For many injured or chronically ill employees, long-term disability benefits are the only way that they can continue to make ends meet. Without these payments, they wouldn’t have any way to support themselves or their families. However, having your long-term disability benefits approved doesn’t mean you will be able to receive them for as long as you think you should. In fact, in some situations, your benefits could be canceled. To help prevent and defend against this action, it’s wise to have a well-versed Philadelphia disability benefits lawyer representing your case.
Reasons LTD Disability Benefits are Terminated:
Failure to Apply for Social Security Disability Insurance (SSDI) Benefits
Most people who are approved for LTD benefits are required by their policy for Social Security disability insurance (SSDI) benefits. Insurance companies that fall under ERISA are legally permitted to “offset” SSDI payments against LTD benefits (subtract the amount you get from Social Security from the benefits they owe you). The insurance company has an interest in seeing you approved for Social Security disability. Failing to cooperate with the insurer related certain requirements can cause your benefits to reduced or in extreme cases terminated.
Many permanent LTD policies have a 24-month limitation on disabilities arising from mental, nervous, and psychological impairments. Suppose you’re receiving LTD payments due to depression, anxiety, post-traumatic stress disorder, chronic fatigue syndrome, or a similar impairment. In that case, you may be limited to receiving only 24 months of benefits. Sometimes exceptions are made for specific mental disorders like dementia and organic brain disease, as well as schizophrenia and bipolar disorder. Sometimes this limited coverage period also applies to:
Time Limitation on Certain Conditions
- Carpal tunnel syndrome
- Back pain
- Other chronic pain conditions
Failure to Continue Treatment
Most LTD policies require you to submit periodic proof of your ongoing disability. Sufficient proof might be annual recertification by your physician that you’re still disabled or attending regular medical examinations. One of the most common reasons LTD benefits are terminated is that the claimant didn’t receive regular medical treatment. No matter the circumstances, don’t stop seeing your doctor. Far too many claimants seek the help of a Philadelphia disability benefits attorney after they stop seeing their doctor about their disability, only to find that it’s too late.
Discovery of Activities
Unfortunately, your LTD insurer may arrange for a surveillance company to watch you over a period of several days. They may follow you as you complete daily errands and medical appointments, parking on the street at your house and recording your every move. Exercise caution when interacting with anyone you think might be an investigator. Suppose they observe and record you participating in activities that aren’t consistent with your physical or mental impairments. In that case, the LTD insurance company could decide that your health has improved, and your benefits might be terminated.
Several other circumstances could cause your LTD benefits to be terminated, including:
- Aging out
- Shifting definition of disability after 24 months
Questions about Your LTD Coverage? Reach Out to a Reputable Philadelphia Disability Benefits Lawyer Today
At The Garner Firm, Ltd., our Philadelphia disability benefits attorneys know that securing and keeping these well-deserved benefits can, unfortunately, be an uphill battle for many claimants. We are here to make the process less stressful and more successful for you. Contact our office today to schedule a complimentary consultation.
See Also: ERISA Frequently Asked Questions