Long term disability insurance is supposed to replace part of your income when a serious injury, illness, or medical condition keeps you from working. But getting approved is not always simple.
The insurance company will not just take your word for it. They will look at your policy, your job duties, your medical records, your doctor’s notes, and anything they think gives them a reason to deny or delay your claim.
If you cannot work and your income is on the line, you need to take the claim seriously from the beginning.
Do I Qualify for Long Term Disability Benefits?
You may qualify if:
Your condition prevents you from working in your own job or any job, depending on your policy
You are covered through an employer plan or a private disability policy
Medical records from your doctors clearly support that you cannot work
The key is not just having a serious medical condition. The key is proving, through your policy and medical records, that your condition keeps you from working.
Missing records, unclear doctor notes, or mistakes in the paperwork can give the insurance company a reason to deny the claim.
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What If My Short Term or Long Term Disability Claim Is Denied?
A denial does not mean the insurance company is right. It means they found a reason to say no.
Common reasons for denial include:
Insufficient medical evidence. More documentation may be needed.
Claim errors or missed deadlines. Small mistakes can lead to denials.
Policy exclusions. Some conditions may be excluded from coverage.
If your claim is denied, do not wait. You typically have a limited time to appeal, and the appeal needs to address the exact reasons the insurance company used to deny your benefits.
Long Term Disability vs. Workers’ Compensation: What’s the Difference?
Many people confuse long term disability benefits with workers’ compensation. Here’s how they compare:
Feature
LTD Insurance
Workers’ Compensation
Covers
Disabilities from any injury, illness, or medical condition
Work-related injuries and illnesses only
Who Pays?
Private insurance policy, through an employer or individual policy
Employer’s workers’ compensation insurance company
Proof Required
Medical evidence proving you cannot work
Evidence the injury happened at work and that you cannot work
Time Limits
Benefits can last for years or until retirement age, depending on the policy
Temporary, partial, or permanent benefits, depending on the injury
Legal Recourse
You can appeal a denial and, if needed, file a lawsuit in federal court
You file a workers’ comp claim, appeal a denial, and request a hearing
Under some long term disability policies, if your injury happened at work and you are covered by a long term disability insurance policy, you may be entitled to both.
Can I Get Long Term Disability and Workers’ Comp Benefits at the Same Time?
Sometimes. Workers’ comp covers work injuries, and some long term disability policies may also apply. Long term disability benefits are often reduced if you are receiving workers’ comp, so both benefits should be reviewed together.
Long Term Disability vs. Short Term Disability: What’s the Difference?
Short term disability insurance covers temporary conditions and has a much shorter benefit period than long term disability. It will usually cover the waiting period for long term disability, which is usually 3 to 6 months.
Feature
Long Term Disability
Short Term Disability
Covers
Long term or permanent disabilities
Temporary or short term medical conditions
Waiting Period
Often 3 to 6 months before benefits start
Often 0 to 14 days after injury or illness
Benefit Length
Years or until retirement, depending on policy
Weeks to months, usually up to 6 months
Who Pays?
Employer-provided or private policy
Employer-provided or private policy
How Long Do Long Term Disability Benefits Last?
It depends on your policy. Some last until retirement, usually to age 65; others stop after a certain number of years depending on when your disability started, especially if you became disabled close to or after age 65.
If you cannot work, your disability benefits may be one of the only ways you can keep up with bills, medical care, and everyday expenses. That is why a denied or delayed claim is not just paperwork. It affects your life.
Many people come to us after a denial, but it is better to get help before filing if you are unsure what the insurance company needs or how to protect your claim.
We’ve been helping people in Washington, D.C., Maryland, and Virginia with serious injuries for over 30 years.
You’re here because of a serious injury or medical condition. Now you’re dealing with an insurance company. You want your life back. We get that. We help guide you through this process so you can stand up to the insurance company and get back your financial security, control and independence.
Why Choose Us
Nationally recognized, Board Certified trial attorney, Attorney Frank Kearney.
I had a great experience working with Donahoe Kearney. Frank, Paul, and Grace did an excellent job helping me reach a settlement and made the whole process much easier to deal with.
I worked with Paul a lot throughout the case, and he was always professional, responsive, and easy to communicate with. What I appreciated most was how he kept everything short, clear, and straight to the point. He explained things in a way that was easy to understand and kept me informed every step of the way.
Thanks to his hard work and guidance, we were able to reach a good settlement. I would definitely recommend Frank and Paul to anyone looking for a lawyer. They are knowledgeable, efficient, and truly work for their clients. Make sure you read the awesome newsletters they are great! Thank you!
