Are you feeling overwhelmed by the prospect of navigating a long-term disability (LTD) claim? You’re not alone. While the average settlement process can be lengthy, understanding the details of your LTD policy can help give you an idea of how long you’ll have to wait before seeing a settlement.
Factors That Affect the Timeline
There is no single answer to how long your long-term disability claim will take to settle, as the timeline and process for filing a long-term disability can vary from case to case and state to state. The complexity of the case will have a major impact on the timeline and process necessary for successful resolution of the claim, as well as certain other factors That’s why it is highly advised to hire a Long-Term Disability Lawyer.
Some of these factors include:
- Complexity of medical condition: Depending on whether your disability is based on physical symptoms or mental/nervous issues, this may greatly impact the length of disability payments. Additionally, the severity of your medical condition needs to be established in order to determine if you qualify for benefits.
- Insurer’s Response: A key factor in how long your claim will take is whether the insurer quickly accepts or denies your claim. If they deny it, it can increase the timeline significantly as you may need additional evidence to support it.
- Appeals Process: If an insurer denies your claims due to lack of proof that a condition keeps you from returning to work, then an appeal may be initiated which could add an additional two months or more onto the timeline of settling a claim.
- Court Litigation: If your dispute cannot be resolved with appeals there are further steps in court litigation that can possibly be taken; however this adds further time onto when the case is expected to be resolved. It is best practice for claimants not to seek compensation beyond their own loss and damages (e.g., punitive damages) or expect disgorgement in such cases to avoid litigation where possible, although this may not always be possible.
The length of time to process a long-term disability claim depends on many factors, including the type of claim being made and the extent of documentation needed to establish it. Generally, the initial application process usually takes about 60 days. However, if the insurer has questions about documentation, or if more than basic medical information is required, this time frame could be extended significantly.
If your initial application is approved by your insurer, you will gain access to benefits for a prescribed period. The exact amount of time that benefits will be available varies from one policy to another; some policies cover disability for up to two years, while others may provide coverage for as long as five years.
If you are unable to return to work during this period, you may need to file a renewal request with your insurance company before your benefits expire in order to extend them an additional period. This review process can also require several weeks or even months depending on the complexity of your claim and the medical evidence needed to support it.
The Appeals Process
Appeals typically involve multiple steps, beginning with an Informal Appeal. During this step, you will meet with your insurance company to discuss any issues and negotiate a settlement amount. If no agreement is reached during the Informal Appeal, you may move on to a Formal Appeal.
A Formal Appeal involves filing an administrative appeal in writing with additional documents that provide evidence of the severity of your disability. This step usually involves interacting with an external reviewer from an independent medical review organization hired by your insurer. During this time, they will assess all the paperwork related to your claim and make a final decision on whether or not it should be approved.
The Settlement Process
When deciding whether to approve your long-term disability claim, the insurance company typically looks at all available evidence. Depending on the specific information your insurance company is requesting and how promptly you respond to those requests, this process may take anywhere from several weeks to several months.
Once a decision about your claim is made, there are two possible outcomes – approval or denial. If the insurance company approves your claim for long-term disability benefits, it will issue a settlement offer based on the facts of your case and its review of any relevant medical evidence.
The next step in the settlement process is for you to accept or reject that offer. Before making a decision, it’s important to understand all of the details listed in the offer and to ask any necessary questions so that you know exactly what you’re getting into before signing it.
Strategies to Speed Up the Process
The best way to speed up the process is to be organized and managed in all steps of filing your claim. Make sure you have all necessary medical records collected and provided to the insurer when needed. Include detailed information about the type of disability, its impact on your life, and any past or present treatments used in managing symptoms or a diagnosis associated with them.
You should also stay in contact with your doctor throughout the process if they can provide more information as requested by insurance companies or adjusters. When completing forms associated with filing a claim, go slowly and double-check all information before submitting as any mistakes could leave cause further delays in settling. If after submitting an application, wait times seem unusually long, don’t hesitate to contact either your representatives assigned to handle such cases or those listed as contact information at insurers themselves directly in order to find out if there are issues causing delays with processing claims further.
Conclusion
Claimants can expect the conclusion of their long-term disability claim to take anywhere from three months to several years, depending on a variety of factors. Insurance providers are often required to conduct extended investigations into a claimant’s physical and/or psychological status in order to assess the validity and extent of their disability before making a decision. This complex process can lead to delays that may be out of the control of both the claimant and the provider.
When pursuing a claim, it is important that you keep accurate records and provide timely updates regarding your diagnosis, condition, treatment plan, physical therapist visits, and changes in symptoms or activity levels as they occur. The more confirmable evidence you are able to provide to successfully demonstrate your disability status and support your claim, the more likely it is that it will be granted in a timely manner.
