Clients often ask our ERISA lawyer how to qualify for long-term disability. Applying for ERISA can take some time, but if you are persistent, you might be able to receive LTD. Take the following steps in order to navigate this challenging process:
Focus on the basics – If you were turned down for LTD benefits, you might need help with housing, food, clothes and heath care. Family, friends, churches and government agencies might provide practical assistance. You can apply for food stamps or ask for help from a food bank. Remember to take care of your mental health as well.
Organize paperwork – When you applied for LTD insurance through your company, your application falls under ERISA plans and the related federal laws. ERISA requires that your company or your insurance provide you or your ERSIA lawyer with a copy of the related paperwork, including the policy, plan and claim at no charge to you. In addition, ask for a copy of your personnel file that includes your job description so that the kind of work that you performed is clearly documented. In most cases, you have 180 days to organize this paperwork and turn it over to your ERISA attorney. The clock quickly counts down when you are seeking an appeal in your LTD case.
Stay home from work if needed – If you attempt to work but cannot do so, your claim might be rejected. The insurer might try to justify the denial by stating that you were working, so you must not be disabled. Ask your primary care provider to write you a work release. You can take paid time off and then request Family Medical Leave as necessary.
Watch out for overpayments – If you are receiving Social Security benefits or workers’ compensation, make sure that any LTD benefits do not overlap. Your provider might stop your payments and claim that they overpaid you. They could even sue you, so do not spend any extra payments if you think you will need to repay the agency that overpaid you.
Seek professional help – The forms and documentation needed for LTD are admittedly confusing. Do not risk making mistakes on questionnaires, medical records or during required medical exams. You need to comply with requests from your LTD provider or your claim could be rejected. Ask for help from a seasoned professional. Before you sign any paperwork, make sure that you read all of the fine print first.
Do not sign a severance agreement without reading it – Some severance agreements include a clause that eliminates health insurance or other important employee benefits. Ask our ERISA lawyer to review these important documents before you sign them.
Be aware of continued investigations – The ERISA insurer might continue to investigate the case, including surveillance. Seek help from a qualified ERISA lawyer if you think that you have been recorded.
Record your daily life – A movie, as they say, is worth at least a thousand words. Recording your daily life and difficulties will demonstrate what you can and cannot do. Have your significant other narrate the recording on a smart phone.
Do not quit your job – If you leave your job, you risk losing important benefits, including your LTD insurance. This could complicate and delay your claim because you likely need continued medical insurance in order to support your LTD claim.
Ask for a work release – You will need two types of work releases, depending on the stipulations of your ERISA policy. The first release states that you cannot perform your basic job duties of your occupation. Generally, ERISA expands the requirement to any type of work after 24 months.