Long term disability (LTD) insurance is intended to provide a stream of income while you are disabled from your employment. Industry statistics suggest most claims are accepted, but many legitimate claims are rejected. Sometimes these denials could have been avoided had the application been completed differently. This blog post will cover 10 tips to increase the chances of having your long term disability claim approved.
1) Obtain the necessary forms
Applying for LTD involves a fair amount of paperwork, starting with forms created by the insurance company. These can usually be provided by your employer, but you can also obtain them directly from the LTD insurer upon request. The forms are sometimes collectively referred to as an application package, and typically consist of three separate documents: one for you to complete; one for your employer to complete; and one for your doctor to complete.
2) Read the benefit booklet
Your benefit booklet will describe the various coverages available, which often include extended health benefits (such as prescriptions and dental), life insurance, and short and long term disability. The booklet will give you a general idea of what you are entitled to under the policy, and some basic information such as how the benefit is calculated, the waiting period, and other information.
3) Read the policy
The benefit booklet is only a summary. The policy will contain much more detail, and can be difficult to understand. In some cases it is important to read the actual policy wording. Provisions that deal with pre-existing exclusions, exceptions to exclusions, all source maximums, direct offsets, and indirect offsets can be quite technical. Consider seeking help from a long term disability lawyer if these or other terms might apply to your claim.
4) Study the entire application package before you complete it
Some LTD claims are denied on the basis of the wrong box being checked, a wrong date, or the wrong description of an illness or injury. Make sure you know what you are being asked before you input any information. Double check it before submitting.
5) Complete the application package honestly and without exaggeration
Contracts of insurance, including long term disability contracts, require both sides to act with the utmost good faith. If you get caught in a lie, or if the LTD insurer suspects you are being less than truthful, the claim will very likely be denied. Overturning a denial is much easier when all information is consistent and can be verified.
6) Focus on your impairments
Functional restrictions and limitations are at the heart of disability claims. While diagnosis is important, LTD insurers are much more concerned with function; that is, why you cannot work. Be specific about what prevents you from performing your job duties. For example, rather than stating “I cannot work due to back pain”, focus on your limited function, such as: “Back pain prevents me from lifting more than 10 pounds, sitting for more than 30 minutes, and standing for more than 15 minutes. In addition, the side effects of medication makes it difficult to focus and concentrate while operating heavy machinery.”
7) Don’t leave anything out
If your primary disability relates to chronic pain that prevents you from heavy lifting, but you also suffer from a secondary condition such as depression and anxiety, list all medical issues. The insurer is required to look at the big picture, not just your primary condition. That said, there is no need to list every medical issue you have ever had, just those that have caused or contributed to your absence from work.
8) Be careful how you describe workplace issues
A claim for depression or anxiety that prevents you from completing the essential tasks of your employment is much more likely to be approved than a claim that your workplace caused anxiety requiring a stress leave. This may may seem like a distinction without a difference, but insurers really don’t want to pay disability claims for what is perceived to be workplace issues. Many LTD claims are denied for this reason, so be careful how you describe the workplace. But also remember point 5! If the workplace did cause or contribute to the disability, be honest and candid.
9) Be aware of important dates
Most group policies contain an effective coverage date, which is not necessarily the date you started employment. Often new workers are not insured for the first several months of employment. If the date of disability is before the effective coverage date, then the claim will be properly denied.
Group policies also include a pre-existing exclusion, meaning if your disability arises from a condition you had been treated for within a defined period of time, the insurer may deny coverage. Usually the pre-existing exclusion only applies for one year from the date of coverage, and there are often exceptions to the exclusion. For example, if you have been insured for less than one year, but have not had treatment for a certain number of days before the date of disability, the exclusion might not apply. Pre-existing exclusions can be very complex. This is an issue where you should consult an LTD lawyer before applying for benefits.
10) Have a long term disability lawyer review your application before submitting it
The chances of your claim being approved are higher if you consult a lawyer first. Most long term disability lawyers will agree to do so for a flat fee or an hourly rate. Michael Jordan is an experienced LTD lawyer who will review your application for free. If the claim is approved, you no longer require any legal assistance. If the claim is denied, Michael can guide you through the process of an appeal or lawsuit.
About The Author
Michael Jordan is a long term disability lawyer with more than 17 years experience litigating all types of insurance claims. He is a founding partner of the Bay Street firm Jordan Honickman Barristers. Michael represents clients across all of Ontario, with satellite offices in Ottawa and London.
Michael Jordan is a honest, fair and intelligent lawyer! He is very patient and spends as much time as is needed to ensure his clients understand what he is doing. I would highly recommend him! Sandra Clarke
Michael Jordan is a man you want on your side! He is compassionate, caring and beyond knowledgeable! He will never steer you wrong! Michael Jordan has already made a huge impact on our family and will always be our go to guy!
Michael Jordan was my lawyer for my long term disability case. I would recommend using him for a LTD case. He was very knowledgeable, helpful and always available when I had questions.
Review for Mr. Michael Jordan, Long Term Disability Lawyer. I am not usually a person who leaves reviews, but on this occasion I felt compelled to given the exceptional service I have received. I was in a situation where I required urgent guidance regarding an LTD matter, I decided that I would find someone who had a very high google review...
I contacted Michael for my long term disability claim. My LTD had been denied and so I reached out to him for help. The process from beginning to end was perfect and simple. He really is there for any questions or concerns and is so kind and helpful. He makes you feel less alone and cares about your well being. With his help I was able to get a...
