Five Things You Need to Know When Filing a Long-Term Disability Claim

If an injury, illness, or disability is keeping you from working on a full-time basis, you may consider filing a long-term disability claim. These claims can be complicated. It is crucial that you understand your rights, your responsibilities, and your options. In this article, you will find an overview of five key things to know when filing a long-term disability (LTD) claim. 

  • Long-Term Disability Insurance is a Private ‘Income Replacement’ Policy

Long-term disability insurance is a private insurance policy that, in general, provides “income replacement” to the policyholder/beneficiary. What exactly a person has to do to apply for long-term disability coverage and the amount that they are eligible to recover will depend on several things, including the specific terms of their policies and their pre-disability earnings. 

  • Most Long-term Disability Policies are Governed By ERISA

While some people obtain LTD coverage on the individual market, the vast majority of people get their long-term disability policy through their employer or their spouse’s employer. All employer sponsored long-term disability insurance policies are regulated by a federal law known as the  Employee Retirement Income Security Act (ERISA). A comprehensive and complex law, ERISA provides some basic protections to policyholders and standardizes the claims process. 

  • Your Policy May Require You to File for Social Security Disability Benefits

Most long-term disability policies require an applicant to file a concurrent claim for Social Security disability benefits. Whether or not this is required by your policy will depend on its specific terms and conditions. If your SSDI claim is approved, then your long-term disability benefits will likely be “offset” to account for that approval. Though, it is possible to get a long-term disability claim approved even if your Social Security disability claim has not yet been approved or has been denied. 

  • You Have the Right to Appeal a Long-Term Disability Denial 

Unfortunately, some people struggle to get access to the full and fair long-term disability insurance benefits that they deserve under the law. The insurance company should send a written notice of denial. That notice should also include basic reasoning behind the denial. You have to appeal a denial by the insurance company. If you have an ERISA long-term disability policy, you have 180 days from the date of the denial to submit a request for reconsideration. This is the initial stage of the long-term disability appeals process. During the reconsideration stage, you can provide supplemental supporting documentation in favor of your claim. 

  • An Attorney Can Help You Overcome Obstacles in the LTD Claims Process 

Long-term disability claims are complicated—especially if you are filing for the first time and trying to navigate an SSDI claim and an LTD claim. You do not have to go through the claims process alone. An experienced disability attorney such as those at the Social Security Law Group can review your case, answer questions, and help you take action to overcome the obstacles that stand in between you and your financial benefits. 


Sue Martinez