Because the definitions and benefits are different in every Long Term Disability policy, you must know the specifics of your policy in order to pursue your claim successfully. At Hermann Law Group, we will review your Long Term Disability policy carefully with you, making sure that you understand your rights and obligations, and we will fight for the maximum benefits to which you are entitled.
The Top 6 Things You Need to Know About Your Long Term Disability Policy
1. What is your benefit amount? How much money are you entitled to under your policy every month? Is it a flat rate, or a percentage of your salary? Is there an inflation index or a rider if you receive Social Security or other benefits?
2. What is the “elimination” or “waiting period” under your policy? How long must you wait between the time you become disabled and the time you are eligible to receive benefits? And when do you have to apply?
3. How does your policy define the term “disability”? Different policies use different definitions, and their exact language is of huge importance in the ultimate determination of any claim. Proving your disability may even rest on whether you have to prove the inability to perform your “job” or your “occupation.”
4. Does your policy’s definition of “disabled” change? In many policies, the definition changes from the inability to do your own work (often referred to as your “own occupation”) to the inability to do any work (referred to as “any occupation”) after one or two years. The insurance company will definitely review your claim at that point, and unless you are prepared and well represented by an experienced attorney, your benefits could be cut off.
5. Does your policy contain a “residual disability” clause? This clause allows you to work and continue to receive a portion of your benefit amount. How much you receive will depend on your earnings and any “offset” provisions that allow the carrier to reduce what they pay by the amount of other benefits that you receive, such as Social Security Disability or Workers’ Compensation.
6. How does your policy treat mental disability or substance abuse? Some policies do not cover disabilities they consider to be “mental” or “nervous,” or which are due to substance abuse. Others limit the time during which they have to pay if the disability falls under these categories. An experienced attorney will make sure that your disability is classified correctly from the time you file for your benefits, so that you can get the benefits to which you are entitled.