Before you apply for benefits, you may be wondering who pays for long-term disability. Unlike Social Security Disability Insurance (or SSDI), which is federally funded, long-term disability (LTD) is private insurance. It is paid by individuals and employers rather than taxpayers.
The process of filing a long-term disability claim can be complex and stressful. Hauptman, O’Brien, Wolf & Lathrop can help you with the process of making a claim, seek to maximize your benefits, and protect your rights at all times.
Call (402) 241-5020 today for a FREE case review. Our LTD lawyers serve clients in Omaha, Sarpy County, and all of Nebraska and neighboring Iowa.
Do Employers Provide Long-Term Disability Coverage?
Individuals may choose to purchase long-term disability insurance on their own. However, the majority of people have LTD coverage through their employer. Employers often include long-term disability insurance in their benefits package as a way to attract workers.
Long-term disability coverage is available when an injury or medical condition leaves someone incapacitated (i.e., unable to work). This is not the same as workers’ compensation insurance, which only covers injuries and illnesses on the job. LTD benefits, meanwhile, can be sought regardless of whether the condition is related to employment.
If your company offers employer-sponsored long-term disability coverage and you become disabled, LTD benefits can help offset the income you lose.
Who Pays the Premiums?
Long-term disability insurance policies are categorized as private disability insurance. If you purchase coverage yourself, you are responsible for the premiums. These premiums may be substantial. However, considering that one-quarter of workers are expected to face disability prior to retirement age, having LTD coverage may be a wise investment.
How much you’ll pay in premiums for an individual policy depends on factors such as:
- Your age
- Any pre-existing health conditions
- Your occupation
- Your income
- Benefit period, or how long you’d like to receive the benefits; longer benefit periods often mean higher premiums
Meanwhile, employers pay the premiums for any employer-sponsored LTD plans. The employer usually pays the premiums for these plans in full, meaning employees will typically not have money taken out of their checks.
How Are Long-Term Disability Benefits Paid?
As a rule, long-term disability benefits are calculated as a percentage of your income. Most LTD insurance plans cover anywhere from 50–70% of your earnings prior to disability.
If you are able to work part-time or in a reduced capacity, you may still be entitled to LTD benefits. However, payments will be adjusted based on the income you earn.
Are You Entitled to Benefits?
Your eligibility for LTD insurance benefits depends on a host of different factors. These may include:
- Whether or not you are currently engaged in substantial gainful activity
- Whether your illness or injury has severely impacted your ability to carry out regular work or life activities
- The length of time you’ve worked for your employer (if LTD insurance is offered as part of your employment)
- Whether your injury or illness can allow you to do some other type of work
- The length of time you’ve been disabled (all long-term disability insurance plans include waiting periods before you can apply)
- The available medical evidence of the disability
It can be difficult to know who pays for long-term disability and what rights you may have. A knowledgeable lawyer can help you navigate the process of making an LTD claim.
What If Your Claim Is Denied?
The majority of first-time long-term disability benefits claims are denied. Common reasons cited by insurers for rejecting claims include:
- Insufficient medical evidence
- Applying before the waiting period ends
- Not meeting the insurance company’s definition of “disability”
In some cases the LTD insurer may act in bad faith. Examples of bad faith include unfairly delaying or prolonging review of your claim, denying a valid claim, or engaging in underhanded surveillance activities.
You have the right to appeal the denial or underpayment of your claim. Handling this process on your own can be nerve-racking, but an experienced lawyer can provide you with the guidance and peace of mind you need.
Get the Long-Term Disability Coverage You Deserve
Filing an LTD benefits claim takes time and effort. Although individuals and employers faithfully pay their premiums each month, this does guarantee that claims will be processed expeditiously or in good faith.
This is why you need the legal help of experienced long-term disability lawyers who know how to navigate the process of getting your claim approved and ensuring you get the full benefits you deserve. At Hauptman, O’Brien, Wolf & Lathrop, our attorneys can fight for your rights, prepare a strong claim on your behalf, and appeal any adverse decisions (such as the unfair denial or termination of your long-term disability benefits).
You deserve to get your benefits. Contact Hauptman, O’Brien, Wolf & Lathrop today to discuss your claim for FREE.
