What does it mean to file a long-term disability claim?
You may be wondering what it means to file a long-term disability claim, and when I talk about this, a lot of times people get confused with the difference between Social Security disability and long-term disability claims.
One is governed by the Employee Retirement Income Security Act, or as we like to call in short ERISA. It’s an acronym for a federal statute created by Congress that governs employer provided long-term disability insurance policies for the employers’ employees. Now a lot of people think of long-term disability as a Social Security disability. And I hear them say, “I’ve been denied twice” or, “I’ve been denied four times and every time I apply, they deny me.” And what you’re talking about there is Social Security disability, and not a long-term disability claim on an insurance policy. And I’ll tell you the main difference between the two.
Long-Term Disability Claim vs. Social Security Disability Claim
For ERISA long-term disability claims, you only have one shot and you have specific timelines within which to file your claim. If you miss those timelines within which to file your claim, then your claim is essentially gone. There are noticed periods where you have to file a notice with the insurance company that you might have a claim, and then you have to wait for a period that would be considered short-term disability within which you don’t get any benefits from the long-term policy. You may have a different short-term policy that will provide you benefits, but you don’t have benefits from that long-term policy until after that elimination period. And then once that elimination period hits, then you have to make sure that you file your claim and you provide proof of your claim within a certain number of days after that’s over and that is all governed by the terms of your policy. All the dates and times are different and it depends on what your specific policy says. So if you’ve been denied and received a denial letter, or have been denied numerous times from the Social Security Administration, that is not the type of disability claim that I’m talking about here. The type of disability claim that I’m talking about here is a type of disability claim that is provided by an insurance policy purchased by your employer for your benefit as the employee. And no matter what the condition is, like a stroke at home on a Saturday night and no longer able to work. You would be covered under this policy because at the time you had your stroke at home, you were an employee of your employer and the policy covers you for that.
So as long as you are completely unable to work or unable to perform the main duties of your occupation, then you would be eligible to collect long-term disability after you’ve given notice to the insurance company. After you filed your claim within the applicable time limits, and after your claim is approved, you would be entitled to long-term disability benefits. Now you can get Social Security benefits and long-term disability benefits at the same time, but those two numbers will combine to get to the total number of your long-term disability benefit. Sometimes your long-term disability benefit could be 60% of your gross revenue prior to your disability, or it could be up to 80%, and it could be even better than that. Policies are all different and it depends on what your employer purchased for your benefit to determine what your benefit amount will be.
I hope this has been helpful. If you have any questions about whether your claim is a social security disability claim, or whether it’s an ERISA covered long-term disability insurance policy claim, give us a call, send us an email. We’d be happy to help.