Long-Term Disability & SSDI: A Comprehensive Analysis

Many working Americans have long-term disability coverage through their employers. What they don’t realize is how the deck is stacked against purchasers of employer-supplied disability insurance.

Imagine you were injured in an automobile accident and filed suit against the man who drove his car into the back of yours because he was busy texting his bookie. You showed up in court and amazingly enough, the judge is the person who smashed into the back of your car! 

Over in the jury box are his wife and family. The defense attorney is his brother. You, of course, are all alone, because you didn’t know that you needed a work injury lawyer in Allentown. What do you think the outcome will be?

License To Steal: How Long-Term Disability Insurance Companies Cheat You Blind

The above hypothetical scenario, disconcerting as it may be, paints an almost perfect picture of how long-term disability claims are handled. Though the law that governs these types of policies says that the insurance companies are supposed to administer these claims in a fair and impartial manner, most of the insurers pay lip service to this requirement.

The insurance company has an array of professional claims people who gather your medical records, and have them reviewed by physicians who make their money certifying that you’re not disabled. Claims personnel make intrusive phone calls to your doctors and then place misleading descriptions of the conversations in the claim record.

Long Term Disability SSDI

To top it all off, you probably won’t know that you’re entitled to take a look at all the records that the insurance company is using to determine whether you’re entitled to benefits. If the record in the case is closed by the insurance company, you won’t have the right to submit more evidence into the record if you’re required to take an appeal of the decision to a federal judge.

Considering all the complexities of the process already imposed by the system, as well as the immense potential for further complications, it’s safe to say that trying to pursue a long-term disability claim on your own would be a grave mistake. Instead, hire an experienced lawyer at the earliest possible moment and let their expertise guide you toward financial security.

Supplementing Your Lost Income: How Your Long-Term Disability Insurance Should Bridge The Gap

After a life-changing injury or medical condition leaves you disabled, it can be difficult to know what your future has in store for you. Other than your own recovery, one of your first priorities is to secure your finances.

Facing what could amount to years without an income is certainly frightening, but fortunately, long-term disability insurance may be able to help you stay afloat during your absence from the workplace.

However, while long-term disability insurance can be a wonderful asset, it can also be very tricky for some individuals to obtain. With complicated application and appeal procedures, many people have a challenging time collecting the benefits that they have paid for much of their tenure with a particular employer.

When these individuals do finally succeed in obtaining long-term disability benefits, many are surprised to learn that it is not an immediate and complete income replacement: it acts primarily as a supplement and is not available immediately. Here are some important things to know about your long-term disability policy benefits:

  • You will not receive your long-term disability benefits immediately after you apply. There is a window in which you will not receive long-term disability benefits. This is known as the elimination period and typically lasts three to six months. During this time, your short-term disability will still be paying out, so you will still have some supplemental income.
  • You may have to apply for Social Security Disability Insurance, as well. Insurance companies are concerned with their bottom line, and if there is another way for you to collect money, they will insist that you do so. If your Social Security Disability Insurance application is successful, the amount you receive monthly will be taken out of your long-term disability benefits, and you will receive the excess.
  • Long-term disability benefits are not meant to replace your income, they are meant to supplement it. This means that you will be receiving a percentage of your income, which will be outlined in your long-term disability insurance policy. Typically, those on long-term disability receive about 60% of their former income.
  • Employer-sponsored plans are covered by the Employee Retirement Income Security Act (ERISA), a law drafted to benefit employers, not employees. If your claim is denied, you may have to pursue internal appeal rights. If you do not have an attorney assisting you in your internal appeal, the decision may be nearly impossible to get reversed.

Now That Taxes On The Wealthy Have Been Cut, It’s Time To Cut Benefits For The Disabled

One of the saddest myths perpetuated by the right is that most people collecting Social Security disability benefits are lazy, as Senator Rand Paul once implied. “Who doesn’t get up a little anxious for work every day and their back hurts?” – Senator Paul asked, demonstrating that he has no idea what the program is about.

President Trump’s 2018 budget called for $72.5 billion in cuts in SSDI and supplemental security income (SSI), another program for disabled people, over 10 years. His position on this is ironic, given that nine out of the ten counties with the highest share of working-age adults collecting SSDI benefits voted for him. 

Social Security Disability Insurance (SSDI) is not a welfare program

We pay into the program to insure against the risk that someday our bodies may give out on us and we will be unable to work. The benefits paid are meager and difficult to get. Sixty percent of the claims are turned down anyhow and, if you appeal a denial, it can take as long as 2 years to get a hearing before a Social Security judge. 

SSDI is a program for people who are desperately ill and suffering from cancer, severe heart disease, uncontrollable diabetes, or other terrible ailments. Beneficiaries of SSDI benefits have a mortality rate that is three times that of people their age. About one-fifth of men and one-sixth of women in the program die within 5 years of getting their first Social Security disability check. 

