Suppose you’re unable to work because of an illness or injury, but you haven’t been able to save enough money to last you for your disability. In that case, long-term disability benefits might be available to help you make ends meet in your time of need. Long-term disability benefits are typically only available from an employer or Social Security. It’s important to know what conditions you need to satisfy to qualify for these benefits.
1. Must Meet the Definition of Total Disability
To qualify for long-term disability (LTD) benefits, you must be unable to work and earn an income, in any capacity, from any occupation or job. It would help if you also were expected to remain so disabled in all settings (work and nonwork) indefinitely. Your insurer can deny a claim if you are working or have a chance of returning to work in six months or less.
However, the definition of total disability may be confusing. For example, it does not mean that you cannot do anything. Instead, your condition prevents you from performing any gainful employment. It’s essential to understand how your condition affects your ability to work before applying for benefits. It’s, therefore, crucial to hire an LTD lawyer as soon as possible after a diagnosis with a disabling condition.
2. You Must Have an Insurable Interest in Your Own Body
To qualify for long-term disability, you must have an insurable interest in your own body. In other words, if you want to collect disability benefits, it is essential to have insurance when you are still able to perform your job. If something happened to you and you could no longer work due to injury or illness, you could potentially file a claim.
If you do not have health insurance, it would not be easy to prove that you had an insurable interest in your own body. Long term disability lawyers can help you determine whether or not you have an insurable interest in your own body.
3. You Must Be Unable to Work at Any Job Other Than Your Own
To qualify for long-term disability (LTD) benefits, you must be so ill or injured that you cannot work at any other job. If you can perform a lesser job activity, your insurer may not pay your disability benefits. Also, to qualify for LTD payments, there are three criteria that your illness or injury must meet:
- Inability to perform an alternative occupation
- Duration of disability or injury (how long will it take until you recover)
- The severity of the condition (the condition’s impact on your ability to work)
Your employer’s company policy is also a factor in whether you can receive LTD benefits. If your employer has hired replacement workers during your absence, they may have grounds to deny you LTD coverage. It’s, therefore, crucial to hire experienced long term disability lawyers who understand both state and federal laws regarding LTD claims.
4. You Need to First Exhaust Your Short-Term Benefits
Before you can receive your long-term disability payments, you need to exhaust other short-term and long-term disability programs. That may include Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). For SSDI, a person must have worked in at least five of the last ten years and earned enough money to pay into social security. SSDI is a no-fault program, meaning that it does not matter why you became disabled or if it was preventable.
You also must exhaust leave-pay from work through sick days and vacation time before applying for the LTD plan. If you cannot return to work because of an injury or illness, you should apply for long-term benefits as soon as possible after exhausting all other resources. An LTD lawyer will help you determine what benefits you may be eligible for and how to go about filing your claim.
Conclusion
Long-term disability insurance provides a monthly cash benefit if you cannot work due to a severe injury or illness. To receive payments, you will have to meet specific criteria, including passing a medical examination and working for an employer that offers coverage. You should also expect that an insurer will closely scrutinize your claim, so it’s essential to understand what factors go into qualifying. It pays to know ahead of time whether you would pass or fail. However, contacting an LTD lawyer is always a good idea before filing for benefits. That way, you can ensure that all your paperwork is in order and avoid surprises later on.
