Short and long-term disability benefits are meant to cover a portion of your income if you become disabled. Your disability can be caused by an injury or an illness and does not need to be work-related.
There are many different conditions that could qualify as a disability. A sudden serious medical condition, such as a seizure or a complicated pregnancy could be considered disabling conditions, leaving you unable to work for an extended time.
What does disability insurance cover?
Disability insurance pays some of your income while you are out of work due to your disability. It typically replaces between 50 to 70% of your income.
However, your employer may allow you to purchase extra insurance. It is important to note that the amount of benefits you receive is based on your income at the time you apply for the insurance.
Therefore, you should increase the value of your plan as your income increases.
The main difference between short-term and long-term disability benefits is the time that you receive benefits. Short-term disability insurance generally pays benefits for a short time after you become disabled, such as three to six months.
Long-term disability benefits last longer, sometimes for several years and potentially even up until you reach retirement age. The exact length of time depends on the details of your policy.
Common reasons long-term disability claims are denied
A common reason a claim for long-term disability may be denied is that the insurer does not have proof of an injury or illness. Some injuries or illnesses do not always show up on medical tests, such as MRI’s or scans.
This can leave you in a challenging situation. Evidence you can submit to provide proof of your injury or illness include doctor’s letters or other medical documentation showing a diagnosis of your condition.
Sometimes long-term disability claims are denied because of technicalities. When your claim is denied, you should receive a letter explaining the exact reason for the denial, as well as the policy language that the denial was based on.
You have a right to appeal a denial. Your denial letter should contain information on the appeal process. If you have questions about anything in the letter, call the claims representative to get more information.
The denial letter will provide a deadline to appeal. It is extremely important to appeal within this deadline.
Preparing for your appeal
While your appeal is pending, begin gathering documentation and evidence to support your claim.
Focus on gathering information that applies to the specific reason your claim was denied. This often means gathering and updating your medical records to clearly identify your disability.
Once you have your information ready, send the insurer an appeal letter. The letter should describe how your information and documentation supports your claim that you are disabled and cannot do your job.
If your appeal is rejected, you can repeat the process again, gathering more evidence each time to prove your case for disability.
The long-term disability application and appeal process can be overwhelming and confusing, especially while you are living with a disability.
The attorneys at Alan C. Olson & Associates can provide advice on your situation and guide you each step of the way.
