with a Chicago long-term disability lawyer at Bryant Legal Group, we will make sure that everything is done right so you can maximize your chances of success.
BRYANT LEGAL GROUP:
Protect Your Long-Term Disability Benefits
If you are unable to work because of an illness or injury, you should contact a disability attorney as soon as possible. The attorneys at Bryant Legal Group have decades of collective experience helping clients get the disability benefits they need to help make up for a loss in income. Our lawyers concentrate their practices exclusively on representing policyholders—we never represent the insurance companies. This focus and commitment ensures that we will do everything in our power to achieve an optimal outcome for you.
Contact a long-term disability attorney in Chicago today by calling (312) 818-3648 or completing our online form so that we can help you take the right steps for your particular situation.
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.
Related Articles
Contact Bryant Legal Group
Get the answers and insight you deserve. Our experienced disability insurance lawyers can evaluate your claim and help you understand all your legal options.