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Jun 28 2021 | Zayouna Admin

Everything You Need to Know About Long-Term Disability

Suffering from a debilitating disability after an accident or illness can put a financial strain on you and your loved ones, especially if it impacts your ability to earn a living. A long-term disability plan helps protect the financial well-being of families after the insured person makes a claim. But how does this insurance coverage work? How do you get it? And what happens if you are denied coverage? We’ve created this comprehensive guide to help you understand everything you need to know about long-term disability.

What is long-term disability and how does it work?

Long-term disability coverage is a form of life insurance that pays out a monetary benefit for some time when you experience an illness or injury that stops you from working. The coverage provided by this form of insurance typically pays out anywhere between 60%-80% of your regular monthly income. You can use the plan’s regular monthly payments to help cover daily living expenses so you can focus on your recovery. You can purchase long-term disability insurance through an insurance company, or you may already have coverage through your work in the form of a group plan.

How to file a long-term disability claim

The claims process can be quite involved, especially if you are unsure where to start and what to do. So here is a simple guide to going about submitting a long-term disability claim.

  1. To begin, it is best to ensure you are completely familiar with your long-term disability plan. Then, before making a claim, check to be sure that your disability is covered by your plan as different insurance providers cover different disabilities.
  2. Obtain a claims form from your insurance provider. The easiest way to get the form is to contact your insurer directly and follow their instructions.
  3. Insurance companies will need proof from a medical professional when making a claim before they will successful payout. Your doctor may have to complete a form known as an “Attending Physician’s Form,” which is where he or she will provide any test results or procedures to back up your claim.
  4. Complete the form using any documents provided to you by your doctor or other medical professionals. Insurance companies typically will ask many questions on their forms like:
    1. How does your injury stop you from working?
    2. Is your disability work-related?
    3. Are you undergoing treatment?
    4. What is the contact information of any medical professionals you have consulted?
  5. Submit the claim via email, mail, or fax to your insurance company and wait for their decision.

Appealing a denial

After submitting a claim, it can be denied by the insurance company. If you are faced with a denial for your long-term disability claim, you can appeal the decision by following some key steps.

  1. Identify your appeal deadlines, so you know exactly how much time you have to appeal the decision.
  2. Gather all necessary documentation and information related to your injury and your employment. This includes a copy of the denial letter, the information about your plan, any medical files that pertain to your injury, and your insurance company’s claim file. 
  3. Go over the denial letter and make sure you organize your paperwork to help with your appeal. You’ll often find that insurance companies point to a gap of information when denying a claim. This gap could be missing medical information, pinpointing how your injury prevents you from working, or simply adding more information from a co-worker or family member. If you can fill these gaps, you are more likely to win your appeal.

Getting legal help

If you feel like you need more support on your side when facing a long-term disability claim denial, it is best to seek legal help as soon as possible. Insurance companies have years of legal experience dealing with these appeals, so to best increase your chances of getting your request approved, you should hire a lawyer to look over your case. Your personal injury lawyer will know what information to provide, how to approach the appeal process, and how to deal with insurance companies throughout the claim.

At Zayouna Law, our personal injury lawyers have the experience to get you the compensation you deserve after facing an injury and being unable to work. Contact us now to get started, and our professional team will be more than happy to help you with your long-term disability claim.

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