Personal Injury Law
Long Term Disability
Personal Injury Law
Long Term Disability Lawyers
If you are unable to work for a prolonged period due to an illness or injury, then you might be eligible to apply for benefits under a long-term disability claim. Normally, under such a claim, the disabled employee will be eligible to receive a certain percentage of their regular income they used to receive before the injury. This will help tide them over at least some of the expenses.
However, you might require the assistance of our long-term disability lawyers to sort out the issues associated with the claim and get the compensation amount you deserve. Our ‘No Win, No Fee’ policy allows you to fully focus on your recovery without worrying about the legal costs while allowing us to fight for the compensation on your behalf. Connect with our experienced personal injury lawyers today for any legal guidance or assistance with your long-term disability claim.
Our Personal Injury law services
- Boating Accidents
- Bicycle Accident
- Car Accidents
- Catastrophic Injury
- Chronic Pain
- Cross-Border Injury
- Dog Bite Injury
- Fractures and Orthopaedic Injuries
- Liability in Personal Injury
- Long Term Disability Insurance
Claims - Medical Malpractice
- Motorcycle Accidents
- Nursing Home Negligence
- Occupiers’ Liability
- Pedestrian Accident
- Product Liability
- Slip & Fall Injuries
- Spinal Cord Injury
(Neck, Back, Whiplash & Spinal Cord Injuries) - Sports Injury
- Traumatic Brain Injury (TBI)
- Truck Accidents
- Wrongful Death
What constitutes a Long Term Disability?
A short-term disability refers to an illness or injury that causes abstention from work temporarily, from a few months to a few years. A long-term disability, on the other hand, could last for many years, all the way up to your age of retirement. It specifically refers to an impairment that will diminish your day-to-day functioning and performance at work. Not all illnesses will qualify for long-term disability. One of the examples often cited by medical experts is depression. Someone suffering from severe depression might qualify for long-term disability benefits, but if you are only suffering from a mild case of depression, your claim is likely to be rejected.
Why consult a lawyer for your long-term disability claim?
Proving the viability of your claim.
The viability of such claims is governed by the terms and conditions of the policy agreed to by both parties—the insured and the insurer. An experienced lawyer will carefully study the document to ensure that your health condition is covered under the policy. This involves understanding terms like total disability and partial disability. Consult a lawyer early to prevent the rejection of your disability claim on these grounds. Your legal team will collect the necessary medical documents and testimonies from experts to prove your inability to perform your duties because of your illness or injury.Maximizing your benefits under the policy
Insurance service providers will always try to negotiate and reduce your claim amount, citing various terms and conditions in the policy. It is always best to let your lawyer handle these negotiations on your behalf to ensure that you are receiving the full amount you are entitled to. For example, as per the policy, you might be entitled to 60% of your employment income as disability benefits. Your insurance provider might argue that it is still possible for you to do some tasks and might offer you 40% instead. It is the duty of your lawyer to fight on your behalf and ensure that you receive the full 60%. In some cases, your lawyer might even be able to win back the pending amount on retroactive payments as well.
We can Help
Feel free to get in touch with our personal injury lawyers for any legal support with your long-term disability claim. Contact our legal team for a consultation today.
Frequently Asked Questions
What is the typical duration of long-term disability benefits?
Typically, long-term disability plans offer benefits for a duration of 2 years or longer. It can be for 10 years or until the retirement age of 65. It will depend entirely on the terms and conditions of the policy and the type of medical condition you are suffering from. Check the terms of the policy to see the duration of the benefits you are entitled to in your case.
What is the common monthly payment amount in a long-term disability plan?
This will depend on the terms and conditions of your policy. Typically, most policies will provide benefits up to 60% to 70% of your last salary before you were disabled. This might be credited as a lump-sum amount or as yearly or monthly payments. Most insurance providers process these payments on a monthly basis. If this is the case, you are likely to receive a monthly amount close to 60 or 70% of your last monthly income.
What is the ‘any occupation’ test?
At the time of your application, if you are found unable to perform the tasks associated with your current job, you are considered eligible to receive the benefits. Typically, under a long-term disability plan, you will start receiving monthly payments for a period of 2 years. At the end of this term, your disability will be reassessed. It is expected that during this period, you must have undergone the necessary vocational retraining to help you obtain any suitable occupation. In other words, you will now have to prove that your injuries impair your ability to perform any work suitable to your qualifications and experience. It is likely that the benefits may be discontinued if you fail to meet this requirement.
Do the terms qualifying period, elimination period, and waiting period all refer to the same thing?
Yes, they all refer to the same duration of time it takes between the day of your injury or diagnosis and the day the insurance provider approves your application for benefits. Different insurance companies might use different terminology to refer to this period in their policy document. This could be anywhere between 3 months and 1 year. Once the claim is approved, insurance companies will pay a lump sum amount as back payment for the benefits owing from the first date of benefits entitlement to the approval date. Some insurance policies provide the option to apply for short-term disability benefits while you wait for approval for the long-term benefits.
What are some of the common reasons for rejecting a long-term benefits claim?
Some of the common reasons insurance providers reject such claims are:
- Pre-existing conditions: Any medical condition you were suffering from before the start of the coverage is considered a pre-existing condition. The list of pre-existing conditions excluded from the coverage will be mentioned in the policy document.
- Missed deadline: You are expected to follow the application format and the deadlines mentioned in the policy document. If you fail to submit the application before the deadline, your claim is likely to be rejected.
- Does not meet the criteria for disability: Not all diseases or injuries will make you eligible for long-term disability. Read the policy document carefully before you submit the application. If your condition does not meet the criteria for disability, your claim will be rejected.
- Not following the prescribed treatment: If, for some personal reasons, you choose not to follow the prescribed treatment, the insurance provider might reject your claim for benefits. When you reject the recommendation of a surgery or rehabilitation therapy to cure your condition, this will be seen as a lack of effort on your part to make the recovery.
What to do if my claim is rejected?
- Check the reasons for rejection: The insurance provider will probably mention the specific reasons in the rejection letter. If so, it might be possible to fix these shortcomings and submit your application again.
- Submit supporting documents: If the application was rejected because of poor evidence of your disability, you may provide more supporting documents, such as a letter from your doctor or employer, to strengthen your claim.
- Submit the appeal before the deadline: The appeal format and the deadlines will also be mentioned in the policy document. Make sure to submit your appeal within the deadline after addressing the issues raised in the rejection letter.
- Legal action: If your case was genuine and the rejection was unjust or unfair, you have the option to take legal action against the insurance provider. At Nanda and Associate Lawyers, our disability lawyers can help you with the legal proceedings and represent you in court. Connect with our legal team today for assistance.
What happens after the approval?
First, you will receive a letter from the insurance provider informing you that your application for long-term benefits was approved. Along with this, or soon afterwards, you will receive another document detailing the amount you will be receiving, the mode of payment, and its duration and frequency. Typically, you will start receiving the payment within 4 to 6 weeks of the approval, starting with a lump-sum back payment from the date you first became entitled to benefits to the approval date.
