Erik Berger, OBL Partner and Long Term Disability Specialist, recently wrote an article for The National Association of Disability:
“According to a 2016 survey, approximately 40% of Americans have a privately purchased disability insurance policy or a disability policy offered through their employer. Since Social Security disability beneﬁts, on average, provide approximately one third of the amount of the average disabled worker’s paycheck, and since many people live paycheck to paycheck without substantial savings, the successful presentation of a Long Term Disability beneﬁts claim (LTD) is absolutely critical to maintaining the worker’s ﬁnancial and personal stability. For instance, a 2017 study of bankruptcy court records demonstrated that over 40% of mortgage foreclosures are attributed, at least in part, to disability.
LTD beneﬁts obtained as a beneﬁt of employment (and usually paid for by the employer), somewhat like Social Security beneﬁts, are paid to beneﬁciaries whose disability is expected to last more than a few months; although the terms of the LTD contract control, generally speaking most workers may be entitled to LTD beneﬁts for up to 2 years if they are unable to work at the job they were performing when they became disabled, and even permanently if the worker’s disability results in an inability to perform any gainful employment. In almost all cases involving a disability policy purchased by the company, the worker will be required, as a condition of receiving LTD beneﬁts, that they also apply for Social Security disability. However, if the LTD policy is bought privately most of these policies provide disability beneﬁts on the sole basis that the policyholder is unable to perform their past job.
One way that claims for LTD beneﬁts is vastly different from Social Security claims is that they are adversarial cases, where the employer and/or insurance company has claims adjusters, doctors, vocational experts and other experts who provide evidence against the worker’s interest. So, even though the “HR person” at the company may be, in fact, a very nice person, this should not lull the worker into forgetting that, in the end, the employer/insurance company will always look out for itself ﬁrst. “