The maze of paperwork and maneuvering through the long-term disability (LTD) insurance claim process is not an easy one. But if your initial claim for long-term disability benefits has been denied, don’t give up. LTD claim money is often paid out during the appeals process and, with help from an attorney with experience in this complex process, your chances of getting the compensation you need and deserve greatly increases. If you decide to go it alone, however, here is some information to help get you through the LTD claim process and collect money on appeal.
What is Long-Term Disability Insurance?
Long-term disability is insurance issued by an employer or purchased privately that protects an individual from loss of income in the event that he is unable to work for a long period of time due to illness, injury, or an accident. Some reports indicate that the average employee with a valid long-term disability claim misses approximately two and a half years of work, which can be financially devastating for the family. Think of long-term disability insurance as a safety net in case the “breadwinner” in your household becomes too ill or injured to provide for the family.
Please keep in mind that LTD insurance is not the same as Workers’ Compensation, which provides compensation for work-related accidents and injuries. LTD covers events like car accidents, falls, burns, disease, stroke, and other serious health events that would prevent someone from being able to work for quite some time.
The LTD Appeals Process
All long-term disability policies provide for at least one, and often two, levels of administrative appeals, and many employees eventually receive their benefits through one of these appeals. It may not make sense that the same insurance company that initially denied your claim would change its mind and all of a sudden award you money during an appeal, but the appeals are evaluated by different claim units that may disagree with the initial decision to deny your claim.
LTD insurance law is complex, and for this reason, it is recommended that you hire an attorney to help you through this difficult process. Many people, however, insist on taking on this endeavor without legal representation and then realize they need a lawyer when all of their appeals are denied.
The appeals process is a multi-stage one that requires a great deal of record keeping, collection of data, understanding of medical records, and patience. The earlier you involve an experienced LTD insurance lawyer in your case, the better off you’ll be. One mistake on your paperwork or one missed deadline will surely result in a denial of your appeal.
Here’s What You Can Expect in the LTD Process
If you choose to go it alone, you will need to be prepared for the following:
- Know if your policy is ERISA or non-ERISA (Employee Retirement Income Security Act)
- Based on the type of policy, you will have an appeal deadline date that cannot be missed
- Request your claim file and any related documents from your employer
- Make sure your insurance company did everything they were supposed to do while reviewing your LTD claim
- Research the experts consulted on during your claim process and find out everything you can about them as information that can prove incentive to deny your appeal will help you
- Review everything in your claim file: medical information, legal information, surveillance information, etc.
- Organize everything and file your appeal before or by the deadline
On a very rare occasion, people have successfully handled LTD claims and appeals without the help of a lawyer, but only with very small claims that are extremely clear-cut. Most LTD claims, however, are due to serious accidents, injuries, and long-term illnesses that will create months and even years of documentation along the way. Only a highly qualified, experienced LTD insurance attorney has the expertise necessary to get you the compensation you need and deserve to get your family through this difficult time.
