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Long Term Disability Eligibility: What Qualifies?

A disability insurance policy is essentially an agreement wherein the insurer promises to provide you with financial support when you can no longer support yourself in return for the premium payments made by you or your employer on the policy. While the arrangement seems straightforward, insurance companies and their policyholders are frequently at odds.

To you, being disabled means that because of a sickness or injury you can no longer work and collect a paycheck. When you have paid the premiums on the policy you rightly believe that you are entitled to the disability benefits you have paid for. Insurance companies sometimes have a different outlook as they are more concerned with their profitability than with making good on their promise to you.

How is Disability Defined?

Although the specific definition of disabled will differ for each insurance company, most companies will define disability as the inability to perform any type of work that you are qualified for. This differs significantly from the inability to do your current or former job and opens up a range of alternative work options the insurance company may claim you can do. In the eyes of the insurance company, simply because you can no longer perform your old job duties that does not mean you can no longer work at all.

What Factors are Considered?

When reviewing your disability claim, the insurance company will take into consideration your education or training, work experience and ability to transfer your skills into a different field or position. Depending on the level of your disability and the prevailing economic conditions, finding this type of work may be near impossible. Nevertheless, the burder of proving your disability falls to you.

Before starting the claim process, review your plan description to see what is covered. The document might be filled with complicated language, but it could give you an idea of what you are up against.

Whether contemplating an ERISA claim or a claim with a private disability provider, working with an experienced long term disability attorney will help you understand your policy’s requirements and how best to approach filing a claim.

Client Reviews
Just when I thought there was no hope to recover my LTD benefits, I found attorney Constantin Roboostoff. With his expertise, I was able to recover all of my back long term disability benefits. Other attorneys wouldn’t take my case because it wasn’t cut and dry. Mr. Roboostoff took the challenge and did an incredible job. Not only did he get my current disability benefits going, he also recovered all my back benefits. He was a true blessing and I would recommend him whole heartedly. CW
It was my pleasure to make contact with Scott Kalkin three years ago after other lawyers had turned me away and told me I would not succeed in my lawsuit. Thanks to Scott's thoroughness, dedication, and diligence, my lawsuit WAS successful and he saw me through to the end, which included putting legal pressure on the insurance company which had invested so much time, personnel, and money, in not paying me what was due. RB
As soon as I met with Scott, I could tell he was knowledgeable, resourceful, experienced, highly professional, and would be dedicated to getting me fair treatment. Scott has handled all interactions with my insurance company ever since. Being able to rely on him to represent me has been a huge relief for a chronically ill person. SO