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Long Term Disability

Long Term Disability Attorney

Are you feeling frustrated because you’re dealing with a long-term disability (LTD) claim in Missouri or Wisconsin? If so, don’t lose hope. Dealing with insurance companies can be challenging, but you don’t have to do it by yourself. A disability lawyer from the Law Offices of Phillip A. Tatlow, LLC, can help.

Our team understands the importance of getting the disability benefits you are due when you’re hurt and can’t work. Our disability benefits lawyers based in St. Louis can help you by reviewing your case, gathering necessary evidence, and representing you in all dealings with the insurance company. If your claim is denied, we’re ready to file a strong appeal on your behalf. We’re committed to fighting for your rights and working hard to get the results you deserve.

Don’t let this process overwhelm you. Let the Law Offices of Phillip A. Tatlow, LLC, take the lead on your LTD claim. Contact us today to learn more about how our law firm can support you.

Understanding Long-Term Disability Insurance

Long-term disability (LTD) insurance is a type of coverage that replaces a portion of your income if you can’t work because of a disabling injury or illness. The income replacement benefits you can get from an LTD policy are usually worth 50 to 70 percent of your gross income, up to a certain dollar amount. These benefits can help you pay your bills and take care of your family if you cannot earn a paycheck. There are two main kinds of LTD policies: those your employer provides and those you can buy independently.

Employer-provided LTD policies often come as part of your job’s benefits package. If your employer doesn’t offer this insurance, or you want more coverage than your job provides, you can buy a private LTD policy. Both types aim to replace a part of your monthly income during the time you cannot work. Most LTD policies require you to wait a certain period, known as the “elimination period,” before you can start receiving benefits. The length of time you can receive benefits can also vary based on your policy.

Own-Occupation vs. Any-Occupation Benefits

The way your LTD policy works after a disabling injury or illness will largely depend on whether it’s an “own occupation” or “any occupation” policy. If you have an “own occupation” policy, you have more targeted coverage related to your specific job function. With an “any occupation” policy, the scope is wider, and claiming benefits requires showing a more comprehensive inability to work.

Own Occupation Benefits

If your policy is an “own occupation” type, it provides benefits if you cannot perform the specific duties of your usual job due to an illness or injury. This is particularly relevant if you have specialized skills or work in a profession where specific physical abilities are essential. For example, let’s say you’re a surgeon and develop a hand tremor that prevents you from performing surgery. If you have an “own occupation” policy in this scenario, you can claim LTD benefits even if you’re still capable of working in another role.

Any Occupation Benefits

If your policy is an “any occupation” policy, you can only claim benefits if you cannot work in any job that fits your skills, education, and experience level. This type of benefit is broader and requires more stringent proof of disability. You need to demonstrate not just that you can’t do your usual job but also that your disability prevents you from doing any other job for which you are qualified.

ERISA and Long-Term Disability Claims

ERISA stands for the Employee Retirement Income Security Act. It’s a federal law that sets standards for most voluntarily established pension and health plans in private industries and protects individuals in these plans. When it comes to long-term disability claims, ERISA plays a big role if your LTD insurance comes through your employer.

If your employer provides your long-term disability insurance, ERISA will cover your plan. This means there are specific rules your plan administrator must follow regarding how they handle your claims, including the process and timeline for filing a claim or appealing a denial.

Under ERISA, your employer’s plan must give you a written explanation if they deny your claim. They also must tell you how to appeal the denial if you don’t agree with the decision. The law sets strict deadlines for you to file an appeal, and the plan administrator must review it within a certain timeframe.

Appealing a denied LTD claim under ERISA is a complicated and time-consuming process. If your plan administrator denies your claim, you should contact an ERISA attorney in Missouri or Wisconsin right away. They can argue your case effectively and present your evidence in a way that highlights why you deserve the benefits. If your appeal doesn’t succeed, your disability appeal attorney can take the matter to court. An ERISA lawyer in Missouri or Wisconsin can stand up for your rights and work hard to get you the benefits you are owed.

The Impact of Long-Term Disability Benefits on Other Benefits

When you receive LTD benefits, it can affect other benefits you might get, like Social Security Disability Insurance (SSDI) or workers’ compensation benefits.

For instance, let’s say you’re getting LTD benefits and then start receiving SSDI. Once you start getting your SSDI benefit payments, your LTD benefits will likely be reduced accordingly. Most LTD policies require this reduction so that the total amount you get from both sources doesn’t exceed a certain percentage of your previous income. The idea is to prevent overinsurance, where you might receive more money than you earned when working.

Similarly, your LTD benefits could also be reduced if you’re eligible for workers’ compensation for a work-related disability. The specifics depend on your LTD policy, but the reduction generally reflects the amount you receive from workers’ compensation.

It’s important to report any other benefits you receive to your LTD insurer. This allows your insurer to adjust your benefits correctly so you don’t have to pay back anything out-of-pocket later on.

Legal Representation in Long-Term Disability Claims

If you’re dealing with an LTD claim or denial, having an experienced disability insurance attorney by your side can make a big difference. Here’s how a long-term disability attorney can assist you with your LTD claim:

  • Reviewing your LTD policy to understand its benefits and limitations
  • Gathering comprehensive medical evidence to support your claim
  • Completing and submitting your LTD claim forms accurately
  • Communicating with your insurance company on your behalf
  • Identifying and meeting all deadlines for filing and appealing claims
  • Arguing against denials or reductions in your LTD benefits
  • Negotiating with the insurance company for a fair settlement
  • Appealing denied claims by preparing a strong case
  • Representing you in court, if necessary, to fight for your benefits
  • Coordinating your LTD benefits with other benefits you may receive
  • Protecting your rights under federal and state laws

Contact a Long-Term Disability Lawyer in St. Louis

Still have questions about your LTD claim? Let our Missouri and Wisconsin long-term disability lawyers help. Contact the Law Offices of Phillip A. Tatlow, LLC, now to speak with our long-term disability attorneys about your rights. Our main office is located in St. Louis, but we assist clients in both Missouri and Wisconsin.

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