Philadelphia Long Term Disability Lawyer for Professionals
Are you suffering from an injury or sickness that is preventing you from working? Or has this injury or sickness limited your ability to work? Can you no longer perform all of your job responsibilities or does it take you significantly longer to complete your duties? Are you losing money due to injury or sickness? If you are a professional with long-term disability insurance provided by your employer, a Philadelphia long-term disability lawyer at Seltzer & Associates can assist you in filing your claim for disability benefits. Properly filing your claim and providing appropriate and necessary “proof of loss” are critical to achieving success in your long-term disability insurance claim. Contact us immediately to begin the process for submitting your long-term disability insurance claim.
Our Philadelphia Long-Term Disability Lawyer Explains the Specialty Coverage for Medical Professionals
Often times, physicians, dentists, psychologists, nurse anesthetists, chiropractors, and other medical professionals have long-term disability insurance policies which cover your inability to perform your specific occupation or your own specialty. When your ability to work in your occupation has been impacted by an injury or sickness it is important for you to understand your policy and know what provisions you must satisfy to obligate your disability insurance company to pay you benefits.
Your policy may contain:
- “Own Occupation” coverage, your inability, due to your injury or sickness, to perform the material and substantial duties of the occupation you were performing when you became disabled.
- “Any Occupation” coverage, your inability, due to your injury or sickness, to perform the duties of any gainful occupation for which you are qualified by training, education, or experience.
These provisions can often cause confusion for individuals unfamiliar with them. Additionally, disability insurance companies will often attempt to construct own occupation for medical professionals as something other than limited to the performance of your clinical medical professional duties, such as an entrepreneur, administrator, lecturer, teacher, or chief of staff , thereby changing or modifying your occupation as covered under your “own occupation” coverage. Contact Seltzer & Associates to assist you with your claim and avoid this confusion.
Understanding Your Insurance Policy
Long-term disability insurance policies often contain the most restrictive provisions and language that can be difficult to understand. We will review your existing policies on a line item basis to help you achieve the best possible understanding of what long-term disability insurance coverage you have and when benefits should be payable. We will methodically analyze the definitions in your specific policy and how those definitions apply to your unique situation.
Let a Philadelphia Long Term Disability Lawyer Evaluate Your Policy Options
At Seltzer & Associates we can also review prospective new individual disability insurance policies and compare them to your employer provided long-term disability policies so you can better understand how best to protect your financial needs without leaving any gaps in coverage. Working with your insurance broker, our long term disability lawyers can assist in providing you with an understanding of the policies you are reviewing for purchase.
Understanding the Important Provisions In Your Long-Term Disability Insurance Contract
It is important to understand your policy is a contract, which must be satisfied in order to obligate your disability insurance carrier to pay you disability benefits. While you may think this is easy to understand, your disability insurance company will require that each definition, each provision, every line and every word in your policy be satisfied in accordance with the position of its claims department before it will be obligated to pay you disability benefits. Therefore, it is important that you fully understand your policy and what is required to obtain the benefits you seek under your policy.
Some of the important policy provisions include:
- Total Disability and Residual Disability
- Own Occupation and Any Occupation
- Appropriate Physician’s Care
- Policy Limitations
Additionally, many long-term disability insurance policies contain specific policy limitations and exclusions. When you have suffered a disabling sickness or injury, it is important to understand how each of these policy provisions work together and affect one another. It can often be a confusing process to understand what you are entitled to and how to obtain the appropriate benefits, especially at this time in your life when you are suffering a severe medical condition and in need of your benefits.
Let Seltzer & Associates analyze the specific policy provisions as they appear in your policy and apply to your unique situation. Your employer provided you long-term disability insurance to assist you in focusing on your health and getting back to work when you suffer a sickness or injury; however, your insurance company is a business looking to protect its profits. After careful review and analysis, your Philadelphia long term disability lawyer will work for you to obtain the disability insurance benefits you deserve.
Social Security and Other Income Benefit Offsets Explained by a Philadelphia Long Term Disability Lawyer
Most long-term disability insurance policies contain clauses which allow your disability insurance company to claim an offset of your LTD benefits based upon other sources of income you are receiving. These offsets often include benefits you are receiving from Social Security, state disability benefits, other group LTD benefits, and compensation from your employer.
Do I Have to File for Social Security?
In addition to taking an offset for Social Security Disability benefits you are receiving, most group long-term disability policies require you to apply for Social Security Disability benefits at the discretion of your disability insurance company. Should your initial application for Social Security Disability be denied, your policy will usually require you to appeal the decision and continue appealing until the disability insurance company is satisfied.
While you may feel you do not qualify for Social Security Disability, as often happens when you qualify for your LTD benefits under an own occupation definition of disability, should your disability insurance company determine they believe you qualify for Social Security Disability and request you apply, then they are usually entitled to take an estimated offset if you refuse to apply or appeal a denial of Social Security Disability benefits.
Some Notes About Policy Limitations for Disability Insurance
Policy Limitations on “Mental Nervous” Conditions in Long-Term Disability Insurance
Many long-term disability insurance policies include provisions which limit disability benefits to two years for disability conditions which result from mental illness. Although there are usually only “organic” brain condition exceptions, these “mental nervous” limitations are extremely broad and encompassing. The long-term disability companies often try to limit any claim that has any “mental nervous” component under this provision. Additionally, even if your policy does not contain a substance abuse limitation, described below, your company may still try to sweep a substance abuse claim under the “mental nervous” limitation.
Policy Limitations on Substance Abuse Conditions in Long-Term Disability Insurance
Many long-term disability insurance policies limit disability insurance coverage for disabilities caused by drug and/or alcohol addiction, use, abuse or dependence to two years. If you suffer from one of these conditions, it is important to understand and recognize how such limitations may apply to you.
Presenting your claim in view of these limitations is extremely challenging, and requires much thought and preparation. Let Seltzer & Associates assist you in preparing and presenting your claim in the strongest possible way with the greatest likelihood of obtaining the maximum benefit payable under your long-term disability policy.
Learn the Ins and Outs of Your Policy by Scheduling a Consultation with a Philadelphia Long Term Disability Lawyer at Seltzer and Associates
It is important to understand when your long-term disability insurance company is entitled to take an offset and especially when they are not entitled to. At Seltzer & Associates, we will work with you, your Social Security attorney, and anyone else helping you coordinate your additional employment and financial options to ensure you are receiving all disability benefits to which you are entitled. The offset process can be complicated and the insurance company will always look to take the maximum offset possible, contact a Philadelphia long term disability lawyer at Seltzer & Associates to assist you with your claim to ensure you receive the proper disability benefits.