What Essential Employees Need to Know About Long-Term Disability Insurance

Jun 10, 2020 - Articles by

A sudden condition or medical issue can devastate an employee’s career and cause financial problems. For example, a physician who has a debilitating heart attack and suffers a reduction of heart function that prevents her from being able to work will experience lost income and unplanned medical expenses for hospitalization, outpatient treatment, rehabilitation, prescriptions, etc. Long term disability insurance exists for scenarios like this one, where an employee is no longer able to complete their essential job duties due to a medical issue, psychiatric impairment, addiction or other disabling condition.

Disability Insurance is Not the Same as Workers’ Compensation

Long term disability insurance provides benefits for injuries and illnesses that cause longer periods of disability.  This should not be confused with workers’ compensation insurance, which provides lost income benefits and medical expenses for work-related injuries and illnesses. Long Term Disability Insurance provides lost income benefits for injuries or illnesses irregardless of whether they are work-related or not.

About Coverage Periods and Benefits Paid

Coverage under this type of policy typically starts after short term disability coverage ends (usually three to six months after the disabling event) and, depending upon the policy’s terms, can provide income replacement benefits for years, even up to retirement age. The policy will usually cover 60% to 80% of an employee’s earnings, to a maximum benefit, until he or she can return to earning usually 80% of their pre-disability earnings.

Your First Step: Policy Review with a Philadelphia Long Term Disability Insurance Attorney

The first thing to do if you’re considering applying for long term disability claim is to review your policy to see how it defines a disability. Under most policies, you’re likely to be found “totally disabled” if you’re unable to perform the essential duties of your occupation as a result of an illness or injury. 

Insurance language can be complex and each policy differs, with many of our clients having both employer provided coverage and individual disability insurance

When reviewing your policies, we will advise you on all of the applicable policy provisions which you may need to satisfy in order to obtain benefits, as well as all limitations and exclusions that may be raised by your individual disability insurance company or your long term disability insurance company.  Moreover, most employer-sponsored plans require you to be a full-time employee (working at least 30 or 35 hours a week) at the time you become disabled to qualify. These are the types of details a Philadelphia long term disability insurance attorney can review to ensure you are taking the correct steps to secure the benefits afforded to you under your plan. 

Consult with a Philadelphia Long Term Disability Attorney

If you have any questions about whether or not you qualify to receive disability insurance benefits or believe that your claim was unfairly denied, contact a Philadelphia long term disability claim attorney today at Seltzer & Associates. Our office is based in Philadelphia, but we work with doctors, nurses, lawyers, and executives throughout the entire country.