What Does Long Term Disability Cover in Pennsylvania?

Many public and private employers in Pennsylvania offer long term disability insurance as a benefit, but have you ever asked, “What does long term disability cover?” It’s a fair question, particularly if you’re dealing with a disability and are trying to plan for the future. Understanding what long term disability insurance covers can help you make a solid plan and know that you have what you need to take care of yourself.

The Pennsylvania long term disability insurance lawyers at Capitan Law focus solely on cases like these to provide the in-depth knowledge and support you need. We can explain what your long term disability insurance policy covers and handle all the legal work in your case. If you have questions about what benefits long term disability insurance provides in Pennsylvania, you’ll find the answers below.

What Long Term Disability Insurance Typically Covers

While every long term disability insurance policy is different, most policies provide the following benefits:

• Income Replacement: Long term disability insurance provides a portion of your pre-disability income while you can’t work, usually between 50 percent and 60 percent. Some policies provide as much as 70 or 80 percent of your pre-disability average earnings. This money can help you cover daily expenses and maintain your standard of living while you can’t work.
• Cost-of-Living Adjustments (COLA): Most long term disability insurance policies include cost-of-living adjustments to increase your benefit amount over time. This adjustment ensures your benefits keep up with inflation, so your purchasing power remains stable despite rising costs.
• Survivor Benefits: If you pass away while receiving disability benefits, your policy might pay some additional months of benefits to your family. This survivor benefit helps your surviving family members manage financially after your death.
• Waiver of Premium: While you are receiving disability benefits, you typically do not have to pay the LTD policy’s insurance premiums. This waiver reduces your financial burden by eliminating the cost of maintaining your policy.

What Medical Conditions Does Long Term Disability Insurance Cover?

Every insurance company has its own rules for what injuries or illnesses they will cover under a long term disability policy. In general, an injury or illness must keep you from working for six months or longer before a long term disability policy will kick in. Some policies only provide benefits if your injury or illness lasts or is expected to last a year or longer. However, the advantage of these policies is that they cover injuries and illnesses that aren’t work-related. Some common injuries or illnesses that long term disability insurance might cover include:

• Chronic Pain: Long term disability insurance often covers chronic pain conditions, such as fibromyalgia and chronic back pain, that significantly impair your ability to work.
• Heart Disease: Conditions like heart attacks, congestive heart failure, and other heart-related issues can qualify for long term disability benefits if they limit your capacity to work.
• Cancer: If you are undergoing treatment for cancer or have long term effects from the disease, you may be eligible for long term disability benefits.
• Mental Health Disorders: Many long term disability insurance policies cover severe depression, anxiety, bipolar disorder, and other mental health conditions that prevent you from working.
• Neurological Disorders: Conditions such as multiple sclerosis, Parkinson’s disease, and epilepsy can qualify for long term disability benefits due to their severe impact on your daily life.
• Autoimmune Diseases: Long term disability insurance often covers disorders like lupus, rheumatoid arthritis, and Crohn’s disease if they leave you unable to work for six months or more.
• Severe Injuries: Major injuries from accidents, such as traumatic brain injuries or spinal cord injuries, often qualify for long term disability benefits.

Common Legal Issues with Long Term Disability Insurance Claims

People often encounter legal issues when they file a claim for long term disability insurance benefits. Some common challenges in these cases include:

• Claim Denials: Insurance companies often deny claims due to insufficient medical evidence or technicalities.
• Policy Interpretation: Disputes can arise over the interpretation of policy terms and conditions.
• Pre-existing Conditions: An insurance company might deny a claim based on pre-existing condition exclusions.
• Surveillance and Investigations: Insurance companies might use surveillance to dispute the severity of a disability, creating a need for legal defense against these underhanded tactics.

Call Capitan Law for Help Getting Your LTD Benefits Today

No matter what challenges you face with a long term disability claim in Pennsylvania, the team at Capitan Law can help. We focus solely on long term disability insurance cases, which gives us in-depth insights and experience you won’t find anywhere else. Call (267) 419-7888 now or complete our contact form for a free case evaluation.