Long-term care (LTC) insurance covers the costs of nursing home and/or assisted living services. Under most long-term care policies, a person is eligible for benefits when they are not able to do at least two out of six “activities of daily living” without the assistance of a home health professional, or they suffer from dementia or other cognitive impairment. The activities of daily living are: Bathing. Caring for incontinence. Dressing. Eating. Toileting (getting on or off the toilet). Transferring (getting in or out of a bed or a chair). LTC insurance is expensive. According to the Alzhei ..read more

When someone becomes unable to work due to injury or illness and goes out on disability, there may be sources of income replacement available through the State that you live in and/or the federal government. Only a handful of states have a State Disability Insurance Program, and the Social Security Administration provides federally funded programs to assist disabled workers. State Disability Insurance Program (SDI) Five states (California, Hawaii, New Jersey, New York, Rhode Island) and Puerto Rico, have State Disability Insurance (SDI) programs. These programs are designed to partially replac ..read more

The Long-Term Disability Carrier Wants Me to Apply for Social Security Disability – Am I Required to Apply for Social Security Disability? If you are currently receiving Long-Term Disability (LTD) benefits under a group sponsored by your employer, or if you are dealing with a claim that has been denied, the claim administrator (usually an insurance company funding the plan) has probably informed you that you are required to apply for Social Security Disability Income (SSDI). It is important that you review the insurance policy, specifically the “offset provisions” that describe what other sour ..read more

If your long-term disability claim is governed by the Employee Retirement Income Security Act (ERISA), you are required to pursue an administrative appeal before you can file a lawsuit against the disability insurance carrier and the long-term disability plan. After your appeal rights have been exhausted, the next step would be to file a lawsuit in federal district court against the insurance company and the long-term disability plan. The law that developed since the enactment of ERISA in 1974 established that a denial of benefits challenged under ERISA’S civil enforcement provision must be re ..read more

If Long-Term Disability (LTD) coverage is offered through an employer-sponsored program available at your place of employment, most group LTD plans will contain a “pre-existing condition” exclusion. These types of policies are not underwritten for each of the individuals in the group, so pre-existing condition exclusions are designed to prevent the insurance company that funds the group LTD plan from insuring someone who immediately presents a claim as soon as their coverage takes effect. The insurance company does not look at the medical history of every member in the group before insuring th ..read more

Long-term care (LTC) insurance covers the costs of nursing home and/or assisted living services. Under most long-term care policies, a person is eligible for benefits when they are not able to do at least two out of six “activities of daily living” without the assistance of a home-health professional, or they suffer from dementia or other cognitive impairment. The activities of daily living are: • Bathing. • Caring for incontinence. • Dressing. • Eating. • Toileting (getting on or off the toilet). • Transferring (getting in or out of a bed or a chair). LTC insurance is expensive. According to ..read more

A portion of your pay is reduced from your paycheck by your employer. This money goes toward Social Security benefits, which you pay into for all the years you work and earn wages. While many people end up using their Social Security toward their eventual retirement, another benefit that comes from it is Social Security disability insurance. Social Security disability insurance is in place in the event that you suffer a serious long-term or even permanent disability that prevents you from working. If you become disabled, you have the right to file a disability claim with the Social Security Ad ..read more

If Long-Term Disability (LTD) coverage is offered through an employer sponsored program available at your place of employment, most of these group LTD plans will contain a “pre-existing condition” exclusion. These types of policies are not underwritten for each of the individuals in the group, so pre-existing condition exclusions are designed to prevent the group LTD plan from insuring someone who immediately presents a claim as soon as their coverage takes effect. The insurance company does not look at the medical history of everyone in the group before insuring them, so the company does not ..read more

Disability  – Am I Required to Apply for Social Security Disability? If you are currently receiving Long-Term Disability (LTD) benefits under a group plan available through your employer, or if you are dealing with a claim that has been denied, the claim administrator (usually an insurance company funding the plan) has probably informed you that you are required to apply for Social Security Disability Income (SSDI). It is important that you review the insurance policy that insures the group plan because these policies usually contain “offset provisions.”   What is an offset? An ..read more

If you are dealing with a situation that will require you to take time off from work due to an injury or illness, you should first check with your employer about whether your employer offers long-term disability (LTD) insurance as part of the company’s benefits package. If so, determine whether you are a participant in your employer’s LTD Plan. If you are a participant in your employer’s LTD plan, contact the human resources department to find out how to obtain the application from the insurance company that funds the LTD Plan. Generally, the terms “disabled” or “totally disabled” are defined ..read more