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

While Capitan Law is not licensed to practice in Massachusetts courts, our long-term disability lawyers assist disabled Massachusetts 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 Massachusetts 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 Massachusetts 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.

Massachusetts ERISA Benefits Claims Experts

Massachusetts employers may offer long-term disability coverage as part of their employee benefits perks. Some employers pay some or all of the premium, while others require the employee to pay part of the benefits. Any long-term disability (LTD) coverage may not conflict with federal ERISA requirements for LTD benefits or qualifications.

If your employer does not offer LTD insurance, you may purchase a private policy. If you don’t know whether your employer offers LTD insurance, your Human Resources department or benefits manager may be able to help you learn more about your options or provide you with a form to file an LTD claim.

Eligibility Under Massachusetts Long-Term Disability Law

Disability insurance, according to the Commonwealth of Massachusetts, is intended to provide income replacement for people who can no longer continue their jobs after becoming disabled. Massachusetts does not have a specific law indicating how much an LTD policy pays the insured, nor a law regarding the length of time the insured receives benefits.

That being said, most policies pay a percentage, usually 60-70%, of the insured’s average wage for a specified length of time. That prior wages taken into account could be the past twelve month’s average, the past three year’s average, or another set period. Check your policy for the exact details, or if you’re shopping for a new policy, you may wish to compare the terms and benefits listed.

Some policies pay out benefits if you become disabled and can no longer work in your current job, while others only pay out benefits if you are disabled to the point where you cannot perform any gainful employment. An LTD policy is medically underwritten, meaning you likely won’t qualify for coverage if you have a pre-existing injury or disability.

How Does Massachusetts Define Long-Term Disability?

Massachusetts long-term disability laws do not have a legal designation outlining what qualifies as a long-term disability. However, the state does note that a long-term disability policy typically pays benefits for people who will be or are disabled for more than six months, and benefits can continue for years or even the rest of the insured’s life.

Your specific insurance policy will list the duration of the benefit term and what conditions qualify as a long-term disability, including progressive and fatal illnesses, like cancer or dementia.

Massachusetts Long-Term Disability Laws

Massachusetts long-term disability laws stipulate a few regulations for insurance companies:

Any insurer offering a Massachusetts-approved LTD plan in the state is prohibited from varying the premiums based on the applicant’s marital status, pregnancy status, gender, and sexual orientation.
All Massachusetts disability insurance policies are required to be gender-neutral.
If you believe that your insurance company violates laws or regulations, you have the right to file a complaint with the state of Massachusetts.

If your employer pays your LTD policy premiums, any benefits distribution will be taxed as income. However, if you purchase a long-term disability plan on your own, with your own post-tax money, your benefits are tax-free.

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 Massachusetts, call us at (267) 419-7888 for assistance with filing for benefits.