The last thing anyone in Massachusetts or elsewhere would want, especially in today’s economy, is to be incapacitated for a long time as this could equate to days without much-needed income. Unfortunately, accidents and illnesses are sometimes unavoidable, and may result in long-term disabilities.
To help the workforce cope with this kind of situation, states and employers provide eligible employees with long-term disability (LTD) benefits through private insurers. Known as group LTD policies, these are mostly governed by the Employee Retirement Income Security Act (ERISA), a federal law designed to protect the retirement funds and health care benefits of employees. Besides the group type, an LTD plan may also be bought individually from private insurers.
The Basics of an LTD Policy
One of the foremost criteria when applying for an LTD claim is to qualify in its definition of “disability.” In all LTD policies, disability is basically defined under one of two categories: infirmity to “any occupation”, and to “own occupation.”
The LTD type that falls under an “any occupation” policy is one which renders you unable to perform your own job, and any other type of work given your experience, training, and education. Meanwhile, a condition that impairs you from doing your “own occupation” only restricts you from performing your current job, but still allows you to do other types of work.
Even while your disability type qualifies you for claims, you may not be eligible to file right away, as most LTD plans have a waiting period or “elimination period” of around 90 or 180 days. In general, before you can apply for LTD claims, you must first have consumed your sick time and short-term disability benefits.
Other restrictions in LTD claims exist, such as a cap for mental conditions, and the duration by which you may receive benefits. Taxability of the benefits may also be a question. Given all these complexities, it would be best to apply for claims on your long-term disability policy with the help of a lawyer experienced in Massachusetts LTD benefit laws.
ERISA allows LTD insurance providers the discretion of approving or denying claims. You may appeal a denial under the provider’s internal appeals process. Only after you have exhausted this means can you file an appeal in federal court. ERISA laws state, however, that the court will only consider the records and evidences presented during the internal appeals procedure. This is why you should work with seasoned lawyers from firms like The Law Offices of Terrence A. Low and Anthony J. Canata, who can help ensure all the evidences you need to prove your claims are in order, right from the start of the process.
  Understanding Your Long-Term Disability Policy. Nolo.com
 Long Term Disability (LTD) Overview. Mass.gov