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Long-term Disability in Arizona

Posted by on Sep 4, 2017 in Long-Term Disability | 0 comments

You might be wondering what a long-term disability really is and if you qualify for this benefit in the state of Arizona. Typically, your employer offers you a long-term disability (LTD) coverage as part of your employee benefits package when you are hired. Or you can purchase an individual long-term disability policy on your own. Having this package in place is essential if there ever comes a time when you need to file a claim for LTD.

Any employee who becomes unable to do his/her job duties can become eligible. Most employer-sponsored LTD plans require that you be a full-time employee at the time you become disabled. Then, there is a waiting period. Most LTD policies have an ‘elimination period’ between the time your disability occurs and when you can get benefits. These periods are often 3-6 months and can last the same length of time as any short-term disability policy that you may have. It is important to know that any short-term disability must be utilized before filing for the long-term disability.

Your employer’s HR department can provide a copy of the plan. Any application for LTD needs to be submitted timely, or it could result in a denial of your claim. Generally, it is best to ask your HR department for the policy’s definition of ‘disability.’ If you are unable to perform your job duties due to illness or injury, you can be declared totally disabled. If your policy provides for partial disability, you may be able to qualify for benefits if you can’t work full-time at your own job, but you could work elsewhere performing other job duties.

Though it is important to consider that two of the most important components of your LTD case are your medical records and your physician’s opinion regarding your limitations, be sure that you check with your doctor’s office that your records are correct. Then it is important to ask your physician to write a detailed report of your medical history and the current limitations.

There can also be some exclusions for pre-existing conditions in some LTD policies. The pre-existing condition can be an illness or injury that was diagnosed and/or treated within a certain period (typically 90-180 days) before the LTD coverage began. If you have such a condition, you probably cannot be paid for long-term disability benefits that arise from the pre-existing condition for the first 12 months of your LTD coverage. There can also be some medical conditions that may be excluded. Before you file an LTD claim, check with an Arizona disability attorney to be sure that your specific illness/injury is covered.

If you find out later that your LTD claim is denied, you can get one or two levels of administrative appeals. A disability attorney is highly recommended to work with you to get a more favorable response in the event of a denial of LTD benefits.

In Arizona, residents should consult with a disability attorney to determine if they can collect both LTD and Social Security benefits. If you have been approved for LTD benefits, you may be required to file for Social Security Disability benefits. Further, if you are receiving LTD benefits for an injury that occurred on the job, you may be required to file for Workers’ Compensation.

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Reasons Long-Term Disability Benefits Can Be Denied

Posted by on Jun 9, 2017 in Long-Term Disability | 0 comments

Long term disability due either to illness or injury can have a devastating effect on the financial life of a struggling family. Quite too often the disability benefit applied for by many individuals get turned down by their insurance provider. The usual reason for such denial is strictly technical, though, and not because of ineligibility. Technical reason may be improper filing of an application, missing a signature or skipping a box when filling out a claims form – these errors often happen because disability insurance policies are long and complex documents that many applicants find confusing.

However, there are also reported instances when applicants are judged not qualified or, if approved, are awarded small payments. If long term benefits are meant to compensate for salary losses, then even being awarded a small amount would never suffice for medical treatment, much more to support a family’s daily needs.

Many insurance providers resort to finding faults in applications aggressively and then deny claims or award small benefits to ensure increase in their profit. Besides using the guise of technical or paperwork issues, these providers also resort to other tactics to make denials appear legitimate, tactics like, misclassification of injuries, undue termination of a policy or delay in the approval and/or release of cash benefits.

Legal experts call denials of benefit as “insurance bad faith,” which is a breach of the contract that providers, themselves, made and signed with the policy holder. If an insurance company, though, denies any long term disability benefits claim, then the applicant must be allowed to a full and fair examination of the denied claim, as well as to appeal the decision.

An appeal is a formal petition that asks for a re-assessment of an unfavorable decision (like a denial, termination or reduction of benefits) made by an insurer.

According to a long-term disability claim lawyer, the usual reasons why long-term disability benefits can be denied include:

  • Inadequate Medical Support: Medical records can help prove how severe your injury or disability is, as well as the impact on your ability to work. If your claim is missing important information, the insurance company may deny your claim due to a lack of evidence.
  • Definition of Disability: Each long-term insurance policy may have a unique disability definition. Some policies have guidelines which are much stricter than others, and certain medical conditions may even be excluded. It’s important to understand what your policy allows, and what criteria must be met in order to qualify.
  • Social Media Investigation: Insurance companies can also deny your claim if they find examples of behavior where you appear to be able to perform activities despite your illness or injury. A common source used by the insurance companies includes searching your social media accounts to show that your condition is not as limiting as you claim.

If you have been denied your long-term disability benefits, you owe it to yourself and your family to get the legal advice you need to ensure your appeal is accepted. A long-term disability lawyer knows what it takes and he/she may be able to help you understand your legal options.

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