BRYANT LEGAL GROUP
Long-Term Disability Benefits
Get Legal Help from Our Illinois Long-Term Disability Attorneys
If you become disabled and are unable to work for an extended period, your long-term disability (LTD) insurance should 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 during filing can lead to an unfair denial of long-term disability benefits with only a limited time to appeal. And 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 disability attorneys at Bryant Legal Group today. We have decades of experience helping workers and professionals across Illinois get the benefits they deserve.
Our Illinois long-term disability attorneys can assist their clients with every aspect of their claims:
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.
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.
Common Challenges Faced When Applying for Long-Term Disability Insurance
You or your employer have paid your premiums every month, so you expect your long-term disability insurance to be there for you need it. 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 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.
Long-term Disability 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 workers’ compensation claim, with disputes typically handled by the Illinois Workers’ Compensation Commission. 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. At that point, the court can only consider evidence that was previously submitted as part of the administrative appeal. This means it’s critically important for claimants to put together an expansive, comprehensive claim file, often 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.
Bryant Legal Group has a long-established and ongoing record of going up against big insurance companies and helping clients receive the benefits they deserve. Our victories include:
- A successful appeal on behalf of a skilled dentist who had been found only Partially Disabled by Fidelity Life Insurance Company. We demonstrated that a Total Disability finding was warranted, and Fidelity reversed its decision without the need for litigation.
- A successful reversal of a UNUM termination of benefits to a sports medicine orthopedic surgon, restoring our client’s long-term disability benefits. This appeal was led by Bryant Legal Group and supported by Meyers & Flowers.
- Persuading Mutual of Omaha to reinstate long-term disability benefits for an educator who suffered a debilitating stroke and continues to experience significant physical and cognitive impairments.
How a Chicago Disability Attorney Can Help You File a Long-Term Disability Benefits Claim
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. We can also recommend ways to avoid delays and problems in the claims process.
Our Chicago disability attorneys usually recommend requesting a copy of your current long-term disability insurance policy to start. This document will contain requirements and procedures such as 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 that administer long-term disability claims require you to complete an initial set of forms. These forms usually include:
- An insured’s claim (claimant statement) form
- An employer’s claim form or statement
- An authorization form that lets medical providers, financial institutions, and government agencies disclose information to the insurer
- An attending physician statement
If you become sick or injured, the insurance company may make it 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 payment.
The filing process can be fraught with pitfalls. Our Chicago disability attorneys understand insurance companies’ tactics and can help you overcome these obstacles.
Related Article: What is a Bad Faith Insurance Claim?
Looking for Personalized Advice From an Insurance Lawyer?
Why You Need an Airtight Long-Term Disability Claims File
It is important to ensure that 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.
The insurance adjuster will likely deny your long-term disability claim if you provide incomplete records and evidence. 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 Chicago disability 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.
Related Article: How to Approach Claims for Hidden Disabilities
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.
Visit our Long-Term Disability Hub for more information on appealing to common insurance companies.
Protect Your Long-Term Disability Benefits with Bryant Legal Group
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 ensure that we will do everything in our power to achieve an optimal outcome for you.
Contact one of our Chicago disability attorneys today by calling (312) 818-3648 or completing our online form. We can discuss your case and help you take the right steps for your situation.
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.
Frequently Asked Questions
- Group disability insurance may be provided by your employer, like 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.
- 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.
- Disabled through intentional or self-inflicted injuries
- Disabled pursuant to military service
- Disabled in an “extreme” and “risky” scenario, as defined by the insurance policy (e.g., skydiving, bungee jumping)
- Disabled during the commission of a criminal offense
- Disabled due to some specific condition (the insurance policy may define a range of conditions that will not qualify)
- Disabled due to a mental health condition (though most disability insurance policies simply limit the time period of eligibility for such conditions)
- Lapse of coverage
- Material misrepresentations in the original insurance application
- Insufficient evidence of disability
- Application of a coverage exclusion
- Disability tied to a pre-existing condition
- Failure to seek ongoing medical treatment
In layman’s terms, this means attending your rehabilitation sessions, following through with treatment (by attending appointments), consistently taking your medication, and more. The insurer is not required to pay full benefits for a disability that was exacerbated by the claimant’s own failure to act reasonably. If you fail to mitigate, then the insurer may have a reasonable basis to either deny your claim or undercut your benefits significantly.
Additionally, most disability insurance policies specifically require that you receive appropriate ongoing medical care; failing to do so, may be a separate reason for an insurer to deny your claim.
- When it comes to supplemental income sources, such as passive income, inheritance, personal gifts, etc., your private disability benefits are generally entirely unaffected.
- Private disability benefits are a form of wage replacement, they are not income-variable.
- Whether you are rich or poor, you are entitled to the full disability benefit that was bargained for through the insurance contract.
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