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How do I qualify for long term disability benefits?

If you are planning on applying for long-term disability (LTD) benefits for the first time, you may be wondering what it involves and what is required in order for you to qualify.

Your disability claim starts at the moment you become injured or unable to work. If you suffer a traumatic or serious injury, you are hopeful that you will recover and return to work. However, in the event that your injury becomes long term or you don’t recover as planned, you should immediately begin taking steps to support your possible LTD claim should you end up needing it.

The first place to start is to recognize what sort of LTD policy you have. Is it through your employer or did you purchase your own policy? Next, review what the policy requires of you. For example, some policies state you must apply within 30-180 days of becoming injured, disabled, or ceasing work. This is also known as an elimination period where you must provide “proof of loss” or “proof of disability.” This is one of the most important steps. If you fail to apply timely, your claim may be denied simply because of that.

The next step is to determine whether you’re injury or disability is covered under your policy. Most LTD policies pay benefits if you disabled from your “own occupation” or “regular occupation.” Most LTD insurance companies define “disability” to mean the inability to do the material and substantial duties of your occupation. You do not necessarily have to have a specific diagnosis to qualify. It is also important to remember that some conditions are specifically excluded and/or have a time limitation for benefits - such as mental illnesses or subjective diseases (fibromyalgia, chronic fatigue syndrome, etc.).

To apply for benefits, you typically start with your employer’s HR department or contact the insurance company directly. You will have to complete an application and sign releases for your medical information. Your insurance company will usually request your records and obtain statements from your doctors. This is where many people become frustrated and ultimately denied - due to their medical providers and the insurance company not receiving information in a timely manner.

Once the insurance company has all the needed information, they will have their medical and vocational professionals review it to determine whether you are eligible. The process can range anywhere from one to six months. If the insurance company denies your claim, you have the right to pursue an appeal.

At Operana Law, we can assist you with filing your application for LTD benefits. We will deal with the insurance company and your medical providers so you don’t have to.

To discuss your options, give us a call today at 855-999-1969.


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