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What Attorneys Need to Know Before Filing for Long Term Disability

attorney filing for long term disability

In the legal field, where mental acuity and cognitive capabilities are as crucial as physical well-being, understanding the nuances of disability insurance becomes imperative.  This article delves into the unique considerations and challenges attorneys face when seeking long term disability benefits.  


From deciphering policy terms to addressing the complexities of proving disability in a sedentary occupation, we aim to empower attorneys with the knowledge needed to successfully navigate the disability insurance landscape and secure financial protection in times of unforeseen health challenges.


What Qualifies As a Long Term Disability for Attorneys?


Long term disability generally refers to a condition that persists for an extended period, often beyond 90 or 180 days.  Short term disability insurance may cover a shorter duration, and long term disability benefits kick in when the disability is expected to be more prolonged.  The eligibility criteria for long term disability benefits as an attorney will be highly dependent on the terms of your disability insurance policy.  Typically policies will define disability as being disabled from your “own occupation” or being disabled from “any occupation.”


For “own occupation” coverage, a disability is typically defined as the inability to perform the specific duties of the attorney’s own occupation.  This means that if an attorney cannot carry out the tasks and responsibilities unique to their legal profession, they may be considered disabled. In some "own occupation" policies, own or "regular occupation" may be defined even more narrowly as an attorney's legal specialty.


“Any occupation” coverage comes into play if the attorney is unable to perform the duties of any occupation for which they are reasonably qualified by education, training, or experience.  This broader definition may apply after the own occupation period, which is usually 24 months.


Many disability insurance policies are a hybrid of these two definitions of disability.   Your policy may start with an “own occupation” definition, providing benefits if you cannot perform the duties of your specific profession as an attorney.  After a specified period, the policy may transition to an “any occupation” definition, where benefits are contingent on your inability to perform the duties of any occupation.


Understanding these definitions and distinctions in your insurance policy is crucial for attorneys when evaluating their long term disability coverage.  It’s advisable for attorneys to carefully review their insurance policies and consult with legal professionals to ensure a comprehensive understanding of their coverage.

 

What Types of Disability Insurance Options Do Attorneys Typically Have?


University of Michigan Law Library

Attorneys have various disability insurance options to protect themselves financially in case of a disability.  Here’s an overview of the types of disability insurance options available:


Group Disability Insurance: Many law firms offer group disability insurance as part of their employee benefits package.  This coverage is typically more cost-effective for attorneys as the premiums are often partially or fully paid by the employer.  Attorneys may also access group disability insurance through professional associations or bar associations.  These plans might offer competitive rates and specific coverage tailored to the needs of attorneys.

 

Group policies usually have a predetermined benefit period and may cover a percentage of the attorney’s salary.  They often have a waiting period before benefits kick in.  However, group policies may transition from “own occupation” to “any occupation” after a specific period.

 

Some group plans allow attorneys to enhance their disability coverage by purchasing supplemental options.  These options might include additional benefits or riders to customize coverage based on individual needs.

 

Individual Disability Insurance: Attorneys can purchase individual disability insurance policies that are personally owned.  These policies provide more flexibility in tailoring coverage to the specific needs of the attorney.  Individual policies often offer “own occupation” coverage for a more extended period, providing benefits if the attorney is unable to perform the duties of their specific legal occupation.  Attorneys can choose the benefit amount, waiting period, and benefit period based on their preferences with individual disability insurance.   While premiums are usually higher than group plans, individual policies offer more comprehensive coverage.

 

Individual policies are portable, meaning attorneys can maintain coverage regardless of changes in employment.  This is beneficial for attorneys who may change firms or establish their own practice.


Many attorneys are covered by both group and individual policies.  These policies often have different terms and eligibility criteria.  If you’re an attorney filing for long term disability, it’s essential to consult with an experienced long term disability lawyer who can help you navigate the complexities of filing claims for multiple LTD policies.


