Protecting Your Long-Term Disability Rights
The Denver disability lawyers at McDermott Law, LLC, are experienced insurance law litigators who deal almost exclusively with cases related to long-term disability and life insurance, including individually purchased policy claims, ERISA claims and Colorado PERA disability program claims.
This overview of disability insurance is designed to give you an introduction to coverage, eligibility and other aspects of disability coverage in Colorado. However, if you have a case related to long-term disability insurance, nothing can replace the personalized advice of an experienced lawyer. If you have a case related to your disability benefits, please contact us today. Our founding attorney Shawn E. McDermott has served Denver, Colorado, and the Rocky Mountain region since 1992.
What Is Disability Insurance?
Disability insurance coverage is income replacement coverage that comes in both short- and long-term forms. Disability insurance is either purchased by individuals through private insurance policies or provided by employers for the benefit of qualified employees. Group long-term disability (LTD) insurance is a benefit of great value to employees and often can be provided at little cost to the employer. Employer-provided LTD benefits are specifically included in the “welfare benefits” plan definition and are therefore covered by ERISA.
Are Employers Required To Provide Disability Insurance In Colorado?
In most states, including Colorado, employers are not legally required to provide disability insurance.
Long-Term Disability Insurance Benefits
Long-term disability (LTD) insurance programs typically begin after short-term benefits have been exhausted — usually three to six months after the onset of the disabling illness or an injury has occurred. LTD benefits usually cover 50 to 67% of an employee’s salary and are almost always subject to a monthly maximum, usually $10,000. Some insurance plans categorize the employee participants in relation to these “welfare benefits,” while executives are entitled to higher benefit limits.
If the employee is also receiving other benefits, such as Social Security Disability benefits, the long-term disability insurance benefits may be reduced proportionately, as designated by the policy language. Benefits generally end at age 65; sometimes they terminate within as little as five years after the disability begins. The age at which the participant becomes disabled also may determine the length of available disability coverage. It is extremely rare to find a group policy providing benefits for life.
If you have a question related to your long-term disability insurance benefits, call us today: 303-964-1800. Founding attorney Shawn McDermott and our entire team have helped thousands of Colorado residents navigate their insurance policies and recover the benefits to which they are entitled.
“Own Occupation” And “Any Occupation” Eligibility
Most group long-term disability insurance plans define disability in two ways for purposes of benefits eligibility. These definitions are often referred to as “own occupation” and “any occupation.”
Disability is usually defined as an inability to perform the material and substantial duties of a person’s “own occupation.” An individual must be disabled from his or her own job, or regular occupation for a specified period to begin receiving long-term disability insurance benefits.
If approved for “own occupation” benefits, a transformation of the definition of disability occurs at a certain point in time in the future, usually 24 months after the “own occupation” period begins. The participant’s eligibility is then based on his or her inability to perform “any occupation.” This new definition requires that the person prove both an inability to do the former job and an inability to perform any job for which he or she is capable or qualified, based on past work experience, education and ability to retrain. If deemed disabled under the “any occupation” definition, the claimant may be entitled to benefits for only an additional three years or, more typically, until age 65.
To determine the eligibility of a plan participant, the claimant and his or her attorney must read the plan documents and the insurance policy. These provide information regarding the exact definitions used, the long-term disability insurance benefits available and the duration of those benefits. Each group policy insurer uses different language, and even the same insurer may use slightly altered language from one group policy to the next. The claimant should also compare the language used in the plan documents with that contained in the group policy, because the language sometimes differs.
Contact Our Denver Long-Term Disability Insurance Attorneys
If you may have a case related to your disability coverage, please complete our contact form or call 303-964-1800. Our firm serves all communities of Colorado, including Denver, Colorado Springs, Fort Collins, Boulder, Pueblo, Grand Junction and the entire Rocky Mountain region. McDermott Law, LLC, has the experience and professional resources to fight for you during the entire claim, appeal and litigation process.