Patient and kind, thorough and knowledgeable, that's Mr Jordan.Im grateful to have made a connection such as this! Thank you.
Michael Jordan is a Wonderful Caring Understanding Professional man that truly helped me when my LTD was denied several times as most are. I knew many people give up but I was entitled to LTD. I called Michael and sent all of my information with all of my medical and he said I had a case. He will take a percentage only if he wins which he did...
Many LTD lawyers will give you advice that will be biased to their advantage. Michael is the only lawyer I spoke to who wants what’s best for you, and does not care if he benefits from your decisions. His advice is fair, he is honest, and I would not trust anyone else with my case. He will tell you what is best for you. I appreciate him so...
Michael Jordan will personally return your calls. He listens to you and provides excellent advise. I strongly recommend him.
Michael was very pleasant to deal with. I'm pleased with the work he did for me, always replied and understood my issue and supplied useful information. I highly recommend him.
My experience with Michael Jordan was excellent. I was given much needed advice and everything was explained to me in very clear terms. Response time was outstanding! Michael was reassuring and compassionate and was able to resolve my disability claim very successfully. I would highly recommend Michael and his team to anyone.
Margherita Del Grosso
Mr. Jordan responded immediately to my first phone inquiry and has been readily available for detailed consultation and support throughout my long-term disability application. As the claim was finally approved and no litigation was required, there was no fee. Knowledgeable, professional and kind, there is no doubt that I will direct all my...
Michael Jordan is a wonderful lawyer. He is polite, very courteous and very professional. He answers his phone, responds to messages and takes the time to clearly explain the information that you need to know. He helped me out with an issue on little notice and was beyond helpful. If I could give him a higher rating than 5/5, I definitely...
I feel very fortunate to have come across Michael Jordan's practice. His responsiveness, sense of service, and professionalism inspired a lot of confidence in me to pursue my case. I highly recommend him to anyone who finds themselves in an overwhelming insurance process.
I recently had the pleasure doing business with Michael, he was very professional and did what he said he was going to do. Michael kept me updated through the entire process! I would highly recommend Michael's services and best of all I got the outcome I was expecting!
Very refreshing to have a lawyer actually pick up the phone himself. Gave me excellent advice free of charge regarding my LTD questions. Would highly recommend.
I would highly recommend Michael Jordan. From the very beginning, he was attentive, clear and precise with his direction, quick to respond and helped me through a very difficult time in my life. He assisted in making this process much smoother than I could have ever anticipated and I was very happy with the outcome. I would not hesitate for a...
Micheal Jordan is very knowledgeable and helpful in regards to long-term disability claims. Very willing to help by explaining and listening/understanding the problem. I would reccomend his services.
Thank you Michael, for your hard work. I like that if I needed anything your office was there to answer my question in a timely manner. You know your information and it was a great help on the case. Michael is respectful, hard work and knowledgeable gentleman that wants the best for he clients. Thank you Michael and Your team for your...
E. Anne Allan-Denys
LTD lawyer, Michael Jordan, jumped right on board to take my case, even though he did not have much time to prepare before the closing date of my case -due to my error. Also, Michael was right up front in our initial contact with his fees.
Due to the Covid-pandemic, we communicated through e-mails -including him taking correspondence...
Mr Jordan came into my disability fight with patience and kindness. He turned my situation around when I was being taken advantage of. He is very knowledgeable and knew exactly how to execute a plan to my benefit. He did exactly what he said he would do, and that is... Win! Thank you Michael Jordan. Much Appreciated!!
Great lawyer to represent you with legal matters. Michael answered the phone personally and listened to my initial concern. He then set up a meeting face to face (prior to COVID) and the rest was history. He is very professional and understanding. Michael was able to get me settlement and get the insurance company to pay.
I would strongly recommend Mike to represent you in a legal action. He is by far an excellent lawyer. Not only is he by far outstanding when it comes to the law but he knows how to handle your case from start to finish and win your case! He is the staple example of what a lawyer should be (has integrity, compassionate, honest, trustworthy,...
I strongly recommend Michael Jordan services as he displayed a high level of integrity. Michael proved to be responsive, knowledgeable, and professional with a high degree of emotional intelligence. My stress level was lessened with his attendance, support and knowledge of my case and situation. Retaining his services was the best thing I could...
Michael helped me with my STD and LTD case as my Insurance company denied all my applications from the beginning. His insight, dedication and professionalism has helped reach the agreement. I highly recommend him because whether it is your first time with a lawyer or not you will be treated like a known customer you will surely get help and...
Strongly recommend. Michael Jordan is professional, detailed and articulate. He can explain complicated issues and has the ability to translate them into a simple understandable terminology. My family was devastated when my LTD claim was denied. Michael defended my position and pursued the incident relentlessly. My very stressful situation...
Michael is one of the kindest and most caring lawyers. He was so patient with me and extremely attentive. Any time I had a question or concern, he would assure me that everything was going to be okay. During this difficult time as it is, he was able to continue with a mediation with ease and was able to have my case resolved to my utmost...
I was diagnosed with a chronic illness which made it impossible for me to do my daily responsibility of my workplace as well not including all my doctors and specialist appointments. I applied for my long-term disability that was provided by my workplace benefits. Unfortunately I was denied even with all the doctor's medical documents to...
When my family member was off of work and dealing with long term disability she went to Michael and was very pleased with his honesty, professionalism and candor. He worked hard and achieved a very positive result.
I am a lawyer and I have recommended Michael to many people because of the above-noted qualities.