Two Costly Mistakes In Long-Term Disability Claims

By Ben Glass, Esquire

Benjamin W. Glass and Associates

. https://www.benglasslaw.com/

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Two Costly Mistakes In Long-Term Disability Claims

A common mistake when filing for Long-Term Disability is stopping work on the “Wrong Day.” There aren’t exactly black-out dates for stopping working, but something to take into consideration is the fact that the insurance company is going to look at your work schedule prior to that day, your Last Day Working (LDW).

To an insurance company, the LDW is a very important date. Much of the investigation of your claim will revolve around the medical, vocational, and financial facts in existence as of that day. Unfortunately, many people stop working on the well-meaning – but legally incorrect – advice of doctors, supervisors, co-workers, and friends or family. As much documentary evidence as possible must already be in existence on your LDW.

If you worked, for example, 40 hours the week before or even eight hours the day before, the insurance company is going to question why you stopped on that day, but were able to work each day before. Even if you have a dreadfully debilitating disease that you’d been working through for a long time, they will still ask why you can’t continue to do so.

The answers to these questions should be found in your medical records before you file your claim. It is better to have all of the information upfront than to have to search for it in the process and risk being denied simply because you were unprepared. And, trust me, it does happen.

Another thing that you should avoid is operating under the assumption that your supervisor or employer saying that you’re too sick to work will be enough for the insurance company.

Remember that you (or your employer) have purchased an insurance policy. Therefore, in almost all cases, the money that would be paid to you for your long-term disability comes from the insurance company, not your employer.

It is that company which determines when you meet the legal definition of disability under the terms of the insurance policy. We have seen cases where the employer would not let the employee come back to work without approval from the doctor and yet the insurance company would not pay benefits.

How Can This Be?

The answer is that most insurance policies insure an occupation, not a job. This means that while you may not be physically able to do all of the specific job requirements of your employer, you might still be able to perform the substantial and material duties of your occupation.

The best and most important thing you can do before filing for long-term disability is to educate yourself on the process and possibilities. Do as much research as you can, talk to a lawyer or free legal advisor who understands disability insurance, and gather as much information as you can, including information on more costly mistakes that many people make that ruin their long-term-disability cases.