According to the Centers for Disease Control, more than 1 out of every 4 American adults live with some form of functional disability. And despite many of the stereotypes that exist about people with disabilities, the truth is that this group of 61 million Americans cuts across all geographic, demographic, and cultural lines.
Anyone can become disabled, from blue collar workers to business executives. And no matter who you are, an individual or group long-term disability insurance plan can replace the bulk of your income (whatever it may be) and help you maintain your previous standard of living if you lose the ability to work.
Of course, the more you make per year, the more you stand to lose. If you are a high-income earner, like a doctor, lawyer, small business owner, or executive, making sure you have robust, own-occupation long-term disability insurance coverage with a high-income replacement percentage and maximum monthly benefit is crucially important.
Unfortunately, high and very high-income earners are especially vulnerable to unreasonable, unfair delays and claim denials, for a wide variety of reasons. In this blog, we will explore why this is the case, and what you should do next if your long-term disability insurance will not pay what they owe you.
High Income Earners and Professionals Need More From Their Disability Insurance Policies
Employer-paid group plans are typically tailored to the needs of an average employee. Often this means income replacement of 60 to 80 percent of pre-disability earnings—but only up to a maximum monthly benefit. If, for example, that maximum benefit is $5,000 per month, a newly disabled employee accustomed to making $200,000 per year would experience a massive loss of income.
If you earn a high salary, it is strongly recommended that you purchase an individual disability insurance policy (or even several sources of supplemental coverage) with key provisions for very highly compensated professionals. This would typically include things like:
- Own-occupation coverage, which covers you if your disability prevents you from working your current job—even if you would still be able to perform other kinds of (typically much lower-paying) work.
- High-limit disability insurance, which may have a much higher maximum coverage amount than typical group LTD plans, as well as factor in sources of income beyond your base salary).
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Disability Income Insurance Companies Frequently Delay and Deny Claims for High Income Earners
If you have already purchased robust supplemental disability coverage, you might be tempted to think that you are totally protected and in the clear. But everything hinges on whether your disability claim is approved.
Even the most generous disability insurance options will not matter much if the insurance company does not agree that you are even disabled in the first place. And the reality is that high wage earners and professionals in complex fields often must clear high hurdles to secure disability insurance benefits.
There are several reasons for this. Here are two of the biggest ones.
Cognitive Impairments Are Frequently Disputed
Most highly paid professionals work in jobs that require a high level of cognitive sophistication. This might include planning and creativity, critical thinking, complex problem-solving skills, negotiation skills, emotional intelligence, and more.
Any injury, medical condition, or other disability that interferes with cognition—for example, those that affect memory, mood, concentration, or rational decision-making—could make it impossible to effectively perform your essential job duties if you are an attorney, business owner, executive, or any other highly paid professional.
Frustratingly, however, many insurers have a tendency to only consider the physical demands of an occupation, while failing to understand or appreciate cognitive requirements. This partially due to reliance on information from the Dictionary of Occupational Titles (DOT), a government document that was innovative for its time but is also simplistic and outdated. It focuses heavily on physical actions and has not been updated or in official government use in more than 20 years.
There are two broad challenges here. The first, outlined above, is getting the insurance company to understand and accept the complex, nuanced cognitive and mental requirements that your role requires. The second is proving that your disability prevents you from fulfilling those requirements.
Symptoms like anxiety, inability to maintain focus on complex tasks, or impaired judgment are absolutely disabling for many professionals. But they are often extremely tricky to prove, since they typically would not show up on any objective tests or scans. Insurance companies often view “self-reported” symptoms with suspicion. To get approved, you may need substantial medical records, notes from physicians, and even statements from colleagues, family, and friends who can speak credibly about how your disability has affected your personal and professional life.
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Insurance Companies Fight High Value Claims Aggressively
Denying legitimate claims is far from unheard of in the disability insurance industry. Insurance companies are incentivized to look for any possible justification to delay or deny a claim. Remember: they are businesses motivated by profit, and every denied claim protects their bottom line.
You do not have to have a salary in the six or seven figure range to fall victim to insurance company intransigence. But because paying out claims to very high-income earners is so expensive, insurers tend to fight them particularly aggressively.
You can expect that your medical records and even social media profiles will be carefully scrutinized. Do not be surprised if a private investigator is hired to conduct surveillance, including taking video recordings in public and speaking with neighbors. Also, make sure you carefully follow your medical team’s treatment plans and don’t attempt to “self-treat” or minimize your symptoms. The insurance company will use anything it can find that might suggest you are not as disabled as you say you are.
Working With an Experienced Disability Insurance Attorney Can Help You Fight Unfair Denials
If your long-term disability claim was denied unfairly, it is time to get serious and hire a lawyer experienced in handling high-limit disability insurance claims. With so much at stake, you want to give yourself every possible advantage.
At Bryant Legal Group, we frequently represent executives, business owners, and other high wage individuals in disability disputes. We are very familiar with the policy language used in various individual disability insurance policies and high-limit disability insurance policies.
Your attorney can help by:
- Understanding and explaining the terms and conditions of any relevant insurance policies and advise you on your rights, responsibilities, and legal options.
- Educating the insurance company about the physical, mental, and cognitive skills your role or position truly requires—particularly those which they are not fairly accounting for in their initial assessment of your claim.
- Working closely with your medical team to ensure you have the evidence you need to prove that your symptoms and/or treatment recommendations interfere with your ability to fulfill your job responsibilities.
Going Above and Beyond for Our Clients
If you are a highly paid professional working through a disability claim, there is a good chance that several other employment law matters could apply to your situation, including provisions in your employment contract, severance agreements, and more. The attorneys at Bryant Legal Group can also advise you on these matters and even help negotiate severance agreements that let you keep your insurance benefits.
- RELATED: Who We Work With: Executives
Bryant Legal Group: Fighting Unfair Denials and Protecting the Rights of the Insured
Disability insurance policies often have strict deadlines and confusing language, especially for high-level employees and other high wage earners. Unintentional mistakes can delay or even derail your claim.
Do not let a long-term disability threaten the career and financial security you have worked so hard to achieve. The sooner you contact a qualified disability insurance lawyer, the better your chances of getting your claim approved, winning your appeal, and maintaining your benefits even when you can no longer work in your position or profession.
To schedule your free consultation with one of our Chicago insurance attorneys, call us at (312) 313-6179 or complete our online form today.