1. What are short
and long-term disability benefits?
Some employers offer short and long-term disability benefits as a fringe benefit
to supplement the benefits available under the Social Security and Workers' Compensation
Acts. You can learn if your employer offers these benefits by looking in your
benefits booklet. If you don't have a benefits booklet, ask your employer to give
you one. Generally speaking, if your employer provides fringe benefits, benefit
booklets are required by law so you can know what benefits are available to you.
2. Who can receive short and long-term disability benefits? The eligibility
requirements are determined by the terms of the benefit plan. Most plans provide
benefits if you become unable to do your regular job because of an illness or
injury. Unlike workers' comp benefits, the illness or injury does not have to
be caused by your work. Unlike Social Security disability benefits, you do
not have to be unable to perform all types of work nor does your disability have
to last or be expected to last at least 12 months. In most plans, to continue
eligibility for long-term disability benefits for more than two years, you have
to show that you are unable to perform any type of job because of your illness
or injury. 3. How do I apply for short or long-term disability benefits?
You should be able to obtain the forms you need by requesting them from your employer. 4.
What if I am also eligible for Social Security or workers' comp benefits?
In most plans, short and long-term benefits are coordinated with Social Security
and workers' comp benefits. That means the amount of your short-term or long-term
benefit is reduced by the amount of the Social Security or workers' comp that
you receive. In some plans, eligibility for workers' comp makes you ineligible
for short or long-term benefits. Your benefit booklet should provide information
on how your benefit plan coordinates with Social Security and workers' comp. 5.
What should I do if my application is denied? In recent years, insurance companies
who sell group disability insurance to employers have become very aggressive about
denying claims that ought to be approved. If your application for short or long-term
disability benefits is denied, you should contact an experienced ERISA lawyer
right away. ERISA (Employees' Retirement Income Security Act) is the federal statute
that governs employer benefit plans. This law stacks the deck in favor of the
insurance company. It will be very difficult for you to successfully appeal the
denial of your application without an experienced ERISA lawyer representing you.
In our office, there is no charge for a conference to review your case.
6. What does it cost to hire a lawyer? In some cases, our fee is one-third
of the past-due benefits if the claim is approved. In other cases, a predetermined
minimum fee is required. In addition to the fee, you would be responsible for
our out-of-pocket expenses such as the cost of obtaining medical records and reports.
There is no charge for an office conference to review your case to determine if
we can help. |