Long Term Disability Insurance Companies Must Consider Your Award of Social Security Disability Benefits When Reviewing Your Claim
Has your long term disability insurance benefit been denied even
though you are receiving Social Security Disability Insurance? If so, the long term disability insurance company most likely wrongfully denied your disability benefits. With certain limited exceptions, if you are receiving Social Security Disability benefits, your long term disability benefits should not be denied.
Why SSDI Success Suggests LTDI Eligibility
The standard for receiving Social Security Disability benefits is generally more difficult to meet than the standard for receiving long term disability insurance. This is especially true if you are under 50 years old (it gets easier to get Social Security Disability benefits as you get older) or if you are in the
“own occupation” portion of your disability policy (this is a lower bar to meet than the
“any occupation” standard, which is similar to the Social Security standard).
Insurers Must Justify LTDI Denial When SSDI Has Been Granted
A disability insurer can deny your claim, even if you have been approved for Social Security Disability benefit, but they must explain their reasoning. I have read far too many denial letters from insurance companies acknowledging the disabled person is receiving Social Security disability benefits, but then simply stating the long term disability claim is denied. This is not good enough. The law requires the disability insurance company to address this evidence and provide a reasonable explanation for discounting it. Courts have found it unreasonable for insurance companies to ignore a claimant’s award of Social Security Disability benefits.
If the insurance company disagrees with the Social Security Administration’s decision to award you benefits, then it must explain, in detail, why it disagrees and why it believes the standards for these two determinations are different. Again, it is not good enough for the insurance company to state that the standards are different without further explanation.
If you have been denied long term disability benefits and are receiving Social Security Disability benefits, please
contact me for a free consultation to discuss your rights.