If you’ve been diagnosed with a medical condition that prevents you from performing your main job functions at work, applying for long-term disability benefits can provide you with the financial support you need while on leave.
A great way to take the first step is to search for a “disability lawyer near me” and book a consultation with an expert in long-term disability claims who can answer your questions and tell you what you can expect along the way.
Check Your Insurance Policy
For the most part, long-term disability plans cover medical conditions that prevent an insured from completing the main tasks of their job. However, check your policy to ensure that your condition isn’t excluded from coverage. You’ll also find rules about the process of filing an LTD claim, including deadlines to file a claim (the deadline is the amount of time you are required to file a claim after your diagnosis); failing to meet the deadline will cause the insurer to deny your claim automatically.
There will also be what your insurance company might call an “elimination period” or “waiting period.” This is a period of time that can be anywhere from 12 to 52 weeks (or longer), wherein the insurer evaluates your claim for benefits to see if you qualify or are no longer affected by your disability and are able to work again. You must be disabled and off work during this time to qualify for benefits.
Have a Conversation with Your Doctor
As the waiting period approaches, and you are receiving treatment for your disability, speak to your doctor about your decision to apply for LTD benefits. Having the support of your healthcare provider is essential for your LTD claim to have a chance of approval.
Speak to your treating physician to ensure that if further testing, documentation or specialist reports are needed to show how your disability prevents you from completing your work tasks, they can book those appointments for you as soon as possible.
Completing the LTD Application Package
A downloadable LTD application package may be available on the insurance company’s website or your work’s employee portal; if not, your workplace should provide hard copies.
An application for long-term disability benefits usually includes the following:
- Claimant’s Statement – This is the section for you to provide information about your medical condition, when it came about, how it affects your ability to work, your medical history, etc.
- Employer’s Statement – Your employer will complete a section providing information regarding your position, duties, pay, how long you’ve been off work, any workplace conflicts and other information regarding your employment. They may be required to send it directly to the insurance company.
- Physician’s Statement – Your primary care provider will have to fill this out and provide information such as when you began treatment, their diagnosis and prognosis, how you’ve responded to treatment, etc. This statement is crucial to your claim and your doctor must provide medical evidence that supports the opinion that you can not or should not be attempting your work duties.
After You’ve Submitted Your Claim
After the insurance company receives your claim, you will likely be contacted by a case manager who has been assigned to your file. They will likely interview you over the phone and ask you questions about the information in your claim. The call will probably be recorded and your answers will be used to deny or approve your claim.
You may also be asked to attend an “independent medical examination” for you to be examined by a medical professional chosen by the insurance company. If you do not attend or comply with any of their requests, your claim will likely be denied.
The average wait time for a decision is between 30 and 90 days.
If your claim is approved, you and your employer will be notified. The approval letter will provide instructions to maintain your eligibility and information about the amount of your payments and the payment frequency.
If your claim is denied, you’ll be given a reason for the denial and instructed on how to appeal the decision.
Speak to an LTD lawyer immediately after receiving the denial letter. They can still get you your benefits regardless of the insurance company’s reasons, but you only have a short window to do so.