California Residents – Get Assistance from Expert Long-Term Disability Insurance Lawyers

While Capitan Law is not licensed to practice in California courts, our long-term disability lawyers assist disabled California citizens with ERISA-governed disability insurance claims. As discussed in more detail below, ERISA is federal law. If you have a claim that is governed by California law, please contact a local attorney licensed to practice law in your state to assist you with that matter.

Facing a non-work-related injury or illness can threaten your financial stability. Let Capitan Law, your experienced long-term disability insurance lawyers, guide you through the application process of disability insurance via your employer’s ERISA-governed policy. Be aware that this process is complex, with insurance companies often attempting to minimize or deny benefits owed.

Our long-term disability attorneys will defend your rights, collate necessary evidence, and strive for the benefits you deserve. We offer free consultations, so call us at (267) 419-7888 today.

About ERISA and Long-Term Disability Insurance

The Employee Retirement Income Security Act of 1974 (ERISA) typically governs long-term disability insurance plans provided by employers. That means if your employer pays for part or all of your disability coverage, you must follow the rules and procedures set forth by ERISA. The benefits that are provided by your LTD insurance policy will replace a portion of your income for an extended period, which is generally determined by your plan and the nature of your disability. As mentioned above, these claims can get complex. An ERISA benefits claim attorney will provide knowledge and experience to guide you through the process.

Each policy varies slightly in its definition of disability, but in general, to be eligible for benefits, the injured individual must be unable to perform the duties of their own job. After some time, eligibility for benefits may change and may stipulate that the individual cannot complete any work at any job due to their disability.

Differences between LTD Insurance and Workers’ Compensation

The main difference between long-term disability and workers’ compensation is that LTD benefits provide a partial-wage replacement for someone who becomes injured while doing something unrelated to their work, while workers’ comp is for job-related injuries and illnesses. If you are injured at work, you may still be able to apply for disability insurance benefits depending on the specific language contained in your policy. However, if you are eligible for both types of benefits, LTD benefits are usually offset by any benefits received through the workers’ comp claim.

Both insurance policies can come from your employer; however, not all businesses in California have a legal obligation to provide long-term disability to their employees. If your employer does not offer LTD insurance, you may have purchased your own individual disability plan and paid the monthly premium. It is also possible to have a policy you purchased yourself and one provided through your employment relationship. If you sustain an injury or get sick, you’ll be able to collect benefits based on your policy type. The attorneys at Capitan Law can help you understand the options available to you and are well-equipped to help you navigate these complex issues.

Disabilities Qualifying for LTD Benefits

LTD policies typically cover severe medical conditions that prevent you from maintaining your previous work schedule. These disabling conditions can include autoimmune diseases, back and spine injuries, mental health disorders, and many others.

Filing a Long-Term Disability Insurance Claim

Immediately file a claim when an injury or illness impedes your work. First, file a short-term disability claim; when these benefits end and your disability persists, your LTD benefits can commence. Start the process early to resolve any claim denials or delays promptly. We are happy to assist you in the long-term disability application process.

Common Reasons for Claim Denial

LTD claim filing is complicated, with any errors potentially leading to denials. Common reasons for denial include discrepancies in the definition of disability, missing medical records, procedural errors, inconsistent information, bad faith by insurance, and lack of understanding of rare medical conditions.

Appealing a Denied Claim

You can appeal a denied long-term disability claim. Under ERISA, you must file the appeal within 180 days from the denial notification date. At Capitan Law, we understand the appeals process and will help you through each necessary step.

Long-Term Disability Laws in California

Life can change in an instant. If you recently sustained a long-term disability, your routine, your job, and the way you’ve always done things might start to look very different. And now, you’re likely grappling with a flood of questions: Will you be able to make ends meet? Do you qualify for disability benefits? How do you even begin to apply for them?

Here’s what you should know about long-term disability laws in the Golden State.

How Does California Define Long-Term Disabilities?

There is no clear-cut definition of long-term disabilities under California state laws. Instead, the definition of long-term disability tends to come from the terms of private insurance policies.

These insurance policies, commonly provided by employers, typically classify a long-term disability as an illness, injury, or medical condition that prevents you from adequately performing the duties of your occupation for an extended period. The duration of this period can vary depending on the precise wording of your policy.

Additionally, your ability to perform the duties of your occupation could be subject to different interpretations. Some policies use an “own occupation” definition, where you’re considered disabled if you can’t perform the duties of your specific job. Others use the “any occupation” definition, where you’re considered disabled only if you can’t work in any job reasonably suited to you based on your education, training, and experience.

Do I Have to Wait Before I Can Claim Long-Term Disability Benefits in California?

Yes, there is usually a waiting period before you can start receiving long-term disability benefits, often referred to as the “elimination period.” This elimination period is typically 90 to 180 days, but the exact duration can vary based on your specific insurance policy.

This period begins on the first day you’re unable to work due to your disability. It serves as a sort of deductible in terms of time rather than money. During this time, you could qualify for short-term disability benefits if you’re covered under a short-term disability policy through the state of California or a private insurer. Short-term disability benefits could replace a portion of your income during the elimination period before your long-term disability benefits kick in.

How Much Can I Get in Long-Term Disability Benefits in California?

The benefits you can receive from long-term disability insurance depend largely on the terms of your specific policy. But most private long-term disability insurance policies offer benefit amounts worth approximately two-thirds of your pre-disability earnings.

These benefits are generally tax-free, as they’re compensating you for a loss rather than providing extra income. It’s also worth noting that your policy could have certain benefit caps or maximum monthly payment amounts. Additionally, certain types of income, such as Social Security benefits, might offset or reduce the amount you receive from your long-term disability policy. Given these factors, it’s important to thoroughly review your insurance policy with an attorney to understand your potential benefits.

Contact our ERISA Benefits Claims Experts

At Capitan Law, we comprehend the urgency of receiving LTD benefits. We work tirelessly to protect your rights and ensure fair treatment during the claims process. If you’re unable to work in California, call us at (267) 419-7888 for assistance with filing for benefits.