When planning to file for long term disability benefits with your insurance company, it’s important to consider the timeline of your claim. Your disability insurance policy will offer you information on the guidelines for filing a claim and any associated deadlines. In your policy, you may have come across the term “elimination period.” This waiting period is an essential aspect of any long term disability insurance policy and can significantly impact the benefits you receive in the event of a disability.
Understanding elimination periods is crucial to making informed decisions about your long term disability insurance claim. In this article, we’ll dive deeper into what elimination periods are and why they matter for long term disability insurance claims.
What is an elimination period?
An elimination period is a waiting period between the onset of a disability and when you start receiving benefits from the insurance policy. The purpose of the elimination period is to prevent people from filing long term disability claims for medical conditions on an interim basis and to ensure that long term disability insurance benefits are used for serious, long term disabilities. The elimination period also provides the insurance company a period of time to evaluate your medical condition before benefits become due.
Once the elimination period has elapsed, you can start receiving benefits from the insurance policy. The length of the elimination period is an important factor to consider when selecting a long term disability insurance policy, as it affects the cost of the policy and the length of time you will need to cover your own expenses before receiving benefits.
How long is an elimination period for long term disability policies?
The length of an elimination period in a long term disability policy can vary depending on the specific policy and the insurer. Generally, elimination periods range from 30 to 180 days, but they can also be longer or shorter than this.
It’s important to note that a shorter elimination period will typically result in higher premium costs for the policy. Conversely, a longer elimination period can lower the premium costs, but it also means that the policyholder will have to wait longer before receiving benefits.
When selecting a long term disability insurance policy, it's important to carefully consider the elimination period and how it aligns with your financial situation and needs in the event of a disability. You should also review your policy’s terms and conditions to fully understand the details of the elimination period and how it will impact your benefits.
Do I have to wait until my elimination period is over before I file my long term disability claim?
No, you don’t have to wait until after the elimination period to file your long term disability claim. In fact, it’s often recommended that you start the process with the insurance company as soon as possible after you become disabled, even if you haven’t yet reached the end of the elimination period. If you think you may become disabled, contacting a long term disability attorney as soon as possible - even before leaving work - will put you in the best position to obtain a favorable outcome.
Filing a claim early allows you to start the process of proving your disability and establishing your eligibility for benefits. It can also help ensure that you receive benefits as soon as possible once the elimination period is over.
It’s important to note, however, that you won’t receive any benefits during the elimination period. You’ll need to cover your own expenses during this time, and the insurance company won’t start paying benefits until the elimination period has elapsed. For many people, short term disability benefits covers this period of time. Indeed, many elimination periods are exactly as long as the maximum amount of time short term disability benefits are payable.
Are there any circumstances that allow me to bypass the elimination period?
If you return to work for a period of time and then become disabled again due to the same condition, some long term disability policies have a provision called a “recurrent disability” provision. This provision allows you to bypass the elimination period if the recurrence of your disability is within a certain period, typically within 6 to 12 months after returning to work.
If your policy has a recurrent disability provision, and your disability recurs within the specified period, you won’t have to serve another elimination period. Instead, you’ll be able to receive benefits as soon as your disability recurs.
However, if your policy doesn’t have a recurrent disability provision, or if your disability recurs after the specified period, you’ll have to serve another elimination period before you can receive benefits. In this case, the elimination period would start on the day you become disabled again, and you would have to cover your own expenses until the elimination period is over.
It’s essential to review the terms and conditions of your specific policy to understand how it handles recurrent disabilities and whether you’ll have to wait through another elimination period if your disability recurs.
If my claim is approved, will my insurance company backdate my benefits to my original date of disability?
No, if your long term disability claim is approved, your insurer will not typically backdate your benefits to the date your disability began. Long term disability benefits become payable at the end of the elimination period.
If your claim is not approved by the end of the elimination period, the insurance company will back date your benefits to the end of the elimination period. This means that you’ll receive a lump sum payment for the period between the end of the elimination period and the date your claim is approved.
Keep in mind that the back payment may not cover the entire period of your disability. This is because some policies have a “look-back” provision that limits the amount of time for which benefits can be paid retroactively, typically to a maximum of six months before the date the claim was filed.
It’s essential to review the terms and conditions of your specific policy to understand how back payments work in your situation.
What common issues arise with long term disability claims and elimination periods?
Several common issues can arise with long term disability claims and elimination periods, including:
Failure to file a claim early: One of the most common issues with long term disability claims is a failure to file the claim early enough. If you don’t file your claim until after the elimination period has ended, you may have to wait even longer to receive benefits, and may not be paid for the time between your date of disability and the end of the elimination period.
Disputes over the start date of disability: Insurance companies may dispute the start date of your disability, which can affect the length of the elimination period and the amount of back pay you receive.
Misunderstanding policy terms and conditions: Many policyholders don’t fully understand the terms and conditions of their long term disability insurance policy, including the elimination period. This can lead to confusion and disputes over when benefits will start.
Recurrent disabilities: As we discussed earlier, if you return to work after a disability and then become disabled again due to the same condition, you may be subject to another elimination period. This can be a significant financial burden if you’re unable to work during that time.
If you’re facing any of these issues or other challenges with a long term disability claim or elimination period, it’s important to seek the advice of an experienced ERISA attorney. An ERISA attorney can help you navigate the process, understand your rights, and advocate for your interests.
How can The Maddox Firm help me understand the elimination period?
The experienced team at The Maddox Firm has successfully filed disability claims for hundreds of clients. We understand how to interpret the language in your long term disability insurance policy and how the terms of your policy affect the timeline for your claim.
The Maddox Firm can help you in several ways when it comes to the elimination period in a long term disability insurance policy, including:
Examining your policy: The Maddox Firm can review the terms of your long term disability insurance policy and help you understand how the elimination period works, how long you will need to wait before receiving benefits, whether there are any recurrent disability provisions, and how these terms apply to your specific situation.
Filing a claim: If you're ready to file a long term disability claim, The Maddox Firm can help you navigate the process, including filing your claim in a timely manner so that you can start the process of proving your disability and establishing your eligibility for benefits.
Appealing a denial: If your claim has been denied or there is any dispute over the amount of benefits you have been awarded, The Maddox Firm can help you appeal the decision, including helping you gather the necessary evidence to prove your disability.
Litigation: If you have exhausted administrative remedies, your only option may be to sue your insurance company. The Maddox Firm can take legal action on your behalf to secure the benefits you’re entitled to, including filing a lawsuit in court. We can represent you throughout the litigation process, advocating for your rights and interests.
The experienced team at The Maddox Firm can provide invaluable guidance and support when it comes to the elimination period in your long term disability insurance policy, helping guide you through the process and obtain the benefits you need to manage your disability and support yourself and your family.
Whether you are looking for assistance in navigating the long term disability claims process, appealing a claim denial, or litigating a final adverse decision, The Maddox Firm can help. The team at The Maddox Firm will look over 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.
Contact us to help you file your claim, appeal, or litigation the right way.