Eligibility For Long-Term Disability Can Be Difficult To Assess On Your Own
If you’re currently on short-term disability, and it looks like your condition isn’t improving enough to go back to work, what happens next? This is a major source of stress and uncertainty for many workers who find it difficult or impossible to work yet are not in a position to consider retirement.
To understand and utilize your legal options, it’s a good idea to consult an experienced attorney like Reagan Toledano. As the founder of Toledano Disability Law, he has been advocating for clients with long-term disability claims since 2005, both in Louisiana and across the country. If your employer’s long-term disability benefits are governed by ERISA, Reagan can help with all aspects of your claim and any necessary appeals.
Do You Meet The Standards Of Being Considered Disabled?
Your employer’s specific plan will define what constitutes a disability. Generally, qualifying for disability means showing that you have a condition or diagnosis that makes you unable to work. Under some plans, you only need to show that you are unable to do the job you were previously performing.
Under other plans, you must show that you cannot manage any gainful employment (similar to the standards of Social Security Disability). Some plans are a hybrid of the two definitions. In order to qualify, you need to meet the disability standards set by your employer’s plan.
What Qualifies As Long-Term?
“Long-term” also lacks a universal definition. Many plans define long-term as a disability lasting six months or more. Often, if a worker was eligible for short-term disability for the previous six months, they may become eligible for long-term disability.
Physicians often don’t know the differences between short-term and long-term benefits, which means they could make paperwork errors that compromise your eligibility. When you hire Toledano Disability Law, Reagan will work directly with you and your treating physician(s) to accurately fill out paperwork and obtain or generate necessary medical documentation.
ERISA Mandates Predictable Timelines And Clear Communication
The Employee Retirement Income Security Act was enacted with the goal of bringing transparency and fairness to the benefit plans offered by private employers. While there are many variations in plan details and offerings, all employees with an ERISA-governed plan can expect:
- Stated timelines for decisions: The insurance company must issue claim decisions with a specific timeline so that you aren’t left with an open-ended claim that drags on indefinitely.
- Clear communication: If your claim was denied, the insurance company must communicate clearly about the reasons for the denial.
- Information on appealing: You have the option to appeal a denied claim, and you must be provided with information to that effect.
Although ERISA strives to bring clarity and consistency, these employer benefits programs can still be quite confusing and frustrating for the average worker to understand or utilize. That’s one of many reasons why it is helpful to work with an experienced ERISA attorney.
Learn More During An Initial Consultation
Based in New Orleans, Toledano Disability Law serves clients throughout the United States. To discuss your long-term disability claim with a highly experienced ERISA lawyer, reach out online or call 877-281-4789.