Over the course of your lifetime, there is a potential that you will become disabled. In fact, according to research from the Social Security Administration (SSA), more than 25% of 20-year-olds will become disabled before they reach retirement age. Having a financial safety net can ensure that you are covered in the event that you cannot work due to a disability.
Long term disability (LTD) insurance is one way to protect yourself. This type of policy offers benefits — at a rate of up to 50 to 60% of your salary — if you cannot work due to a medical or mental health condition. Unfortunately, insurers often find ways to delay or deny legitimate LTD claims or to terminate coverage early.
At Bross & Frankel, we have more than 20 years of experience helping people with their LTD disability claims, from providing an initial claim review to assisting with applications, and filing appeals of decisions made by the insurance company. We take on the biggest insurance companies for you — so that you can focus on your health and well-being. If you are considering an LTD claim, our team of New Jersey long term disability attorneys will advocate for your right to benefits.
What Is Long Term Disability Insurance?
LTD insurance is a specific type of insurance policy that provides income protection if you are unable to work due to a disability. Unlike workers’ compensation, which offers benefits for work-related illnesses and injuries, LTD insurance covers disabilities that are not connected to work. It may be offered through a group insurance plan, or purchased individually.
If you become disabled due to a medical or mental health condition, an LTD policy will provide a percentage of your monthly income. You can apply for LTD benefits after a waiting period, which is usually 6 months after you can no longer work. An LTD policy may also offer incentives or rehabilitation services to help you return to work sooner.
LTD policies purchased through an employer’s group plan are governed by the federal Employee Retirement Income Security Act of 1974 (ERISA). Under ERISA, insurance companies must follow specific standards, which includes providing information to policyholders and offering a process for appeals. LTD policies that are not subject to ERISA are subject to state law.
Under both ERISA and state law, you can file a lawsuit against your insurance carrier if it wrongfully denies a claim or terminates benefits. ERISA lawsuits are filed in federal court, while other claims are filed in state court. An experienced New Jersey long term disability attorney can advise you on your rights and file a lawsuit on your behalf in the appropriate court.
Why Was My LTD Claim Denied?
Long term disability insurance is a vital part of a financial plan. Too often, however, insurance companies engage in tactics that make it difficult for policyholders to get benefits or to obtain the full amount of benefits that they are entitled to under the law.
Like other insurance companies, LTD insurers are in the business of making money, not paying out on claims. To maximize profitability, your insurance company may delay your claim, deny it outright, or end your benefits early without cause.
This can happen in a number of ways, such as:
- Denying your claim because of a pre-existing condition
- Denying your claim because you haven’t proven that you are disabled;
- Using the opinion of an independent medical professional to argue that you are still able to work;
- Terminating benefits at 24 months for certain conditions;
- Using surveillance to deny your claim;
- Arguing that you no longer meet the definition of disabled; or
- Stating that your disability is not supported by objective medical evidence.
Working with a seasoned LTD lawyer from the start of the process can help you avoid some of these issues. Your attorney will analyze your insurance policy and explain its terms and limitations, which will help you decide when to apply for benefits and how to structure your claim. This may help you avoid some of the most common tactics used by insurance companies to delay or deny your claim, or to terminate your benefits early.
If your insurance company does act unreasonably or in bad faith, then your lawyer can assist you with the administrative appeals process and file a lawsuit on your behalf, if necessary. Depending on the type of policy that you have, there may be strict deadlines for filing an appeal with the insurance company. A New Jersey long term disability attorney can ensure that your appeals are filed properly and on time — and take on the insurer in court if they deny your claim again.
Fighting Back Against Unfair Denials
At Bross & Frankel, we know how devastating it can be to be diagnosed with a disability — and learn that you cannot work because of it. In addition to being financial stress, this news can take an emotional toll. We can help to ease some of the burdens by handling the insurance claim for you and providing advice throughout the process.
With more than 90 years of combined experience, our law firm is well-positioned to help people who are unable to work due to a disability. We have helped people with their claims against some of the largest insurance companies in the country. While each situation is unique and results are not guaranteed, our knowledge of the law and skill at handling LTD claims can help you achieve the best possible outcome for your case.