What Documentation is Required from An Attorney for a Long Term Disability Claim?


attorney long term disability documentation and claim forms

When filing a long term disability claim as an attorney, it’s important to provide comprehensive documentation to support your claim.  Here’s a list of some of the necessary paperwork, medical records, and other documentation that you may submit to your insurance company:


  • Claim Forms: Complete and submit all required claim forms provided by your insurance company.  This typically includes personal information, details of your disabling condition, and authorization forms.

  • Medical Records: Provide a thorough set of medical records, including but not limited to: diagnostic reports; physician statements; treatment plans; medication history; hospitalization records; surgical reports; and rehabilitation or therapy notes.

  • Attending Physician’s Statement (“APS”): An Attending Physician Statement (“APS”) is a form provided by your insurance company for your treating physician to complete that certifies your disability.  Request and submit an APS completed by your treating physician (preferably a specialist of your condition).  This statement should detail the nature and severity of your disability, treatment plans, and your physician’s opinion on your ability to work.

  • Vocational Documentation: Vocational documentation may strengthen your claim, including but not limited to: a vocational expert report; your resume; official job descriptions and requirements of your position as an attorney; and statements from employers or colleagues addressing your job duties and responsibilities, work hours and schedule, and their observations on how your disabling condition has impacted your ability to work.

  • Financial Documents: Your insurance company will likely request your financial documentation to determine your pre-disability income.  You may submit this documentation, including but not limited to: tax returns; pay stubs; and W-2 forms.

  • Any Additional Supporting Documentation: Include any other documents that can further support your claim, such as: statements from family members or friends who have witnessed the impact of your medical condition on your daily activities; any additional medical testing or vocational assessments; and/or a personal affidavit outlining your background and the onset of your disabling condition.


Submitting a comprehensive and well-documented disability claim is essential for a successful outcome.  You should always thoroughly review your insurance policy to understand the specific requirements and consult with legal professionals for guidance in preparing and submitting the necessary documentation.


 

Are There Specific Challenges Attorneys Face in the Claims Process?


Attorneys often face unique challenges in the long term disability claims process, and proving disability for a sedentary occupation can pose specific difficulties.  Here are some challenges attorneys may encounter:


  • Sedentary Occupation Challenges: Proving disability for a sedentary occupation, such as that of an attorney, poses unique challenges due to the often intangible nature of legal work.  Unlike physically demanding professions, the disability in sedentary roles may stem from mental or cognitive impairments, making it inherently challenging to quantify and document.  Attorneys are frequently engaged in intellectually demanding tasks, requiring a high degree of concentration, critical thinking, and problem-solving.  Demonstrating the impact of conditions like depression, anxiety, or cognitive disorders on the ability to perform these complex job functions can be subjective and may face skepticism during the claims process.

 

Even in a sedentary occupation like that of an attorney, physical conditions can significantly impact your ability to perform essential job functions.  Conditions such as chronic pain, musculoskeletal disorders, or mobility issues can hinder your capacity to sit for extended periods, navigate an office environment, or maintain static positions required for tasks like reviewing legal documents on computer screens, thereby disabling you from effectively practicing law.  However, your insurance company may underestimate the physical functioning required for your role and how your symptoms prevent you from performing these essential job duties.

 

  • Proving Subjective Symptoms: Some medical conditions, such as pain syndromes, cognitive impairment, and mental health disabilities, can be subjective – meaning they are difficult to demonstrate via objective medical testing.  Consequently, if you suffer from a condition that consists of primarily subjective symptoms (such as pain, fatigue, headache, etc.), your claim may be met with skepticism by your insurance company.  Proving the impact of conditions like Chronic Fatigue Syndrome (“CFS”), migraines, anxiety disorders, or depression on the ability to practice law will likely require thorough documentation and additional evaluations.

 

  • Unique Work Environment: The demanding nature of legal work, characterized by high stress levels and long working hours, may contribute to health issues.  Establishing the link between these work-related factors and your disability can be crucial but challenging.

  • Vocational Challenges: Proving disability for a sedentary occupation may be challenging because insurance companies may argue that there are alternative sedentary jobs within the legal field.  As an attorney, you may need to demonstrate the specific limitations that prevent you from performing any sedentary occupation effectively.  Insurance companies may conduct a transferable skills analysis to identify other occupations an attorney could perform.  Successfully countering this analysis requires a detailed understanding of legal skills and limitations.


