ERISA Experience You Can Rely On.

Attorneys Raquel Busani + Robert Rosati

Do long-term disability claims have to be work-related?

On Behalf of | May 19, 2023 | Long Term Disability Claim Denial

Many private employers offer long-term disability (LTD) benefits to their workers. Since LTD plans are often part of an overall benefits package, many employees aren’t sure what they entail and may not even look at them until they cannot work due to an illness or injury. That can lead to confusion over eligibility and, in some cases, how they differ from workers’ compensation benefits.

Most employers must carry workers’ comp coverage, which usually applies to temporary injuries directly related to a person’s employment. Employers voluntarily offer LTD plans, which cover various conditions and illnesses that leave employees unable to work. If an LTD plan covers a condition, it typically doesn’t matter whether or not it is work-related.

LTD benefits depend on your disability, not how you were injured

Long-term disability becomes an essential lifeline for many people unable to earn a living due to a covered condition. While each plan differs, benefits typically replace up to 60% of a person’s base salary. Benefits end if the disability ends but can continue for a specified period of time or up to retirement age.

LTD benefits can result if you suffer critical injuries in a car crash or are diagnosed with cancer or another debilitating medical condition rendering you unable to work. The cause of your illness or condition doesn’t prevent you from receiving benefits as long as it is covered under your employer’s plan.

Employer-sponsored LTD plans vary in how they define disabilities. If you become ill or injured and can’t perform your job duties, it’s crucial to understand what the plan covers and to file the paperwork correctly. Benefits may not begin for 90 to 180 days if everything goes smoothly, so having all your ducks in a row is crucial.

Denials happen frequently, mostly due to paperwork errors or insufficient information regarding medical conditions. The insurance companies administering these plans take advantage of every opportunity to keep from paying benefits. If your claim is denied, it’s advisable to consult an attorney experienced in ERISA regulations to file an appeal, so you can receive the benefits you’ve earned.

Categories

Archives