Finding yourself disabled, even temporarily, can be a confusing haze of administrative work you may not be familiar with while you’re trying to heal. There are different types of disability classes, but long-term disability generally means that you are unable to go back to work in a short period of time. This type of policy provides income when you are unable to work, usually 60% of your previous income. The Herren Law Firm has been helping Houstonians through the disability process for over 30 years, and we can help you too.
What Does “Long-Term” Disability Mean?
A “disability” is a legal term that just means a medical condition that prevents you from working. Long-term disability means that you are unable to work an extended period. The average case lasts about 3 years. When you file for long-term disability and get it, you’re covered for things like car accidents, having a baby and serious illnesses and injuries, but it doesn’t always mean that you are permanently disabled.
You can only file your claim after a waiting or “elimination period,” when you have exhausted all paid time off (vacation, sick and any other PTO) and short-term disability has ended. Payments start after your claim is approved. Payments aren’t immediate, so it’s best to file as soon as possible so that there is overlap with the end of short-term disability.
Review Your Policy Before You Need It
When you receive your policy (whether through your employer, or on you own), review it carefully and take note of specific previsions. How does the policy define “disability?” What’s the waiting period (or “exclusion period”) on your policy? Will they pay if you’re unable to work the job you’re in, or if you’re unable to work any job, part time or full time? (There’s a difference.) How long will the policy pay you while you’re disabled—a year? Two or three years? Until you retire?
Review your exclusions. Most policies will not cover a disability for things like pre-existing conditions, acts of war, drug abuse, suicide attempts and any injuries sustained during the commission of a crime. There may be other exclusions in the policy—read carefully so you understand them before you prepare your claim.
Pay Attention To Deadlines
Find the deadline in your policy for submitting your claim. The policy will tell you when you’re required to file, and how long you have. Once the deadline is passed, most insurers will not allow you to file a claim.
Ensure That Your Claim File Is Complete
When you submit your claim, make sure that everything is included. Don’t assume that the insurance company has everything they need to process and approve your claim. Request a copy of your claim file for your own review. If anything is missing (X-rays, test results, etc.), request copies from the appropriate parties, forward them and ask the insurer to include them in your file. Complete medical records are a must, including a letter from your doctor explaining why you are disabled. If there are any errors, request that your doctor correct them.
Although he or she may charge you, asking your doctor for an additional detailed report about your current disabilities, limitations and medical history would be an advantage.
Long Term Disability Is Not Health Insurance
Disability payments replace your income when you are unable to work. Medical expenses are not covered under long-term disability. Health insurance, which is separate, only covers your related medical expenses.
Keep Copies Of Everything
It’s always important to know who you spoke to, when, what was mailed, to whom, and when. If you do find yourself fighting the denial of your claim, you’ll need copies of everything to file and appeal, and to take to your attorney. Keeping detailed records will help you fight denial and make it easier for an attorney to work on your case.
With over 4,000 successful disability claims under our belt, we’re ready to help you too. We work on a contingency fee basis—you only pay us a fee if we can win your case. Call us today at (713) 682-8194 or (800) 529-7707 to schedule your free consultation.
