Long-Term Disability: How To Win
If your long-term disability company has denied you benefits, there are a few things you’ll need to be prepared to address if you are going to try to appeal your case. First, there are periods or components of long-term disability that you should be aware of. Those components include not being able to function at either your “own occupation” and/or “any occupation.” Both of those definitions rely on what your current job description is. Based upon your current job description, let’s take a look at some long-term disability policy language and discuss how to win. So, when it comes to Long-Term Disability, how to win?
It is important to note that each long-term disability policy is different. So, you should be sure you know what your policy says.
“Own Occupation” Period
Many long-term disability policies define a period of disability as one which begins when you are unable to do your “own occupation.” In this case, your disability policy may allow you disability benefits if you are not able to do your own job as it is usually performed in the national economy. Basically, this means that your disability insurance company will look at your job description or job duties and compare your duties with jobs from the Dictionary of Occupational Titles (DOT). The disability insurance company will likely then choose the job it believes most closely matches your job description.
Then, the insurance company will review the restrictions given you by your medical providers and determine whether those restrictions interfere or conflict with the requirements of the job title listed in the Dictionary of Occupation Titles. If your physical or mental restrictions do not conflict with the requirements of your job, your disability insurance company will likely say that you are NOT DISABLED.
“Any Occupation” Period
Usually, the period known as the “any occupation” period will frequently begin after your “own occupation” period ends according to the terms of your policy. This type of disability will give you benefits if you can’t perform 1) ANY work or 2) if you can’t earn wages that are equal to or which exceed the wage required by the disability policy. The “required wage” is defined differently for each disability policy. However, most of the time the required wage is somewhere between 50% and 80% of the wage you were earning when you became disabled.
So, this means if you become disabled from your “own occupation,” you may be eligible for disability benefits if you are not able work in any job where you would earn from 50%-80% of what you made previously. Your disability insurance company will review your work restrictions to determine whether your remaining physical capabilities will permit you to earn 50%-80% of what you earned before.
Work History Form — The Most Important Part of Your Disability Claim
If you get a Work History form from your disability insurance company, it is extremely important that you fill it out as accurately and with as much detail as possible. If you don’t include complete information on this form so that the insurance company can’t determine your skills and abilities, it is quite possible that there could be confusion when it comes to the disability company determining what other jobs you might be able to perform.
What Makes Ritchie Law Firm Different?
Many Virginia lawyers say they practice Social Security Disability law. But, most of those lawyers don’t work with long-term disability or short-term disability insurance claims. Before you hire any lawyer to handle your long-term or short-term disability claim, you should ask if he or she has been trained in handling or has handled ERISA claims before. If that attorney can’t answer yes, he or she is probably not the right lawyer for you.
That’s what makes us different. At the Ritchie Law Firm, we have a team of lawyers who have been trained to handle the complexities of long-term and short-term disability cases. Sure, we also handle Social Security Disability cases. But, ERISA long-term and short-term disability cases are a different beast. And, we know how to handle them.
If you have been denied long-term disability benefits, our disability team will review your denial letter for FREE. Then, with no obligation and NO STRINGS ATTACHED, we’ll tell you our game plan for winning your case.
If you want your long-term or short-term disability case handled by a team of lawyers trained to handle this difficult area of the law that few lawyers know the first thing about, your search is over. Whatever stage of applying for benefits you are in, whether you haven’t yet applied or you’ve been denied, we are happy to help. We can even help if you live in states other than Virginia or West Virginia by associating with counsel local to the jurisdiction where you live.
We can help with denials from both ERISA and non-ERISA (private) disability plans. Click here to give us some details about your case.
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