Long-Term Disability Frequently Asked Questions

The Maine Attorneys at the Law Offices of Joe Bornstein Have Your Answers

At the Law Offices of Joe Bornstein, we know that you may have many questions about long-term disability if you're considering filing a claim or your claim has been denied. That's why we've provided the following list of FAQs. If you need help with your LTD claim, call us today for a free and confidential consultation.

If you've been injured or disabled and denied LTD or ID benefits, call the Law Offices of Joe Bornstein today for a free and confidential consultation. Don't let a missed deadline or improperly completed form keep you from getting the justice you deserve.

What is long-term disability insurance?

Long-term disability insurance (LTD) is an insurance policy that protects an employee from loss of income in the event that he or she is unable to work due to illness, injury, or accident for an extended period of time. Employers purchase these policies as part of their employee benefits package.

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What is individual disability insurance?

Individual disability insurance (ID) is a policy purchased by a single person to protect that person from loss of income due to an illness, injury or accident that prevents the individual from performing his or her regular job for an extended period of time.

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How do I receive benefits and for how long will payments continue?

Both LTD and ID benefits are paid directly to you for as long as your plan considers you disabled or you reach your maximum period of payment, whichever comes first. Most policies have a defined period of time.

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When should I hire an attorney?

It's never too early to hire an attorney to represent you in your disability case. However, it is absolutely critical that if your LTD or ID claim is denied initially, that you hire an attorney IMMEDIATELY AFTER THIS DENIAL to represent you in the appeal of that decision which the insurance company will require or offer to you. Having an attorney by your side helping you prepare and file this appeal gives you the best chance of success.

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Am I guaranteed coverage?

Most LTD policies purchased by employers for their employees automatically cover all full-time employees. For these policies, full-time employment is the only requirement for coverage.

ID coverage can only be obtained by completing an application for an ID policy. The insurance company then must decide, based on the information in the application and answers to the medical questions, whether or not to accept the individual's application and issue a policy. The insurer does not have to automatically accept an ID application and issue a policy.

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Does workers' compensation affect benefits?

LTD benefits may be reduced if you are receiving income from other insurance policies, retirement or government programs. However if an employee is hurt off the job, workers' compensation will not cover them and LTD insurance kicks in after a short term disability policy has run out (generally three to six months).

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What can a long-term disability attorney do for me?

Most LTD insurance policies are governed by the Employee Retirement Income Security Act (ERISA), a federal law that provides specific procedures and time limits for filing LTD claims. Most ID policies are governed by state law. A lawyer experienced with LTD and ID claims will know how to abide by the ERISA rules and help you in the following areas:

  • Working with your physicians to obtain supportive opinions about your work-related limitations while ensuring your claim contains all relevant medical evidence.
  • Knowing the right questions to ask your doctors, rather than relying on the paperwork provided by your insurance company. A critical component of your appeal for LTD benefits is the information obtained from your treating physician.
  • Hiring vocational experts to testify about the requirements of your position and/or the overall labor market.
  • Acting as your representative with the LTD carrier or plan administrator. In addition to obtaining persuasive evidence of your disability, your attorney will also interact on your behalf, file the initial application and appeals in a timely manner, conduct settlement negotiations, and if necessary, bring a lawsuit in federal court.

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