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When Is a Person Considered Disabled by a Long Term Disability Insurance Company?

July 14, 2020 //  by Dawn Keller//  Leave a Comment


If you have a long term disability policy through your employer or you have an individual policy that you purchased on your own, you may be able to receive disability benefits to replace most or part of your salary if you are unable to work.

The first thing you need to do is read through your LTD policy. You can pick up a copy of your plan from your employer’s human resources department. Sometimes human resource departments will try to delay providing you with this documentation. If you request a copy verbally or in-person and you do not get a response within 7-10 days, send a letter requesting a copy of your policy. If you are provided with a summary of benefits but the summary does not answer all of your questions, you need to request a copy of your full policy.

How Does Your LTD Policy Define “Disability”?

Every long term disability policy has a definition of what “disability” means to the insurance company. They are usually “totally disabled” which means you can no longer work at all and “partially disabled” which means you can no longer work full time in your current job.

It is also important to know that your policy will define – or outline – exactly what they consider to be your “own occupation” or “any occupation“. “Own Occupation” typically refers to your specific occupation and your essential duties of that occupation, whereas “Any Occupation” typically refers to being able to find gainful employment that is suited for your work experience and education level.

Proving that you cannot work or that a job is not suitable for your skills will be your responsibility. Using a disability attorney can help with this, but the first thing to do when applying for long term disability is to read your policy thoroughly. If you have a group policy through your employer, you can request a copy from your human resources department.

After you read your policy, you can decide if you think you have a case for LTD benefits. When you start gathering information for your claim, be sure to include all the necessary information that will “stack” your administrative file. Your administrative file is everything in your case. It includes all the correspondence between you and your insurance company, all your medical information, notes from your doctors, and even surveillance footage. 

Legal Representation in LTD Claims

Applying for long term disability benefits can be tedious. The process involves a lot of gathering information and can be overwhelming to some. If you have questions, you may want to consult an experienced LTD attorney. Although based in Florida, the Ortiz Law Firm represents claimants across the United States.

If your LTD claim has been wrongfully denied or terminated and you’d like to speak to an experienced Long Term Disability Insurance Attorney about your denied claim, contact us at (866) 853-4512 to schedule a consultation. We can help you evaluate your claim to determine if you will be able to access Long Term Disability Benefits and how to move forward with the process.

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Category: Eligibility for Long Term Disability Claims, Long Term Disability

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Don't try to navigate disability on your own! Mr. Ortiz and his group care for the client and their situation. They walked me through every step of the claims process and provided help to me in a time of desperate need. They are honest, professional, and understand their clients' hardships.

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