If you are suffering from a debilitating injury or illness that makes it impossible for you to perform your job, you may be eligible for long-term disability (LTD) insurance benefits. Although you can purchase a private disability income insurance policy, the majority of workers get LTD insurance through group policies their employers provide. These policies are regulated by the Employee Retirement Income Security Act of 1974 or ERISA. The federal law governs the obligations of insurance companies when a worker cannot do their job for an extended period beyond short-term disability coverage because of a serious disability or illness.
Workers’ Comp vs ERISA
Workers’ compensation offers coverage if you are involved in a workplace accident. The majority of states will prescribe fixed amounts you could get for specific injuries, often based on what part of your body is injured. Also, workers’ comp covers related medical bills and therapy for an on-the-job injury.
In ERISA LTD claims, a lot of rules govern the disability application process. Claimants need to observe strict deadlines and what evidence they can use during an appeal. Also, you must be aware of the conditions that qualify for long term disability in the U.S. and ensure you suffer one to be eligible for benefits. This makes it essential to work with an experienced ERISA attorney.
Qualifying for LTD Benefits
Although LTD benefits include coverage for injuries or disabilities incurred on the job, LTD insurance protects employees when they sustain serious injuries or illnesses that prevent them from returning to work even if their condition did not result from an on-the-job accident.
LTD gives more emphasis on the extent of the disability than its cause. Disabilities suffered through car accidents, slip and falls, or other personal injuries may qualify for ERISA LTD benefits. Also, workers are qualified for this coverage if they suffer debilitating diseases which can be emotional or physical. These include Parkinson’s disease, multiple sclerosis, rheumatoid arthritis, dementia, depression, and other acquired or hereditary diseases that impact mobility, speech, coordination, hearing, cognitive abilities, the immune system, concentration and focus, the ability to stay on task, and work at a normal pace, as well as the ability to work without unscheduled breaks and to get along with colleagues and superiors.
If you are denied benefits or terminated from benefits, you usually have 180 days to submit an administrative appeal to the insurance provider that denied your claim. You must complete the appeal on time; otherwise, you won’t be able to challenge the denial in court later. Therefore, if you have received a denial letter from the insurance company, you must contact an experienced LTD lawyer as soon as possible.