Long-term Disability Benefit Denials

February 6, 2024

By: Terri-Ellen Haddy

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If you have suffered an illness or injury and are unable to work as a result, you may have access to income loss disability benefits through your work and should check with your employer. In order to receive benefits, you must submit an application to your insurance company. There are usually forms that must be completed by you, your employer and your doctor. Some benefits plans provide coverage over the short term (also called “short-term disability benefits”). Short-term disability benefits typically cover a portion of your income loss for the first several weeks.

But what happens if you are not cleared to return to work at the time your short-term disability benefits run out? Some individuals have access to long-term disability benefits, which often pay at the same or a reduced rate compared to short-term disability benefits. In order to receive long-term disability benefits, you will likely have to complete a separate application with more forms for your doctor to fill out on your behalf. Being approved for long-term disability benefits can be more difficult than being approved for short-term disability benefits.

Even if you are initially approved for long-term disability benefits, many insurance plans have a change in the test you must meet in order to continue to qualify for benefits. In many policies, the test will change from requiring that you be disabled from the job you worked at the time of your illness/injury (often called the “own occupation” test) to requiring that you be disabled from any job that you are reasonably suited for by means of your education and experience (often called the “any occupation” test).

If you are denied income loss disability benefits, either when you initially apply or sometime after you have begun receiving benefits, it is important to speak with a lawyer who understands the process and can advocate on your behalf. The lawyers at Beckett have considerable experience representing individuals who have been denied disability benefits. We always provide a free initial consultation and would be happy to discuss your legal issues with you.

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