Long-Term Disability Frequently Asked Questions

Answer: Your disability can and will impact your financial planning. Your savings can be depleted and you may have to ask family members for loans. Your health insurance will be higher because you will have to be on COBRA and your overall bills will be harder to pay because disability only pays a portion of your salary that you were collecting before you became disabled.

Some of the questions include: (1) How much will my long-term disability benefits be when I stop working? (2) How do I file for Social Security Disability? (3) How long will COBRA last once I am on it? (4) What if I can’t afford COBRA? (5) Do I have alternative sources of healthcare?

You can call us and we can answer all of these questions for you and others you may have.

Answer: Usually this process can take up to 3 months. The long-term disability carrier will get your medical records, contact your employer and do an investigation to determine if you meet the long-term disability insurance policy requirements. I would recommend you contacting an experienced long-term disability attorney during this process.

If you don't have an answer in 3 months, contact your state's Department of Insurance and Tiller Allison immediately.

Answer: There are lots of reasons you should have a lawyer represent you.

At Tiller Allison we help you even before you file for disability by gathering your medical records and making sure your doctor supports your claim for disability. We help your doctors fill out the forms on your behalf so they fill them out correctly and also have your doctors complete additional questionnaires if needed. We also help you to fill out the forms that are required by the insurance company for you to complete. The insurance company has many forms and questionnaires for you to complete and these forms can be overwhelming

Answer: Your medical records, your job description and other material they get from your employer. They will look at the statements that you make on your Activities of Daily Living forms and may even conduct surveillance of you. If they conduct surveillance on you, they will send the surveillance to your doctors to review and ask your doctors to comment on the surveillance. You need to be aware of this!

Answer: Before you reduce your hours, request a copy of your long-term disability policy and look at the provisions which outline part-time hours and elimination periods. Tiller Allison will review a copy of your policy free of charge to advise you on how to proceed. Every policy is different, so it is very important that you receive a copy of this policy so you know what you are entitled to and what you have to do in order to prove your disability and win your claim.

There is no such thing as a standard disability policy!

Answer: Most long-term disability policies have a provision that says if you are granted your long-term disability benefits, your premium for continuing long-term disability coverage is waived and you don't have to pay. This is called a "waiver of premium" clause and you need to check your policy to see if you have that provision in your long-term disability policy.

Answer: Make sure the long-term disability insurance company is paying you the right amount of long-term disability benefits, not taking any improper deductions and is paying you any back benefits that you are owed.

Make sure you have a copy of your long-term disability policy so you understand why the insurance company is paying you and how long they will pay you. Each policy is written differently and they have different time periods that they pay you and different definitions for you to qualify for disability benefits. You need to know your rights and what you are entitled to.

Just because your policy states it will pay you to the age of 65, that does not mean the insurance carrier will pay you until the age of 65. That means you will have to meet the definition of disability as defined in your long-term disability policy in order to qualify.

Answer: If your long-term disability policy is governed by ERISA, you have to exhaust all of your administrative remedies before you can file a lawsuit. There are no jury trials in an ERISA case unlike a state disability claim.

Answer: After you have filed your initial claim for disability benefits, the insurance carrier will contact you by phone or in writing to acknowledge they have received your claim. You will be provided a claim number so you can reference any documentation you have to send to the insurance carrier in the future. If the carrier calls you, do not give a statement or answer any questions. You might get confused by the adjuster's questions or give the wrong answer that can damage your long-term disability claim. We suggest that you have your initial claim for disability benefits reviewed by us or another long-term disability law firm to make sure you have completed the forms correctly or to the best of your ability to help you win your disability claim.

Answer: This is a tough question. Each and every long-term disability policy has different provision about how long you have to be out of work or what kind of reduction in your hours and pay you need before you are eligible for long term disability.

Before you do anything, we suggest you get a copy of your long-term disability policy and we will review it for you free of charge.

Answer: Tiller Allison recommends you contact us immediately. This is a practice routinely used by long-term disability carriers to deny claims.

We won’t ever refuse an exam as most policy provisions allow the insurance companies the right to have you examined by doctors of their choosing. Other exams they may request you have are known as Independent Medical Exams (IME) or Functional Capacity Evaluations (FCE). However, there are a number of things that can be done to protect your interests.

These include:

(1)video taping the exam that has been scheduled;
(2)obtain your own neuro-psychological exam before attending the exam that has been scheduled through the insurance company;
(3)limit the carrier’s neuro-psychological review to the raw data of your examination; and
(4)have your doctor request a copy of the exam results from the independent doctor who performed the neuro-psychological testing.

Answer: Tiller Allison are highly experienced long-term disability attorneys and you can call us for a free case evaluation and go over the best way to handle your situation. Remember this is not a social call and your insurance adjuster is not your friend.

