During the first two years (this can vary) of disability, most long term disability insurance policies are required to pay benefits if the claimant is disabled from his “own occupation.” After that initial period, the claimant must prove that he is disabled from “any occupation” in order to continue receiving benefits. This seems fairly straightforward, but the term “own occupation” is defined in most policies to mean something other than your actual job. Rather, your own occupation is defined as being your job “as it is performed in the national economy.”
Skip to the Calculator
If you have been offered a lump sum settlement by your disability insurance carrier, you need to know the present value of your claim to make an educated decision. This calculator does all the hard work for you, and can even generate a nice looking report showing every monthly payment so you can see how the value of each payment is reduced over time (to account for the time value of money).
In honor of the start of college football season, I’m offering a $10.00 discount on The Disability Insurance Appeal Guide. This discount will expire on September 30, 2011.
The code is G8RS. Enter it before you hit the “Buy Now” button and save $10.00! Go Gators!
If you have a question about ERISA, Short Term or Long Term Disability Insurance and need a quick answer, you can now submit it to a disability attorney online 24/7 by clicking this link. You need to pay for the answer, but you only pay for answers you accept, and the rates are far cheaper than what attorneys usually charge. In fact, you set the price on the question you ask (of course, no one will answer if you offer too little, but $40-$50 isn’t unreasonable for a question that can be answered in a paragraph or two). The site explains the whole process, and it’s quick and easy to get started. I’m one of the experts on this site, so if you ask a question I may be the one answering it.
I realize that not everyone who visits this site is from the Northwest Florida area, where I practice. In fact, most visitors to my site aren’t. For those of you who live outside my practice area, but are looking for a long term disability or ERISA lawyer, I now offer free referrals via my online referral request form. I only make referrals to lawyers in the USA (sorry, but ERISA is US law and I don’t really know any non-US lawyers).
Know that I won’t just refer you to some random lawyer I found on Google. I will only refer you to lawyers for whom I can personally vouch as being well versed in disability and ERISA law. I know hundreds of LTD lawyers across the country (we’re a pretty small community). The odds are good that I know one close to you. If I don’t, I’ll just say so.
So, you can get a free referral from me, and know that your lawyer is highly qualified in this area of law, or you can pick the lawyer in the phone book with the nicest ad and cross your fingers. There’s no obligation for you to hire the lawyer I recommend, so you really don’t have anything to lose by letting me do the legwork for you. And did I mention that it costs you nothing?
If your disability insurance company has denied your ERISA-based disability claim once and then subsequently reinstated benefits, either through your successful appeal or through your victory in court, there is nothing preventing it from cutting off your benefits again in the future. In fact, in the Eleventh Circuit (Alabama, Florida and Georgia), if your policy is an ERISA policy, your insurer has every incentive to cut your claim off as many times as possible. This article does not apply to disability policies not governed by ERISA.
UPDATE: After writing this article, I went ahead and wrote an e-book for disability claimants who want to handle their own appeals. It includes form letters and disability forms for your doctor to fill out (which I use in my own practice). If you’re interested, check out The Disability Insurance Appeal Guide.
If you apply for long term disability insurance benefits and your claim is denied, you will likely receive a letter from your insurance company telling you that you have the right to appeal its decision within 180 days. You should get a similar letter if you had been receiving LTD benefits and the insurance company cut your benefits off. While appealing the denial within 180 days is vital to preserving your right to sue under federal ERISA law, you should not try to handle this appeal on your own. Instead, you should contact a disability lawyer who knows ERISA as soon as possible after getting your denial letter.
This is a continuation from Long Term Disability Policy Provisions – Part I.
Long Term Disability Insurance – The “Maximum Benefit Period”
Almost all long term disability policies stop paying benefits when you turn 65 years old, or when you reach the federal retirement age. This is often referred to as the “maximum benefit period.” Your policy should be very clear on this issue. Also, if you are near age 65 at the time you become disabled, there will likely be a specific number of months you can receive benefits spelled out in the policy which may extend your benefits beyond the usual cut-off age. For example, the policy may provide that you can collect 36 months of benefits if you become disabled between ages 63-65.
Your long term disability (LTD) insurance policy probably reads like most insurance policies, meaning that it is long, confusing and full of industry-specific terms of art that you will have a hard time understanding unless you are a lawyer or insurance professional. In this article, I will explain some of the most important provisions found in most long term disability policies. Of course, the language in your policy may differ from the standard provisions, so it is always best to consult a disability lawyer if you have questions.
Long Term Disability Insurance – The “Elimination Period”
If you live in Panama City, or anywhere else in Bay County, Florida and have been denied long term disability insurance benefits, call me today for a free consultation. Use the toll-free number above and even the call is free. You don’t have to travel to Pensacola to meet with me. I will come to you, as part of my Personal Service Guarantee.