Maintaining Long Term Disability Eligibility

January 01,2013
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Despite being unable to work, it is not unusual for long term disability claimants to find themselves doing battle with their insurance carriers over eligibility, and many require the services of New York long term disability lawyers to ultimately gain approval of benefits. For all disability recipients and especially for those who have fought hard to win benefits, it is important to understand how to keep those benefits.

Initial Considerations

Not all long term disability coverage is the same; New York long term disability lawyers will emphasize that reading and fully realizing the exact nature of the benefits provided is essential. For example, does the policy cover disability for up to five years, ten years or until Social Security retirement age is reached? Does the coverage provide benefits for a disability related to the claimant’s “own” occupation for a period of time and then switch to coverage only if the claimant cannot perform the duties of “any” occupation? Or does the policy apply exclusively to the individual’s own occupation for the duration of the coverage?

Continuing Eligibility

Not every condition that renders a person eligible for long term disability remains the same. The insurance carrier has the right to and often will seek information regarding whether the recipient’s condition has improved to the extent that they no longer fit the policy’s definition of disabled. However, as New York long term disability lawyers caution, not everything the insurance company does to determine continuing eligibility is completely above-board.

In-home Interview
It is not unusual for an insurance company to try and set up an appointment with a disability recipient in their home. Too often, this is a ploy to uncover some possible reason to deny benefits. It is advisable to meet only in public places and best at the offices of the individuals’ New York long term disability lawyers.


It is becoming an increasingly common practice for investigators of insurance carriers to videotape the activities of recipients of long term disability benefits. Although it may be very disconcerting to consider, there is no law against following a person and recording what they do while they are in a public place. It is important to realize the limitations the doctor has placed on physical activities when doing things such as exercising, yard work and lifting items at the store.

Social Security Representation

Most policies require the recipient of benefits to apply for Social Security Disability (SSD) and many carriers offer to provide representation. The recipient should decline that offer and seek the services of a New York long term disability attorney instead. Too often, the insurance company recommends a non-lawyer or an inexperienced lawyer and the SSD case is denied. Even though the two issues have no connection, the insurance company will use the SSD denial to try and prove the individual is not disabled.

Contact a New York Long Term Disability Attorney for Legal Advice

Getting long term disability benefits is not the end of the fight. Insurance companies have a lot of tricks up their sleeves. For a free case evaluation, call Hermann Law Group, PLLC, at 1-877-773-3030.