Employee benefits encompass a wide variety of compensation and insurance policies. Along with health, life, dental, and vision insurance coverage, disability insurance is often offered to full-time employees. This includes both short term disability and long term disability benefits.
When an employee becomes disabled and stops working, they must carefully review their disability insurance options. Depending on the terms of the policy, short term disability benefits are usually available for a time period of 30 to 180 days. If an employee remains disabled after the maximum duration of the short term disability benefits, they should immediately apply for long term disability benefits. Some employees make the mistake of assuming that their short term disability benefits will automatically roll into long term disability benefits; however, in most circumstances a separate application for long term disability benefits (LTD) is required.
Here Are 5 Steps to Apply for LTD Benefits:
1. Request an Application from Your Employer
Someone at your employer’s Human Resources Department should be able to provide you with an application and all instructions to complete your LTD application. However, sometimes there are situations where your employer fails to provide you with the materials necessary to apply for LTD benefits. If so, you can probably find an application from the insurance company or claim administrator online. For example, if CIGNA (also known as Life Insurance Company of North America) is your insurer, try a Google search for “CIGNA long term disability application” or “CIGNA long term disability claim form”. There is a good chance that the forms necessary to apply for LTD benefits will be available on the insurance company or claim administrator’s website.
2. Complete and Submit the Employee’s Statement
This is the section of the LTD application that you are responsible for completing and it is sometimes called the Employee’s Statement. The requirements of the Employee’s Statement vary depending on the insurance company, but generally you must disclose information such as:
- Your name
- Social Security number
- Date of birth
- Address and phone number
- Family members
- Name of your employer and your occupation
- Your work history and education information
- Date of your injury or sickness
- Last date worked
- Your reason for disability
- All medical providers and their contact information
- Prescribed medications
- And any other forms of income that you may be eligible to receive
You will want to complete this form in detail. You may notice that the form does not allow much space to write or type your responses, so you may want to provide additional pages in order to fully respond to these questions. Further, you will have to submit a signed authorization that allows the insurance company or administrator to request your medical records.
3. Acquire Your Employer’s Statement
Your employer is also responsible for completing a portion of the LTD application. In this section, the employer will generally have to provide information such as your date hired, effective date of insurance coverage, earnings, last date worked and whether you returned to work, other insurance benefits or income you are eligible to receive, title of your occupation, and the physical and mental requirements of your occupation.
4. Get a Statement from Your Attending Doctor
In addition to statements from yourself and your employer, the insurance company or claim administrator will require your doctor to complete a statement. The insurer will usually request that your doctor provide information about diagnoses, signs and symptoms, objective findings, whether your injury or sickness is work related, dates of treatment, types of treatment (such as hospitalizations, surgeries, and medications), referrals, an estimate of your physical limitations and/or mental impairments, an estimate of when you may return to work, and additional remarks. I recommend taking this form directly to your treating physician and asking them to complete this statement in-person. That way, this form will not be misplaced and you can remind your doctor to complete this form in detail.
5. Submit Anything Else in Your Possession that Supports your Disability Claim
Do not assume that the insurance company or claim administrator will gather all medical records and other evidence for your disability claim. If you have test results, doctors’ records, or anything else you believe supports your disability claim, submit this documentation with your long term disability application. Doing so could potentially shorten the time you have to wait for a claim determination and strengthen your chances of being approved.
For reference, see the following examples of long term disability claim forms taken directly from insurance companies’ or claim administrators’ websites:
- CIGNA long term disability application and physician’s statement
- Unum long term disability claim forms
- Reliance Standard long term disability claim forms
- Sedgwick’s Physician’s Certificate for Disability Benefits
Contact Keller & Keller for a Free Consultation
If your claim for short term disability or long term disability benefits has been denied, contact an experienced disability attorney at Keller & Keller today. We can provide a free consultation about your short term disability and long term disability claims. Please be advised that a denial of disability insurance benefits must be timely appealed. If you fail to submit a written appeal to the insurance company or administrator, then you may forfeit your claim for short term or long term disability benefits.
You May Also Qualify for Social Security Disability Benefits
In addition, if your disability will last 12 months or longer, then you should consider applying for Social Security disability benefits. Keller & Keller can assist you with your Social Security disability application. Call 1-800-253-5537 today to learn more.