A long-term disability is any health-related issue that prevents you from working for a sustained period of time. Whether the result of illness, injury, or an accident, the end result is that you can no longer perform the tasks required of you in your place of employment.
If this were to happen to you, how would you support yourself and your loved ones? The best way to safeguard your financial future in these situations is through long-term disability insurance. Here’s everything you need to know to ensure you’re covered correctly! (Please note that the Firm cannot assist you in obtaining long-term disability insurance coverage.)
What is Long-Term Disability Insurance?
Long-term disability insurance is the method by which employees can access the financial support they need in the event of an injury or disability that forces them to stop working. It is an often overlooked area of financial and life-planning, but according to the Social Security Administration, around a quarter of all workers will become disabled prior to the age of retirement – potentially leaving them without a way of earning for themselves and their families.
That same study indicates that two-thirds of private sector employees do not currently have any form of long-term disability insurance – and when you put those two numbers together, you can see that this is an area that needs significantly more attention.
How Does It Work?
If you are rendered unable to work by an illness or injury and you have insurance, you can apply for short-term disability support. Once you have applied and presented relevant evidence of your inability to work, your insurance company will assess whether or not you are eligible and inform you of their decision. You’ll then either be awarded payment or you will have to make an appeal.
That support will last for a short time (depending on your policy provider, it could be anywhere from three months to a year) and then if you are still unable to work, you will have to reapply – this time for long-term disability. This follows the exact same process (apply – assess – decision/appeal), but unfortunately at this point the insurance company may be even tougher on you. This is because the support, when granted, could last up to retirement age and so can be a considerably more expensive proposition for the insurer.
Insurance Bad Faith
Insurance bad faith is not available in all employer-sponsored coverage, so it is best to speak with an attorney to learn what your particular rights and remedies are under your policy. Insurers are required to give you equal consideration to its own; in ERISA, the insurer must act as your fiduciary. As part of the bad faith tactics that insurance companies will sometimes use, the terms of your contract may be misrepresented, even misrepresenting the applicable law.
In an insurance bad faith case, you’ll need skilled trial attorneys, which is exactly what we offer at Sandstone Law Group. Partner Kyle Shelton received a jury verdict in the millions last year. Experience in court is important, and Firm partners Erin and Kyle are routinely in court and are fully prepared to take your case to a jury trial. Insurers have teams of lawyers working aggressively to help them escape liability. You deserve the same tireless representation and passion to hold them accountable. You will find such advocacy at Sandstone Law Group.
Know Your Policy
As the insured, you should know the details of your policy. If you are receiving group long-term disability coverage as an employee benefit, but it has extremely stringent terms and conditions when it comes to defining what constitutes a payable injury, illness, or disability, then that benefit could be somewhat mitigated. And, you should the policy limitations to avoid coverage pitfalls.
Likewise, if you are paying for an individual policy, you should know what is covered and what is excluded. The more you know about your policy, the better you will be positioned to make a successful claim and ensure your continued financial stability.
Insurance Through Your Company & ERISA
ERISA, or the Employee Retirement Income Security Act, is a federal statute that was brought into force in 1974. It relates to long-term disability insurance specifically when it comes to group plans – so if you have coverage through your company as a benefit of employment, then chances are that ERISA law will affect you. Essentially, the statute means that as a disabled employee, you have to follow a defined process for making your claim and for presenting any appeals – this includes everything from the details that you give, to the timing of each part of your claim. You can read more about ERISA here.
ERISA has strict guidelines, and oftentimes, you cannot file a lawsuit unless you appeal. Consult with an experienced ERISA and long-term disability attorney, such as the attorneys at Sandstone Law Group, to make sure you understand how to proceed. We will make sure that you are filing each part of your claim correctly and on time, properly appealing a denial, and minimizing the chances of your claim being denied. If you need to litigate, we have significant litigation experience and can hold the insurance company accountable in federal court.
When hiring an attorney, make sure you are retaining the best. Not many attorneys do this work or have experience with ERISA. It is a complex federal law and requires significant focus and discipline. All attorneys are not created equal in practicing ERISA. What to look for when hiring a long-term disability lawyer.
So, What Do You Need To Do?
If you are making a claim for long-term disability insurance or dealing with a denial of benefits, you should consult with Sandstone Law Group. Do not give up! Do not appeal on your own without seeking guidance! We practice exclusively in ERISA and insurance bad faith with decades of combined experience in advocating for the disabled.
Sandstone Law Group will aggressively and competently fight for you if your claim is denied for any reason. Our lawyers have secured millions of dollars in disability benefits for our clients and have the expertise and tenacity to take on the insurance companies on your behalf.