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What are the various stages of Long Term Disability Claims?

by Kristen Gyolai | January 26th, 2015

There are several stages to submitting and getting accepted for long term disability claims. If you feel like you are no longer able to work at your job because of an illness, disability, or other condition, consider applying for long-term disability benefits.

You must start by applying for long-term disability benefits, followed by the insurer’s investigation and decision. Depending on the outcome, you may need an attorney to help you through the process following a denial, including appealing the decision. Our Minnesota Long Term Disability Lawyers can help you with any stage of the process. Call us today for answers to your questions!

Here are the most common stages in the Long Term Disability claim filing process:

APPLICATION

Request an application for benefits from the long-term disability insurance company. The application will ask for biographical information, as well as information about your disability, condition, or illness. The insurance company will make a decision about whether or not you are entitled to long-term disability benefits based on the information you provide in your application. Thus, it is important to take the time to read through the application and then fill it out completely and accurately.

Do not let the form the application form limit you; if you need more room to describe your disability, attach additional pages, even if the application does not instruct that you are allowed to do so. You may even wish to submit a short narrative statement about what it is like to live with your disabilities and how they affect your ability to work. You may also include what steps you have taken in an effort to get back to work.

INSURER’S INVESTIGATION

The insurance company will review your application. The insurance company may have a medical expert review your records and make determinations about your conditions. The insurance company will likely request information about your job duties from your employer. The insurance company may have a vocational expert review the job description and other information about your job.

INSURER’S DECISION

The insurance company has 45 days to make a determination about whether or not you are entitled benefits. However, the insurance company will likely request either one or two 30-day extensions to make their decision. Thus, it can take up to 105 days to get an answer from the insurance company. After you submit the application to the insurance company the insurer will make a decision about whether or not you are entitled to long-term disability benefits. The insurance company will mail you a written decision.

If the Insurance Company approves your application, that is, if they decide you are entitled to benefits, they will contact you about the amount you will be receiving, how often, and how you will be paid (direct deposit or paycheck).

If the insurance company denies your application for long-term disability benefits they will send you a denial letter. The denial letter must state the reasons for which the insurance company denied your application. In fact, you can even request that the insurance company provide you with the specific information that you would need to submit to them in order for your benefits to be granted.

The denial letter will inform you that you have 180 days to appeal their decision. In other words, you have a second chance to convince the insurance company that you should receive long-term disability benefits. You should contact an attorney as soon as you receive the denial letter, so that an attorney can help you get started on your appeal.

Although 180 days (six months) seems like a generous amount of time, there is a lot of work to be done in that time frame. It takes time to request medical records and employment records to support your claim. Additional, it takes additional time to seek medical treatment or obtain medical testing to support your claim.

What if I’m denied after submitting an appeal?

It’s not over yet! There are several reasons to appeal your Long Term Disability claim. You have an option to bring a lawsuit in federal court. The rules and regulations that govern these claims are very difficult to understand, even for experienced attorneys. Contacting an attorney to help you with this stage of the process is very important; going at it alone will simply be too difficult.

As a Long Term Disability attorney, I am happy to help you with any stage of the process. Contact me today if you have any questions about your Long Term Disability claim and what to do next.

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Kristen Gyolai studied law at William Mitchell College of Law in St. Paul, Minnesota after earning her bachelor’s degree in communication and writing studies at the University of Minnesota Duluth, where she graduated magna cum laude. Kristen believes that being a good lawyer means being a good listener. Her ability to listen allows her to be the voice for injured victims who need help standing up to big insurance companies.