Long Term Disability insurance is intended to provide income protection to individuals or employees that become ill and unable perform all or any of the duties of his or her regular occupation.

The amount of Long Tern Disability benefits that each claimant is entitled to is greatly dependent on the provisions set out in their insurance policy. Some claimants may be entitled to full coverage, while others only qualify for partial or residual benefits.

Not all disability plans or policies  are the same. Many  policies require the claimant to be “totally disabled”  before they can make a claim for benefits. But what if you can only work a few hours a day, and your employer is unable to accommodate these changes in your ability? Does your policy provide for partial benefits? Or does this mean you meet the requirements under the definition of  “Total Disability?”

Partial benefits and residual benefits. How are these definitions of disability similar? How are they different?

Partial Disability Benefits
In many insurance policies partial benefits may be payable to those Long Term Disability claimants who are still able to perform some of there job and work related duties.

• Claimant is unable to perform any of the duties of his or her regular occupation
• Determined in the policy, has a qualified percentage of loss in monthly earnings due to the same sickness or injury
• “Partial” definition of disability. In some policies – the claimant has to be totally disabled during the elimination period.

Residual Disability Benefits

• “Residual” definition of disability. In some policies – the claimant may not have to be totally disabled during the elimination period.
• Is limited from performing the material and substantial
  duties of his or her regular occupation
• Determined in the policy, has a qualified percentage of loss in monthly earnings due to the same sickness or injury

The Kahler Personal Injury Law Firm represents those clients  who have been denied disability income protection benefits under either a group disability insurance policy or a private policy.

• necessary medical evidence to prove the disability as it pertains to the policy
• Disability insurance policies often contain time limits that can be hard for the insured to understand
• experienced legal advice

Definitions

Elimination Period

Calculating elimination periods

Accumulation period

Regular Occupation

Gainful occupation

Indexed Monthly Earnings

“totally disabled”