Answer: The long-term disability adjuster will be assigned to your claim and will contact you in writing or by phone. You should not deal with the adjuster without having a lawyer. If you choose not to hire a lawyer in the initial stages, we would recommend you at least consult with a lawyer so you know your rights.

Answer: Change doctors! That’s what you really need to do. Sorry, but your doctor may be the best doctor in the world but if your doctor won't fill out the long-term disability insurance medical forms, you will most likely NOT get paid your disability benefits.

Before you apply for long term disability, we suggest you get a copy of your doctor's records and see what is in those records about your complaints, your symptoms and your ability to do your job. If those records don't support your claim you will have a problem with the long-term disability carrier awarding you benefits. Your doctors can make or break your case!

Make sure that before you stop working your doctor supports your inability to work and make sure that he or she is willing to put that in writing and fill out disability forms as often as needed and required by the insurance carrier.

If your doctor won't cooperate, we suggest you consult a disability lawyer for a recommendation about finding another doctor who will treat you and provide assistance with you long-term disability claim.

Answer: If it has been longer than 3 months, call Tiller Allison immediately.

Answer: Call disability lawyers Tiller Allison at (615) 234-6000 immediately! The appeal clock is ticking! The long-term disability carrier is betting that you will give up and won't appeal within the 180 days allowed by ERISA law. Some cases take 180 days to obtain the proper documentation in order to perfect your long-term disability denial, so please call Tiller Allison immediately.

Answer: Pick up the phone immediately and call disability lawyers Tiller Allison at (615) 234-6000.

Answer: Every state, including Tennessee, has laws that govern personal private (non-ERISA) disability policies.

Answer: Maybe! Just because you have paid the premiums for years does not mean the insurance company will pay you. Immediately request a copy of your long-term disability policy if you do not have it.

You need to know your rights and what you need to do in order to qualify to receive your disability benefits that you have paid premiums on for so long.

Just because your doctor says you can't work, does not mean the long-term disability carrier will agree and pay you your long-term disability benefits you deserve.

The claims process is very complex and is designed to find reasons to deny your claim. The long-term disability carrier is not really in the business of paying claims. They are in the business of collecting premium dollars they invest to make lots of money.

Answer: Yes. It’s the difference between night and day!

Short-term disability is just like it sounds. Short-term disability benefits provide income replacement for a short period of time. This policy generally provides some type of income replacement for about 6 months.

What happens after that? If you have purchased long-term disability, you may be eligible for long-term disability benefits once you have been paid all the short-term disability benefits that you are owed.

The change from short-term disability to long-term disability is one of those transitions periods that we normally see a large number of long-term disability denials.

Answer: The United States Supreme Court has said "No!" Unlike Social Security, there is no treating doctor rule in long-term disability cases.

This does not mean that your doctor's opinion does not count.

Answer: Yes, they can but don’t always have to. At Tiller Allison, we think a call from the carrier saying they want to come and take your statement is bad news. There are several mistakes that can be made in filling out your forms and giving the insurance company any statements. If you get a call from the insurance carrier wanting to schedule an appointment to come out to your house, call Tiller Allison immediately.

This is not a social visit but more likely, a trap.

Answer: Yes they can and probably will! The disability insurance carrier will start by talking with your employer to get your job description and information about your job performance. They want to see if you have stopped working because of problems with your job or supervisor rather than a disability.

They may talk to family members and your neighbors. This can be a huge problem. Your family members might say something that unintentionally hurts your insurance disability claim and your neighbors just might say something intentionally to hurt your claim! At Tiller Allison we will guide you, your family members, friends and even neighbors through the long-term disability claims process to help you reduce the chances of your disability claim getting denied.

Answer: Before you file a claim, get a copy of your long-term disability policy and then call Tiller Allison and we will go over your policy with you and advise you of your rights.

Answer: No! Absolutely not!

The long-term disability insurance company will miss use any release you give them. What do we mean?

Tiller Allison has found that carriers will use the release to call up your doctor and question your doctor's diagnosis, opinion about your ability to work, and even have your doctor look at surveillance film.

The long-term disability insurance company doctor isn't interested in the truth! Many times, they get paid based on a denial of your claim. Tiller Allison has seen numerous instances where the treating physicians have innocently spoken with the disability insurance company’s doctor, who then misstate what the treating physician said about their patients ability to work. If this happens, this is a huge mess that now has to be undone!

Tiller Allison revoke any medical releases you've signed and let your doctor know that they don't have to deal with the long-term disability insurance company other than to send copies of your medical records. We prefer to work with your physician in every aspect of your claim.

Answer: ERISA excludes local, state, and federal employees from coverage. For those covered under a private plan, the claim for the denial of benefits is going to be a claim for the breach of a contract and can be tried by jury in a state court system.