We’ve all been there: Struggling with a serious illness or injury, while also having to face a large stack of paperwork and trying to figure out what a disability policy is, what your policy does and does not cover and, if you’ve done everything you’re supposed to and already had your claim denied, where to start in challenging that denial because you don’t have any other choice in supporting yourself while disabled.
This is where we come in: As a law firm dedicated to dealing with bad faith and insurance claims, we can help explain what your policy should be doing, and how to successfully file a claim and/or appeal, depending upon where you are in the process. It is on your insurance company to honor the contract and not deny valid claims. In particular, if you are filing an appeal, it is crucial that you understand what long term disability insurance entails, and work with an experienced attorney. It can make all the difference.
If you are having difficulty with your insurer, contact us for a free consultation so that we can help. Our Oklahoma bad faith insurance attorneys are committed to ensuring you have the best possible representation when you need to make sure that medical bills, lost wages, and other issues are covered by the policies you’ve been paying for all along.
What Is Long Term Disability Insurance? What Does It Cover?
Disability insurance plans are typically designed to provide at least a partial replacement of any income lost as the result of a disabling illness or injury. They are distinguished, however, from unemployment insurance, workers’ compensation, disability retirement, and Social Security Disability Insurance.
Benefits are typically calculated based on what your base salary is at the time you become disabled (for example, long-term disability benefits can be equal to 60 percent of your base salary at the time you become disabled), although there are both short-term and long-term benefits, and they are all usually reduced by other benefits payments you receive during your period of disability. For example, your monthly benefit could be reduced by any retirement benefits. Short-term disability benefits in a plan, for example, might begin after the 30-day elimination period and apply to the first 150 days of disability, and carry a predetermined maximum monthly benefit. Long-term disability benefits, however, could begin after 180 days of disability and usually pay a higher maximum monthly benefit. During this “elimination” phase, because benefits are not paid, injured or sick individuals tend to have to use up sick or other leave that is available from their employer.
Disability benefits in general tend to have a maximum benefit period which is based on your disability, how old you are at the onset of that disability, and how many years of service. Many times, they cover you as an employee of a participating employer, but will not cover a disability that is defined as “preexisting” according to their own handbook.
The Law in Oklahoma
Under the law in Oklahoma, you are considered disabled if, as a result of injury or illness, you are unable to perform the material duties of your occupation and work for a consecutive 31 calendar days or longer. However, after 24 months, that definition slightly changes, and becomes the inability to perform each of the material duties of any gainful occupation that you are qualified for or could become qualified for through education, experience or training.
Although your disability may or may not relate to your job, you will need to have your disability documented and certified by a qualified provider, which often means working with your insurer on who they consider can objectively document it for insurance purposes. In terms of continuing to remain covered, you remain eligible for these types of benefits as long as you provide continual proof of a disability and participate in a rehabilitation program, all based on the specifics of what your plan requires.
Contact Us for Assistance
If you are facing roadblocks concerning your long-term disability benefits, our experienced Oklahoma bad faith insurance attorneys may be able to help. We’ve helped many pursue bad faith insurance lawsuits and we work on a contingency fee basis so that you do not pay attorney’s fees unless we obtain a favorable settlement or court judgment on your behalf.
You have nothing to lose, but everything to gain, by getting in touch. Contact us to schedule a free consultation – you can schedule it online or call us at 405.272.0303.