Nobody wants to think about sustaining an injury or falling ill. However, the reality is that anyone can experience it at any given time. An extended period of disability can make it difficult to support yourself and your family. It can also prevent you from working. Fortunately, long-term disability insurance can alleviate some of the financial strain during this time.


How Long-Term Disability Insurance Works


Enrolling in a long-term disability insurance program provides income replacement if you are unable to work due to illness or injury. The benefit percentage is based on your income, usually 40 – 60% of your pre-disability earnings. The disability must last for the defined waiting period, which can range from 90 to 365 days. Long-term disability benefits typically have an end date, often when you reach retirement age.


How do I prove I am disabled?


Most LTD policies consider you disabled if a medical condition prevents you from performing job duties for at least 90 days. If you meet this definition, provide the insurer with medical evidence that supports your claim. Your treating doctor is the best source of such evidence. Make sure your doctor provides detailed records of your diagnosis, treatment plan, and prognosis. The insurer also wants objective medical findings, such as test results, imaging studies, and surgical reports.

Medical evidence varies in quality. An MRI or X-ray can reveal a herniated disc but not the pain level, mobility impact, or flare-up frequency. Your doctor’s professional opinion is crucial here. They can provide written opinions on functional limitations, estimated disability duration, and activity restrictions. These opinions give context to medical records and evidence, which may not be clear to insurers.


When can I use LTD benefits?


Before applying for LTD benefits, review your policy thoroughly. The summary plan description provides a detailed definition of “disability” and essential information about the waiting period before filing a claim. Remember that each LTD insurance provider may have slightly different requirements, so understanding your policy’s specifics is important.

Most policies require filing for LTD benefits after short-term disability (STD) ends. This typically occurs between three to six months. LTD insurance, which has similar requirements and guidelines as STD insurance, essentially replaces STD insurance. The main difference is that LTD benefits become available once the elimination period is over or STD benefits are exhausted.


How much will my LTD monthly benefit be?


LTD policies typically pay between 50 to 70 percent of your pre-disability wages monthly for total disabilities. However, there is usually a cap of around $8,000/month. This payment is designed to support you financially while you can’t work and covers basic living expenses like rent, food, and utilities.

Partial disability claimants receive a monthly benefit calculated based on a percentage of the difference between their pre-disability and current wages. For example, if you previously earned $4,000/month but now make $1,000/month due to your condition, your benefit will be a percentage (50 to 70 percent) of the $3,000 difference. These benefits are often time-limited and may expire after a certain period.

Keep in mind that LTD benefits can continue as long as you’re eligible, according to your LTD plan’s rules. Some plans offer benefits for a specific duration, like five or ten years, while others pay until retirement age.

You may also qualify for Social Security disability (SSD) benefits if your condition lasts or is expected to last a year or longer. Once eligible, your LTD insurer may encourage you to apply for SSD as it will offset your LTD benefit. Remember, your insurer may also deduct your SSD check for the months it should have offset your LTD benefits.


Our disability lawyers can help you get the disability benefits you need.


The Social Security Administration states that about one-quarter of today’s 20-year-olds may become disabled before retiring, which can impact their ability to earn a living. Long-term disability (LTD) benefits can provide support during periods of inability to work. However, applying for and receiving disability benefits can be a confusing and time-consuming process.

By having legal representation during the application process, you can ensure that your application is completed correctly and accurately. Our attorneys have in-depth knowledge of the requirements and criteria necessary to approve your application. We can assist you in providing medical evidence to support your condition and obtaining records that strengthen your case.

If you or a loved one requires disability benefits, our experienced attorneys at Gallon, Takacs & Boissoneault can help you secure those benefits. Our attorneys will handle the legal process and guide you through the complex procedures, ensuring that you receive the benefits you deserve. Contact us today at 419-843-6663 for a free consultation, and let us assist you in navigating this journey to obtain the disability benefits you need.