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

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

Utah ERISA Benefits Claims Experts

Private employers offering long-term disability insurance as part of an employee benefits package select the insurance carrier and plans available for employees. The plans offered by your employer may be limited to just a few. In addition, there is usually a waiting period before you become eligible to enroll in an LTD plan through your employer, such as being a full-time employee (working more than 30 hours) who passed their 90-day probationary period.

Qualifying Conditions for Long-Term Disability Benefits in Utah

Insurance carriers each define what qualifies as a disability and what criteria a disabled policyholder must meet to qualify for LTD coverage. Each policy may also have a list of specific non-covered conditions, which may be referred to as “exclusions,” such as:

Diagnosed mental illness or mental health conditions
Pre-existing health conditions
Illness or injury stemming from substance abuse
Nervous disorders

Definitions of a Long-Term Disability

Each policy may have specific language defining a long-term disability, just as they do excluded conditions.

Conditions that are typically covered by LTD plans include:

Severe, debilitating back or spinal cord injuries
Cancer
Cardiovascular complications
COPD or chronic respiratory concerns

The purpose of Utah long-term disability insurance is to provide a source of income for individuals with severely debilitating injuries that prevent them from working. It can complement your short-term disability plan by providing benefits after the short-term disability plan benefits end. If you have trouble getting your claim approved, contact one of our LTD claims lawyers. We can draft and file an appeal on your behalf.

Utah Long-Term Disability Benefits

Your LTD policy defines the benefits you receive. Your LTD benefits will be determined at the time you purchase the policy and will be based on your income for a set period of time (like a three- or five-year average) before you become disabled. LTD policies generally pay between 50-80% of that amount.

If you receive LTD benefits from a private policy you purchased and paid the premiums on, you will not have to pay Utah state income taxes since you paid the policy premiums using “after-tax” dollars. However, if your employer paid for the premiums on your LTD plan as part of your benefits package, then you may have to pay taxes on the benefits you receive from that plan.

Contact an ERISA Benefits Claims Expert

We understand the urgency you feel when filing for LTD benefits and how frustrating it is if your claim is denied. That’s why the Capitan Law lawyers work hard for our clients. We can help you file your initial application for benefits, and we can form a strong appeal if your claim is denied. Contact us at (267) 419-7888 for assistance with getting the benefits you’re owed.