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November 27, 2022
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Limits and Exclusions Policies May Impose on Long-Term Disability Benefits

 

Long-term disability insurance policies can provide you with financial support if you cannot work because of an illness or injury. However, your state or other governmental agencies may impose limitations on these policies, including how long the benefits will last and how much the benefits will payout per month or year. If you’re considering buying disability insurance, familiarize yourself with these two limits to decide how much coverage to purchase and how much it will cost you.

1.   Maximum Benefit Period

One of the most critical factors you’ll want to consider when selecting a policy is its maximum benefit period. It refers to how long your insurance company will pay disability benefits each month before cutting off your coverage. An LTD lawyer can help you determine your policy’s maximum benefit period and monthly payment.

Most policies offer between six and 36 months of disability payments, but you can purchase policies with unlimited benefit periods if you’re willing to pay more for that added protection. The maximum benefit period usually resets annually, or every time you return from sick leave. If you have a severe illness or condition, it may be worth paying extra for an extended maximum benefit period.

2.   Maximum Monthly Benefit Amount

The maximum monthly benefit amount is one of the primary criteria you’ll consider when purchasing a policy. What is your monthly income goal? Are you looking for enough coverage to replace your entire salary, or will something less than that suffice? Many policies have a cap on a certain amount, but there are some that you can purchase with no limit at all. You can go here to access a team of long term disability lawyers who will help you understand your policy and deal with any issues which may arise.

However, consider that these more expensive policies may have additional requirements and restrictions. Suppose you’re only planning on using long-term disability insurance for a short period (perhaps after recovering from an injury). Therefore, it might not make sense to purchase a policy with an unlimited maximum monthly benefit amount—you may end up paying more in premiums than what you receive in benefits if you need coverage for only several months.

3.   Exclusions for Mental and Nervous Disorders

Although every long-term disability policy will include some exclusions, most policies will expressly exclude mental and nervous disorders. Hence, if you develop a major depressive disorder or any other mental illness, your insurance company will likely deny you coverage under your long-term disability policy. However, it’s important to note several exceptions to these exclusions.

For example, many policies will cover an employee who develops a mental health condition due to witnessing or experiencing an accident at work, such as post-traumatic stress disorder. Also, some policies will provide coverage for psychiatric conditions resulting from physical injuries sustained in a car crash or on-the-job injury. However, it’s crucial to contact a team of long term disability lawyers to help you ascertain what is and isn’t part of your specific policy.

4.   Postpartum Depression

One of those policies that long-term disability policies commonly exclude is postpartum depression. Most long-term disability insurers will not offer coverage for any psychiatric or emotional condition you develop within two years of childbirth.

So if you are pregnant, planning a pregnancy, considering adoption, or experiencing any emotional or psychological issue related to your pregnancies and new motherhood, it’s best not to rely on your long-term disability policy alone. However, you can contact an experienced LTD lawyer who can help you ascertain whether your condition qualifies as a disability under state law.

5.   Period for Making Long-Term Disability Claim

In most cases, you have one year from your disability onset date—or two years from the policy’s effective date—to claim long-term disability coverage. If you fail to do so within these time frames, you’ll likely forfeit any future benefits. However, some policies offer an extended period in which you can file a claim.

If your plan does not cover pre-existing conditions or work-related injuries and illnesses, it may require that you apply for coverage within 30 days of becoming disabled. Therefore, you should contact an LTD lawyer to help you process your application as soon as possible.

Conclusion

No matter what kind of long-term disability plan you opt for, it’s essential to understand its limitations. For example, most programs will not cover any illness or injury present before purchasing your plan. It’s also common for policies not to cover conditions arising from pregnancy, even if you become pregnant after purchasing your policy. Many short-term disability policies also require medical evidence of severe impairment and are limited to a set number of weeks per benefit period. However, consulting with a team of long term disability lawyers can help ensure you know all of your options when filing a claim.

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