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Many Factors Determine How Long it Will Take to Settle and Receive LTD Benefits

If you have recently settled a long-term disability lawsuit, you will likely be wondering how long it takes to receive your LTD benefits. The answer is not always clear. A variety of factors determine the length of time it will take to receive your long-term disability settlement. On average, it will take between 45-105 days to receive the initial decision about your LTD claim.

However, it can take over a year to settle your LTD claim, especially without a lawyer fighting to push your case forward.

Some factors that affect the waiting period for you your LTD benefits:

  • The nature of your injury or illness
  • The willingness to cooperate and the availability of your physicians
  • Correspondence between your insurer and their legal counsel
  • If your case goes directly to mediation or if discovery is required
  • If your forms are completed thoroughly and accurately
  • If you can follow the deadlines defined by your insurance company
  • Your willingness to comply with requests for further information

Your LTD Elimination Period

Another factor that determines when you will see your long term disability money is your LTD elimination period. Almost all disability insurance policies contain an elimination period. This is the period between when you become disabled and when you can start receiving LTD benefits. You must remain continuously disabled during this elimination period to be entitled to your benefits. There is no event where you will be entitled to your benefits before the policy’s elimination period expires.

How Insurance Companies Calculate Long Term Disability

The terms of your LTD contract or policy determine how your rate of LTD benefit is calculated. Your monthly rate of LTD is calculated by taking a percentage of your basic gross monthly salary. The percentage of basic gross monthly salary is determined and defined by your LTD contract. The average percentage we see is 66.66% or 2/3 of gross monthly income.

Your basic salary means this calculation does not include overtime pay, bonuses, or commission. Your gross salary means it is calculated using your take-home pay, before accounting for any deductions or taxes. Using your gross income means that your long-term disability benefit is taxable. However, your long-term disability benefit might not be taxable, depending on the terms of the policy and method of calculating the benefit.

Don’t Like Their Decision? Deciding Whether to Appeal or Sue

If you have been denied an LTD claim, deciding whether to appeal or sue is the next step in determining how you will obtain the benefits you are entitled to.

The Difference Between Appealing or Suing for an LTD Benefit Denial

If you appeal an insurance company’s decision for denial, you are not having the reconsideration made by a neutral third party. Instead, you are leaving it up to that company’s own employees and internal processes to review your case once again and consider reversing their decision. By starting a lawsuit, you are putting the decision in the hands of a court of whether you are entitled to the LTD benefits after all. Faced with your lawsuit, your insurance company will either have to start paying you your benefits or agree to a settlement. Otherwise, they will have to allow the final decision to be made by the court.

Deciding which option has the best chance at getting you your LTD benefits depends on a variety of factors.

Reasons You Would Appeal

Sometimes, an internal appeal is the easiest and cleanest way to settle a long-term disability claim. There are some circumstances where an appeal makes sense, mostly when you know the insurer is missing substantial information about your case.

An appeal could be successful, for example, when an insurance company has made contact only with your family doctor and has not heard the beliefs and opinions of the specialist you have seen regarding your disability. Another example would be if your disability has undergone further testing or imaging, and a defined diagnosis has been produced as a result.

Even with additional medical information, appeals are most often not successful. Unless you can provide unwavering and substantial new evidence, it’s unlikely an insurance company will be willing to change their decision. If your appeal is unsuccessful, it can end up being a large waste of your time and resources.

Insurance companies will always prefer you to appeal rather than sue. They will happily waste their time and yours dealing with multiple appeals for the same case to keep you from going the route of an LTD lawsuit. Our disability lawyers typically do not recommend clients appeal unless you have compelling new medical evidence which was not available during the initial adjudication. The delay in appealing often creates significant financial stress on the claimant before litigation is commenced, which provides the LTD Insurer with leverage on future negotiations. This limitation period means you only have a limited time to take out a lawsuit after your LTD claim has been denied. The limitation period is 1 year in most jurisdictions. The case law is mixed about whether the 1-year limitation starts after the initial denial or the final denial.

If you would like to appeal your disability insurer’s decision, our long-term disability lawyers can help you prepare a persuasive appeal letter with all the supporting medical information we can get. Our team can help increase the chances of your appeal being approved the first time.

Reasons You Would Sue

If your insurance company has all or almost all of the crucial medical documentation you can provide them, it’s not likely that they will change their decision just because you file an appeal. Starting a lawsuit is far more promising to getting your LTD benefits if you think your insurance company has made a misjudgment. Having a team of experienced disability lawyers present your case to a court stands a much better chance of having your claim approved than leaving it up to the insurance company once again.

Your lawyer can gather and present the facts and documentation about your case in a way that can help prove the severity and reality of your disability, even without new information. An experienced disability lawyer also knows the right questions to ask your medical specialists to prove your case further.

Stepping right into a lawsuit can help you avoid wasting time with appeals when we know they often have a bleak chance of being approved. Spending months filing multiple appeals means months without receiving a salary or disability benefits. As your financial situation worsens, you may feel compelled to go back to work before you’re ready, compromising your health even further. There are also tight time limitations to filing your lawsuit for a denied LTD claim due to the limitation period. The sooner your lawsuit is filed, the less you worry about making your LTD lawsuit before the time limit expires.

What Happens After you File an LTD Lawsuit?

After a lawsuit has been filed to settle a long-term disability claim, your case will move to either discoveries or mediation.

What is Mediation?

Disability cases are often settled at mediation. A day or half-day is set aside where a specialized lawyer acts as a mediator and presents offers between you and your insurance company, who are in different rooms. The purpose of this mediation is to see if you can agree on a settlement by the end of the day and if so, your case is over.

There are also Judicial Settlement Conferences available where a Judge acts as the mediator. These are confidential, and unlike hiring a private mediator, they are free.

A reasonable settlement has less to do with what your lawyer does at the mediation but more so with what your lawyer did before the mediation. An experienced disability lawyer will put the time and effort into building up your case with reports from medical experts, medical statements, and written arguments. If your lawyer did their job right, they would have started building your case from your first consultation.

What is Discovery?

Both sides, the claimant and the defendant, always have the right to ask each other questions under oath during a process named discoveries. Discovery is a day when your lawyer is allowed to ask questions to the insurance company, and the insurance company’s legal team is allowed to ask you questions. Discoveries can be an uncomfortable and stressful time for all involved. Our experienced team of disability lawyers has found it possible to go to mediation without discoveries in certain cases. This means you can settle your case sooner without having to deal with the stressful discovery process. For those cases where discovery is necessary, we spend a lot of time preparing the client to have a successful day by empowering the client to tell the truth.

When to Contact an LTD Lawyer

If your LTD application has been denied, it is in your best interest to contact an LTD lawyer right away. Appealing or filing a lawsuit to reverse the decision of an insurance company is not an easy task. You should not have to fight alone during an already difficult time in your life. With guidance from Valent Legal, we can help push your case forward and get you the benefits you deserve and should be entitled to.

Our long term disability lawyers strive to get you the results you need to get your financial, physical, and mental wellbeing back on track. Contact us to find out more about how we can help you with your long-term disability appeal or lawsuit today.

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