Many LTD insurance policies contain a pre-existing conditions clause. While the exact content and interpretation of this clause may vary from one plan to the next, a pre-existing clause typically makes you ineligible for long-term disability benefits if your medical condition is something for which you have been treated in the past. In other words, if you saw a doctor or took medication for a medical condition that you are now claiming has made you disabled and unable to work, the insurance company may be able to use this clause to deny your claim for benefits.

A pre-existing conditions clause in an LTD policy usually provides for a specific timeframe that defines a pre-existing condition. In other words, the insurance company often can only consider your medical condition to be pre-existing for a limited time.

For instance, some policies may deny you coverage if you had cancer in the past, and cancer reoccurs. However, some plans may allow you coverage for this condition if you had been in remission for three or five years before you became sick again.

Another example of a common pre-existing conditions clause is one that prohibits you from benefits for any medical condition for which you received treatment within the 12 months before the effective date of your insurance coverage. This clause can be particularly problematic for employees who are newly hired and have just gained eligibility for LTD benefits. For example, if you had a back problem that you received treatment for three months before you were hired into your current position, you probably will not receive LTD coverage based on back problems. However, if you previously were treated for a back strain, but you then were in a car accident that caused a severe injury to a different portion of your back, the new injury is likely not a pre-existing condition.

If you need to apply for long-term disability benefits, you may greatly benefit from calling us today and getting the advice that you need. Bonnici Law Group has the experience and knowledge that is invaluable when applying and qualifying for long-term disability benefits. When you need answers, contact Bonnici Law Group today at 858-261-5454. As we focus our efforts on long-term disability claims, we know how to protect your rights and build a strong demand for compensation in your case.