We have received many calls from folks confused about whether they are eligible for Long Term Disability (LTD) benefits, or Social Security Disability (SSD/SSI) benefits, or both.
Private Disability Insurance
Long Term Disability is a term used to describe an employee benefit you may have through your employer. Many workers receive Long Term Disability coverage through a Group Policy available to all employees of the company, which is purchased by their employer, and premiums are paid through payroll deduction.
Long Term Disability benefits are usually provided by an insurance company (such as Cigna, Hartford, Liberty Mutual, or Lincoln Financial to name a few). Just like you may have health insurance provided as a benefit to you by your employer, some employers also provide LTD insurance for their employees as well. (Or you may have purchased LTD insurance yourself, if your employer did not provide it for you.)
Short-Term & Long-Term Plans
Your Disability Contract is usually divided into 2 periods: Short Term Disability & Long Term Disability.
Usually an employee will go on Short Term Disability first, when he/she is unable to perform the duties of his/her “own occupation”. Depending on the disability insurance contract, the Short Term Disability can vary from 13 weeks to 1 year.
Long Term Disability begins after the contract period for Short Term Disability ends. Long Term Disability is now divided into 2 periods:
1. Own Occupation – which means you are unable to perform your work
2. Any Occupation – which means you are unable to perform any job that you may normally be able to do with your education, training, and experience.
Once you transition to the “any occupation” phase, it is very common to receive a denial of benefits at that point.
All benefit denials from the insurance company, MUST BE:
1. In writing
2. And provide you with an opportunity to appeal.
Denied Private Insurance Claims
The time frame to appeal cannot be less than 180 days. When you receive your denial letter from the insurance company, that is the time to contact an attorney who has experience with appealing Long Term Disability Denials.
On the other hand, Social Security Disability benefits, are available to anyone who has worked, contributed into the Social Security system by paying Social Security taxes, and has earned enough work credits to be eligible. This benefit comes from the government (Social Security Administration).
Social Security looks at your age, and when you became disabled, to determine if you have enough work credits to qualify for disability benefits. If you do not have enough work credits, you MAY qualify for Supplemental Security Income (SSI).
Which Should You Apply For?
You may be eligible for both LTD & SSD/SSI, but the SSD/SSI benefit acts as an offset to any payments by your Long Term Disability Insurance carrier.
Whether you are applying for Long Term Disability or Social Security Disability, you still need the same thing: medical proof of your disability! This means, you need to be under the continuing care of a doctor for your disability.