Long-term disability lawyers help people with private or employer-sponsored disability insurance claims, including initial applications, denied claims, terminated benefits, and appeals. The right lawyer may depend on the type of disability policy, the reason benefits were denied, available medical evidence, and whether the plan is governed by ERISA. Because LTD policies can use different definitions and procedures, the specific policy language is often important.
A long-term disability lawyer may assist with different stages of an LTD insurance claim, including:
Long-term disability insurance and Social Security Disability are different benefit systems.
| Long-Term Disability | Social Security Disability |
|---|---|
| Usually comes from a private insurance policy or employer benefit plan | Federal disability benefit program |
| Eligibility depends heavily on the policy language | Eligibility follows Social Security Administration rules |
| Benefits may replace part of a person's income | Benefits are calculated under federal Social Security rules |
| Claims may be handled by an insurer or plan administrator | Claims are handled by the Social Security Administration |
| Some employer plans may be subject to ERISA | SSDI is a federal government program |
Long-term disability claims may be denied for many different reasons. Common issues can include:
Depending on the claim, useful documentation may include:
After receiving a denial, a claimant may need to:
A person may consider consulting a long-term disability lawyer when:
When comparing lawyers for a long-term disability matter, consider whether the professional has experience with issues similar to yours. Useful factors may include:
What does a long-term disability lawyer do?
A long-term disability lawyer can review disability insurance policies, evaluate medical and occupational evidence, assist with claims and appeals, and help address disputes involving denied or terminated LTD benefits. The lawyer's role depends on the type of policy and the stage of the claim.
Can a lawyer help if my long-term disability claim was denied?
Yes. A lawyer may review the denial letter, insurance policy, medical evidence, claim file, and appeal procedures. The goal is to identify why the claim was denied and determine what additional evidence or arguments may be appropriate during the appeal process.
How long do I have to appeal a long-term disability denial?
The deadline depends on the policy and the laws governing the plan. Employer-sponsored plans subject to ERISA may have specific administrative appeal procedures. Claimants should review the denial letter and policy documents carefully and avoid waiting until the deadline is close.
What evidence is needed for a long-term disability claim?
Evidence may include medical records, physician reports, diagnostic testing, treatment history, functional limitations, occupational information, job duties, claim forms, and insurance correspondence. The most useful evidence often explains not only the diagnosis but also how the condition affects the person's ability to work.
Are employer long-term disability plans governed by ERISA?
Many employer-sponsored disability benefit plans are governed by ERISA, but not all LTD policies fall under ERISA. Individual insurance policies and certain employer arrangements may follow different rules. The plan documents can help determine which legal framework applies.