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

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

Many Missouri employers offer Long-Term Disability (LTD) benefits insurance as part of a benefits or compensation package. LTD benefits are intended to provide a source of income for people who cannot work after becoming disabled or developing a qualifying debilitating illness. These policies are optional for employers, so your employer may not include LTD insurance in their benefits package. However, if you are concerned about being unable to work after becoming disabled, you may purchase your own policy from an insurance carrier approved to sell these policies in Missouri.

Although the state does not have laws mandating specific coverage that LTD insurance must provide, all plans are required to comply with federal ERISA standards. Each insurance carrier sets its own policy terms, from eligibility to the dollar amount it pays each policyholder.
If your employer provides your LTD plan, then your human resources manager may be able to help you with the claims paperwork and answer your questions. Private policyholders should file a claim as outlined in their policy’s claim submission process, which should be listed in the policy.

Benefits Eligibility Under Missouri Long-Term Disability Laws

Missouri does not have laws that cover eligibility for LTD benefits; each insurance company has its own standards for eligibility. However, all LTD policies have an elimination period or waiting period before someone is eligible for benefits. Usually, this is the length of the short-term disability benefit period. Long-term disability is often available only after the insured is disabled for at least six months and unable to work because of the disability.

Eligibility for LTD benefits also depends on how long you were employed. Most plans require the insured to have been employed full-time for at least one year before filing a claim. You may be ineligible if you have a pre-existing disability or one that is specifically excluded in your policy’s language.

Your monthly benefits are a percentage of your pre-disability wage. The insurance company sets the exact amount, but the industry average is about 60% of your average wage at the time you became disabled. Some carriers offer tiered plans, where the insurer may select more coverage for a higher premium price, although there is a minimum coverage that each policy must offer.

Long-term disability insurance may pay our benefits for a set period, the lifetime of the policyholder, or until they reach 65 years old and can start collecting Social Security.

How Does Missouri Insurance Law Define Long-Term Disability?

Missouri insurance law does not include a set definition for long-term disability. Some policies consider the insured to be disabled if they cannot work at any occupation, while others may pay out benefits if the policyholder cannot work in their “own occupation” or the job they had before becoming disabled.

Usually, though, an insurance policy considers long-term disability as a disability or progressive illness that lasts for more than six to twelve months and renders the person unable to secure gainful employment.

Other Things to Note About Missouri Long-Term Disability Laws

LTD benefits are only federally taxed if the insured’s employer paid the premium. If the insured paid their own premium using their after-tax money, then the monthly benefits are not considered taxable income.

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