Do You Qualify For Social Security Disability Insurance Benefits?

Long Term Disability Insurance Companies

The process for applying for Social Security Disability Insurance (SSDI) benefits can be daunting. Many people are unsure of where to start and are intimidated by the large number of applicants who are denied benefits each year.

One of the first questions we are often asked as Social Security disability attorneys is if the individual even qualifies for SSDI benefits. While it can be challenging to determine each individual’s eligibility, especially since many people suffer from several ailments simultaneously, we have included some of the basic requirements for disability benefits below.

Are You Eligible to Receive Social Security Disability Benefits?

SSDI benefits are benefits that you work hard to earn, and have paid for over your working life through FICA taxes. Depending on the length and recency of your work history (it varies based on your age), you may have already met the work requirements to be eligible for SSDI, so let’s look at some of the other qualifiers:

  • You are unable to work because of a disability;
  • You have medical records that support your disability;
  • You have been, or are expected to be, disabled and unable to work for at least 12 months;
  • You are under the age of 65.

The Social Security Administration provides a comprehensive list of qualifying disabilities, and here is an example of just a few:

  • Blindness;
  • Amputation;
  • Cancer;
  • Traumatic brain injury;
  • Spine injuries;
  • Multiple sclerosis;
  • High blood pressure or cholesterol;
  • Heart conditions;
  • Diabetes;
  • HIV-positive diagnosis;
  • Mental impairments such as depression, bipolar disorder, schizophrenia, or PTSD.

Each condition has its own set of guidelines and standards for being considered a disability, and solid medical evidence of your conditions and treatments provided by your physician can greatly help your case. Remember, be sure to list all of your conditions when applying for SSDI and not just the ones you consider disabling, as their effects will be considered as a combined whole.

Star Trek, Social Security Disability, and the Nature of Human Rationality – Thinking Like Mr. Spock Is Not Logical

In Antonio Damasio’s book, Descartes’ Error, he relates the story of a patient he calls Elliot, who appeared to be “intelligent, skilled and able-bodied,” but who nonetheless was incapable of working and whose application for disability benefits had been denied.

When Dr. Damasio met Elliot, he was coherent and capable of talking about all that was occurring in the world, including political affairs, history, and business. His memory of his life story was flawless.

Elliot had an excellent job and was rising up the ladder in a good firm. Eventually, however, he began to develop headaches that interfered with his ability to concentrate. His condition worsened, and his work had to be completed or corrected by others. His family physician suspected a brain tumor, which turned out to be correct. 

Just above his naval cavities, he had a tumor about the size of an orange that compressed both frontal lobes. Though benign, the tumor was growing rapidly and he had to undergo surgery if he were to survive.  His medical team successfully removed the tumor. Unfortunately, however, he was left with a radical change in personality.

Though he continued to be intelligent, he could not get up for work without prompting. He proved to be unable to manage time and devoted inordinate effort to activities that were only loosely related to his main tasks or were relatively trivial compared to other pressing matters.  

He read and understood the materials provided to him, but he would devote his time to activities he found most interesting rather than those that were most important. For example, he occasionally began sorting client documents, which he ordinarily did well. Suddenly fascinated by a particular document, he would waste an entire day reading and analyzing it, ignoring more important tasks.

Soon he lost his job, fell prey to con artists, and lost all his money and his family. Elliott suffered no anxiety from his poor decisions. He accepted catastrophic reversals with complete aplomb, never losing any sleep. He could have starved to death, calmly accepting his terrible fate.

Star Trek fans think of emotions as interfering with, rather than supporting rationality. When the Enterprise faced annihilation at the hands of the evil Klingons, Captain Kirk nearly always turned to Mr. Spock, whose emotionless logical advice often saved the day. Had Elliott been advising Captain Kirk, he might have been too busy making a paper clip chain to consider how to maneuver the ship away from the Klingon death rays.

Decision-making can be rational only if we suffer the emotional consequences of error. Though anxiety can be disabling if it is excessive, it is an adaptation crucial for survival. If he were not a fictional character, it is likely that Mr. Spock would need Dr. Damasio to testify in his social security disability hearing.

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Qualify For Social Security Disability Insurance Benefits

While long-term disability benefits do have certain limitations, they are an important financial lifeline for many individuals and families throughout the United States. If you have been injured and are applying for long-term disability benefits, or have already been denied, reach out to Liberty Bell Workers’ Compensation today, located near Allentown Public Library.

With decades of experience in the field and thousands of successful cases behind us, we’re the premier team to guide you through the complexities of Pennsylvania’s legal system. Don’t wait to realize your rights – call our office or begin a live chat now to schedule a free consultation with our firm!