How to Apply for Disability Insurance: A Professional’s Guide
At Bryant Legal Group, we get a lot of phone calls from high-income professionals, including doctors, lawyers, and entrepreneurs, who need to file a long-term disability insurance claim. Many of these professionals are struggling with their decision to file. They’ve invested a lot of time and effort into building their practices, only to find that their health is suddenly making their life’s work impossible.
In this article, our experienced lawyers explain how to apply for disability insurance. Keep reading to learn more about the application process, disability laws that may impact your claim, and ways you can improve your chances of getting approved.
Do I Qualify for Long-Term Disability?
Generally speaking, you are eligible for long-term disability benefits if you can prove the following elements:
- You have disabling medical conditions, illnesses, or injuries
- Due to your health, you either cannot perform your actual job or any other occupation
- You’ve completed a waiting period (sometimes called an elimination period)
If you meet these requirements and have evidence, like medical records, to support your claim, you should receive a monthly benefit payment from the insurance company.
However, insurance companies deny more disability insurance claims than they approve. A variety of factors can impact the strength of your claim, including:
- The severity of your medical conditions
- The strength of your evidence
- Your LTD policy’s language, especially its exclusions and limitations
- Whether you have a disability insurance lawyer or are unrepresented
Long-term disability policies are purchased from for-profit insurance companies. When either you or your employer purchased long-term disability coverage, you agreed to specific terms and conditions. These terms can vary from policy to policy. To understand your LTD plan’s precise terms, review your Plan Document or Summary Plan Description (SPD). A disability insurance lawyer can also help you translate and interpret these documents.
When Should I Apply for Long-Term Disability?
We encourage you to consult your doctors and a skilled disability lawyer as you make decisions about your disability insurance application. Your decision to apply for disability benefits should be grounded in your prognosis and a comprehensive legal strategy.
If your medical providers are encouraging you to file for disability, or your short-term disability benefits are about to run out, it’s a good time to start the long-term disability application process.
How Much Will I Get in Long-Term Disability Benefits?
Your monthly benefit will vary depending on the specific terms and conditions of your long-term disability policy. While most LTD plans pay between 50% and 80% of your monthly earnings, plans typically have maximum benefit caps (often between $10,000 and $20,000 per month).
Supplemental Disability Insurance Can Help Fill Your Income Gap
If you have a high income, these maximum monthly benefit caps can lead to a significant income gap when you’re disabled. For example, suppose you’re an anesthesiologist who earns $400,000 per year. Suppose your LTD policy pays out 75% of your monthly income, but the policy also has a $15,000 maximum monthly benefit. Without the maximum monthly benefit cap, you’d receive $300,000 in annual LTD benefits ($400,000 x 0.75 = $300,000). But, due to the cap, you’ll only get $180,000 ($15,000 x 12 = $180,000).
For many professionals, that lost income would be catastrophic. That’s why people add supplemental long-term disability insurance policies to their employer-sponsored plans. If you have multiple long-term disability insurance policies, you’ll need to file separate claims with each one. While this may seem burdensome, it can provide you and your family with much-needed financial support, and a lawyer can help you streamline the process.
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What Does the LTD Application Process Look Like?
Once you’ve consulted your doctors and an ERISA lawyer, you should start the application process. First, you’ll need to notify the insurance company of your disability insurance claim and fill out a series of forms. You’ll typically need to provide information about your medical treatment, work experience, education, and daily activities, along with any other information that supports your claim.
Next, the insurance company will assign your long-term disability claim to an adjuster, who will assess your eligibility for benefits. During their investigation, the adjuster may ask you for more information. They may even ask to meet with you in person to discuss your claim. If you have a disability insurance lawyer, they will help you navigate these issues. If you’re unrepresented and feel uncomfortable with these requests, now is the time to schedule a free consultation with a disability attorney.
Eventually, the adjuster will either approve or deny your claim. If it’s approved, you should start receiving your monthly benefit check. If the insurance company denies your long-term disability claim, you can explore your appeal options.
The Adjuster Denied My LTD Claim. Now What?
As we mentioned above, insurance companies deny a large proportion of long-term disability claims, including many legitimate ones. If the adjuster denies your LTD application, you need to act quickly and decisively.
Depending on your policy, either state or federal law may apply to your appeal, and each system has its own procedures and rules. Under ERISA (Employee Retirement Income Security Act of 1974), federal claims involve relatively short filing deadlines and a two-step appeal process.
Will I Also Have to Apply for Social Security Disability?
Many long-term disability policies require that you apply for Social Security Disability Insurance benefits. These policies will offset your monthly LTD benefit by any amount you receive from the Social Security Administration. If you refuse to file a Social Security application, your LTD carrier may terminate your monthly benefit payments.
Social Security disability is an entirely different process than long-term disability. You’ll need to convince the federal government that you cannot perform any type of work, including the simplest, lightest jobs. This definition of disability may be very different than your LTD’s policy terms, especially if you have a liberal “own occupation” plan.
If you have questions about how a Social Security claim may impact your long-term disability benefits, please contact Bryant Legal Group. We can answer your questions; however, we do not handle standalone Social Security disability claims. Our focus is on employer-sponsored and privately funded disability insurance policies.
The Insurance Company Scheduled Me for an IME. What Does That Mean?
During an “independent” medical examination (IME), a physician will examine you and provide the insurance company with a report that outlines their diagnoses, recommended restrictions, and records other information. Unfortunately, these examinations are rarely neutral or independent. Insurance adjusters pay a significant fee for IMEs, so they want to get the most out of their investment. Insurers often use IME doctors who consistently support insurance companies’ interests by minimizing claimants’ conditions and limitations.
If you’re scheduled for an independent medical exam, it’s a sign the insurance company may be preparing for a fight. Before you attend the evaluation, you should consult a disability insurance lawyer who can help you prepare for the appointment and guide you through your legal claims.
Bryant Legal Group: Fighting for People With Disabilities in Illinois
As one of Illinois’ premier disability insurance practices, Bryant Legal Group has helped many professionals get the long-term benefits they deserved. We take a proactive approach to LTD claims, helping doctors, lawyers, and others from the very beginning of their claims. Using this approach, you can potentially avoid simple mistakes that could cost you your benefits. And, if the insurance company denies your claim, you’ll already have a trusted partner at your side who can file an appeal.
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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.