Navigating these challenges requires careful preparation and documentation.  Attorneys should seek legal advice to ensure that their disability claim addresses the unique aspects of their profession.  A long term disability attorney with experience handling both ERISA and non-ERISA disability insurance claims for attorneys can provide valuable insights and assistance throughout the process.

 

How Does the Attorney-Client Relationship Factor into Long Term Disability Claims?


long term disability and ethics

The attorney-client relationship can have significant implications for attorneys filing for long term disability, especially when continuing to represent clients or handle cases during the claims process.


Attorneys have an ethical duty to provide competent and diligent representation to their clients.  Filing for long term disability does not automatically relieve attorneys of their professional obligations to existing clients.  Attorneys should maintain open communication with clients, keeping them informed about potential changes in the handling of their cases, consistent with their ethical obligations.


The onset of disability may limit an attorney’s ability to handle a full caseload.  Attorneys need to assess their capacity realistically and consider reducing or reassigning caseload responsibilities to ensure quality representation.  Attorneys may explore options such as referring cases to colleagues or bringing in co-counsel to share responsibilities.  This allows for continued client representation while acknowledging potential limitations.


Insurance companies may scrutinize an attorney’s continued legal work during a disability claim.  Attorneys should be prepared to provide evidence of the impact of their disability on their ability to handle cases effectively. 


Seeking legal advice is essential when navigating the intersection of disability claims and ongoing legal work.  A long term disability attorney can provide guidance on ethical obligations, client communication, and strategic decisions, as well as help you navigate the disability claims process, address insurer inquiries, and ensure compliance with policy terms.

 

Can Attorneys Continue Practicing Law While Receiving Long Term Disability?


The ability of attorneys to continue practicing law while receiving long term disability depends on various factors, including the nature of their disability, the terms of their disability insurance policy, and legal or ethical considerations.  In some cases, attorneys may have the option to engage in limited legal activities, but there are important restrictions and considerations:


  • Policy Terms and Definitions: The disability insurance policy’s terms and definitions play a crucial role.  If the policy includes an “own occupation” definition, allowing benefits while the attorney is unable to perform the duties of their specific legal occupation, they may have more flexibility.  However, policies often transition to an “any occupation” definition after a certain period, making it more challenging to continue practicing.

  • Engaging in Limited Legal Activities: Some disability policies may permit attorneys to engage in limited legal activities without jeopardizing their disability benefits.  This could include providing legal consultation, legal writing, or non-trial-related work.  However, the specifics vary and depend on the policy terms.

  • Ethical Considerations: Attorneys must consider the ethical implications of practicing law while on disability.  Continuing to represent clients when unable to provide competent and diligent representation may violate ethical standards.

  • Impact on Benefits: Engaging in legal work while on disability may impact the attorney’s eligibility for benefits.  Insurance companies will closely scrutinize the nature and extent of the attorney’s work to determine whether it aligns with the disability claimed.

  • Risk of Benefit Termination: Insurance companies may view the ability to continue practicing law, even in a limited capacity, as evidence that the attorney is not fully disabled.  This could lead to the termination of disability benefits, especially if the attorney’s work contradicts the claimed limitations.

Attorneys considering continuing legal activities while on disability should consult with an experienced long term disability attorney who can help navigate ethical obligations and provide insights into the potential impact on disability benefits.

 

What Are the Common Pitfalls for Attorneys to Avoid During the Long Term Disability Claims Process when Filing for Benefits?


Attorneys filing for long term disability benefits should be mindful of common pitfalls to enhance the likelihood of a successful claim.  Here are key mistakes to avoid:


  • Incomplete or Inaccurate Documentation: If you are unfamiliar with the claims process, it can be easy to accidentally provide incomplete or inaccurate information on claim forms, medical records, or other documentation.  Make sure to thoroughly complete all required forms, ensuring accuracy in detailing your disabling condition, medical treatments, and its impact on your ability to work.

