If you've been injured, or you're ill and can't work, and you have long-term disability (LTD) insurance, you might assume you'll automatically get disability payments. LTD insurance is supposed to be there when you need it, right? But you could be shocked by how difficult it can be to get the insurance company to approve your long-term disability claim.
Unlike a disability claim with the federal government (Social Security disability), long-term disability insurance companies aren't impartial. LTD insurers have a vested interest in the outcome of your claim because the fewer disability claims they approve, the more profit the insurance company makes.
Since the insurance company is looking out for its own interests, you should hire a long-term disability lawyer to protect yours, especially if the LTD company denies your initial claim. Here are some of the reasons you need an LTD attorney for your long-term disability claim.
To protect their profit margins, long-term disability insurance companies sometimes make the claims process overly difficult. And you can bet your long-term disability insurer has systems in place that are designed to trip you up—to catch you trying to "cheat the system."
Even if you're completely disabled and need your LTD benefits to survive, if you make one of the following simple mistakes, it can sink your disability claim:
An experienced LTD attorney knows how to navigate the insurance process and understands how to fight against unfair practices.
While some LTD insurers regularly pay out valid claims, other LTD insurance companies will deny or delay your claim unfairly. This is called acting in bad faith. Here are some examples:
An experienced long-term disability lawyer knows how the LTD claims process should work and can spot unfair practices you might not see coming.
Some LTD companies will conduct surveillance on people applying for benefits. For example, an investigator from the company might secretly follow you and take a video of your activities, such as:
Later, the insurer might use this visual evidence to justify denying your long-term disability benefits or even to accuse you of misrepresenting your condition (which can be prosecuted as fraud).
This video footage can be unfair to you because it usually only shows part of the picture. For instance, while you might be recorded taking a heavy bag of garbage to the curb or bending down to get a newspaper, the recording probably won't show you later resting and recuperating from the demands of that physical activity.
LTD insurance companies are notorious for showing only the "highlights" from the recordings they obtain—meaning they show only evidence that might damage your disability claim, not support it. Your LTD attorney can ensure the full story of your disability is told—not just the insurer's edited version.
Hiring a long-term disability lawyer to help with your claim improves your odds of getting the LTD benefits you deserve. And since most long-term disability attorneys offer free consultations before you hire them, there's no risk involved in speaking with one as soon as you know you're going to file an LTD claim.
And having an LTD attorney on your side is especially beneficial if you have to fight the insurance company to get your long-term disability benefits.
Sometimes it makes sense to consult with an experienced attorney before you even file for long-term disability benefits. There are a couple of good reasons why you can benefit from hiring an LTD attorney early on:
Most applicants for long-term disability benefits willingly comply with every request for information the LTD insurer makes—even when the insurance company isn't entitled to that information. Having an attorney from the outset can give you protection in the form of:
Unfortunately, some LTD insurance companies don't always play fair. They manipulate the rules and use loopholes to make it more difficult than it should be to get your long-term disability benefits. This unfairness can result in your long-term disability claim being unjustly denied.
Administrative appeals. If the insurance company has denied your LTD claim, you'll have at least one, and often two, administrative appeals available to you. Hiring a long-term disability attorney as soon as possible after a denial will ensure your appeals are as effective as they can be.
Hearings. It's especially important to hire a long-term disability lawyer before any hearings are set for your LTD claim. An experienced LTD attorney knows how long-term disability insurance companies operate—including the way some maneuver to keep you from presenting your strongest case.
For instance, after an administrative hearing for your long-term disability claim, your record will be "closed"—meaning you can't add additional medical records or evidence to your file. And your LTD company probably won't tell you this right away because, if you knew, you'd work harder to ensure that all possible medical evidence supporting your disability claim was in your file before the hearing.
Medical evidence. A long-term disability lawyer can help you gather important medical evidence for your appeal—including asking your doctors to submit supporting information—before your file is closed. Your LTD attorney will know the following:
LTD insurers count on the fact that you probably won't know their rules and procedures. As a consequence, there's less chance you'll be able to effectively fight and win your long-term disability benefits—never mind that you (or your employer) have dutifully paid the LTD insurance premiums.
To level the playing field, it makes sense to hire an experienced long-term disability lawyer when you need to file an LTD insurance claim.
Learn more about what long-term disability insurance is and how it works.
Updated December 30, 2022