What is Long-Term Disability?
Having a productive and healthy workforce is crucial for the progress of our economy. Unfortunately, injuries or medical conditions can affect the workforce and result in loss of productivity. Many employers have short-term and long-term disability programs in place to help compensate employees who are unable to work.
A long-term disability insurance policy can be described as coverage made to protect a portion of an employee's income if they are unable to work due to a serious injury, illness, or medical condition. An eligible employee who suffers an illness or injury lasting for several weeks or months may qualify to receive long-term disability benefits. The disability payments will continue until the employee is able to return to work.
What Conditions Qualify as a Disability?
Here are some common types of medical conditions that may qualify for long-term disability:
- Musculoskeletal disorders including back pain, amputation, arthritis, joint disorders, spine disorders, and soft tissue injuries
- Neurological disorders including cerebral palsy, Alzheimer's disease, epilepsy, paralysis, and dementia
- Autoimmune disorders including poisoning, allergic reactions, chemical sensitivity, and lupus
- Mental disorders including autism, mood disorder, drug addiction, depression, panic attacks, anxiety, and bipolar disorder
- Special senses and speech disorders including burns, vision loss, eye disorder, and loss of speech
- Respiratory disorders including asthma, lung transplant, pneumonia, influenza, COPD, and asbestosis
- Chronic illnesses including kidney disease, heart disease, and Fibromyalgia
- Degenerative diseases including Huntington's disease, Parkinson's disease, and ALS
- Other conditions including chronic fatigue, chronic pain, blindness, deafness, and certain long-term injuries
A knowledgeable long-term disability lawyer can review the medical conditions covered under your LTD policy, determine whether you are eligible for disability benefits, and guide you through the process of filing claims.
What is the Process of Filing a Claim?
Here are the steps involved in filing a long-term disability claim:
- Request an application and all instructions to complete your LTD application from your employer.
- Complete and submit the Employee's Statement. You will be required to disclose personal information such as your name, SSN, date of birth, address, phone number, employer's name, occupation, medical provider, and prescribed medications.
- Allow your employer to complete their portion of the LTD application.
- Get a statement from your doctor. The doctor may need to provide information regarding your diagnoses, objective findings, symptoms, and whether your illness or injury is work-related.
- Gather and submit all medical records, supporting documentation, and other evidence for your disability claim.
An experienced attorney can guide you through every step involved in filing your LTD claims, ensure that it meets all ERISA rules and requirements, and improve your chances of getting approved.
What is ERISA?
The Employee Retirement Income Security Act (ERISA) is a 1974 federal law governing how employers provide benefit plans to employees. The Act establishes specific guidelines and requirements for employers and benefit plan managers, trustees, and some other service providers. Under the Act, an employee must be notified of the terms and conditions of their benefit plan, including coverage, funding, and costs.
What Rights Are Protected Under ERISA?
Employees participating in retirement or benefit plans have many important rights under ERISA. These include:
- Right to disclosure of important plan information
- Right to a timely and fair process for benefit claims
- Right to information regarding the appeals process for accessing denied benefits
- Right to notification of any important changes to your benefits
- Right to access detailed information regarding the health conditions covered by your plan
A skilled attorney can help ensure that all your rights are protected or file a complaint against your employer for violating any of your legal rights under ERISA.
How Legal Counsel Can Help
Filing for long-term disability claims in California often involves several complicated processes. Understanding ERISA rules and procedural requirements, determining your eligibility, and filing the necessary paperwork can make the whole process overwhelming. If you believe you may be entitled to disability benefits, reach out to an experienced long-term disability claims attorney to advocate for your legal rights and help file your long-term disability claim.
At The Law Office of Bennett M. Cohen, P.C., our attorneys have the necessary experience, diligence, and resources to assist clients in filing their short-term or long-term disability claims. Using our knowledge of ERISA rules, our team can help guide you through the often complex legal process. We will obtain convincing evidence of your disability, work together with the LTD plan administrator on your behalf, and help file your claims application.
Even if your application is denied, we will appeal in a timely manner and help negotiate a fair settlement with your best interest as a priority. If necessary, we will take additional legal steps to help recover your deserved disability payments.