  • Insufficient Medical Evidence: Many claimants fail to gather and submit comprehensive medical evidence supporting the disability claim.  When filing a claim, obtain detailed medical records, physician statements, and diagnostic reports to substantiate the severity and permanence of your disabling condition.

  • Lack of Vocational Documentation: Neglecting to include vocational documentation that highlights the specific challenges attorneys face in performing legal tasks can lead to your insurance company wrongly assessing your occupational duties.  To ensure your insurance company has a comprehensive understanding of your role as an attorney, provide a detailed analysis of how your disability affects your ability to perform essential job functions and any accommodations needed.

  • Misunderstanding Policy Terms: If you are unfamiliar with policy language, you may fail to understand the terms and definitions of your disability insurance policy, including any transition from “own occupation” to “any occupation.”  Thoroughly review the policy terms and seek clarification on any ambiguous language.

  • Delaying the Claims Process: Your insurance policy will dictate the timeframe where you must notify your insurance company of your claim.  Missing crucial deadlines can lead to benefit denial.  It’s essential to notify your insurance company promptly after becoming disabled.  Delaying the process may lead to challenges in obtaining retroactive benefits.

  • Not Seeking Legal Advice: An experienced long term disability attorney can significantly increase your chances of a successful outcome for your claim.  Always consult with a long term disability attorney familiar with non-ERISA and ERISA long term disability insurance claims who understands the best strategies to get your claim approved.


Avoiding these pitfalls requires careful attention to detail, proactive communication, and a thorough understanding of the disability insurance policy.  Seeking guidance from a knowledgeable long term disability attorney can significantly enhance your chances of navigating the claims process successfully.

 

How Can The Maddox Firm Help Attorneys Prove Their Disability Claims?


The Maddox Firm has helped hundreds of clients, including many attorneys, successfully secure their long term disability benefits.  We understand the specific challenges involved and offer comprehensive support to attorneys navigating the claims process.

Here’s how The Maddox Firm can assist attorneys in filing for long term disability:


  • We Examine Your Policy and Assess Your Claim: The Maddox Firm conducts a thorough examination of your disability insurance policy.  This involves a detailed analysis of the policy terms, definitions, and any potential ambiguities that may impact the claim.  We assess your specific situation to determine the most effective strategy for securing long term disability benefits.

  • We Handle All Communications with Your Insurance Company: Communication with the insurance company is a critical aspect of the claims process.  The Maddox Firm takes on the responsibility of handling all communications with the insurance company on your behalf.  This includes submitting initial claims, responding to inquiries, and ensuring that your insurance company meets all of its legal obligations under ERISA.

  • We Help You Obtain Evidence to Support Your Claim: The Maddox Firm assists in gathering compelling evidence to strengthen your disability claim.  This includes obtaining vocational assessments to highlight the challenges you face as an attorney in performing legal tasks.  If needed, we will also refer you to undergo additional assessments, such as Functional Capacity Evaluations (“FCE”s) (conducted to assess physical capabilities) or neuropsychological evaluations (used to provide insights into cognitive deficits impacting your ability to work).  These tests can provide your insurance company valuable objective evidence of your inability to work due to your condition.

  • We Handle Appeals and Litigation: In the event of a claim denial, The Maddox Firm takes proactive steps to handle the appeals process.  We employ our expertise in ERISA regulations to strengthen your case, gather additional evidence, and challenge the denial.  If necessary, The Maddox Firm is prepared to represent you in litigation to secure your deserved long term disability benefits.

  • Legal Insights into the Attorney’s Occupation: The Maddox Firm provides valuable insights into your occupation as an attorney.  This includes a nuanced understanding of the unique challenges attorneys face in their profession, including your particular legal specialty, allowing for a more effective presentation of the impact of your disability on your ability to practice law.


Whether you are looking for assistance in navigating the claims process, appealing a claim denial, or litigating a final adverse decision, The Maddox Firm can help with your short or long term disability claim.  The experienced team at The Maddox Firm will examine your insurance policy, correspondence from your insurance company, medical records, and any other relevant documentation in order to give you personalized guidance on how we can help you win your short and/or long term disability claim. Our New Jersey and New York long term disability attorneys help clients nationwide.

 

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