When you are injured or develop a disabling medical condition, you may look to your long-term disability insurance plan to replace your income. You might think that since you are clearly disabled, you can just file a claim for benefits and immediately start receiving those benefits. Unfortunately, most long-term disability insurance policies contain a waiting and/or elimination period that you must go through before your benefits start.
A waiting period is a certain amount of time that you must wait before you are covered by a long-term disability insurance policy. This can vary widely from one employer-sponsored plan to the next. For instance, you might not be entitled to coverage until 30 days following the date of your hire. If you develop a disabling condition prior to the date on which the waiting period expires, you may not be entitled to benefits.
In contrast, insurance companies measure elimination periods starting from the date that you become disabled. The exact length of any elimination period before you qualify for long-term disability benefits is determined by your long-term disability insurance plan. You typically must be completely disabled for the duration of this waiting period before you become eligible for long-term disability benefits.
Some plans set the elimination period at three months, six months, or for the same length of time for which you may qualify for short-term disability benefits. Therefore, if you are receiving short-term disability benefits, but do not remain totally disabled during that time period, then you likely will not be entitled to long-term disability benefits.
The idea behind both waiting and elimination periods is one of cost-savings for the insurance company. By requiring an elimination period, the insurance company can “eliminate” any claimants who have only a short-term disabling medical condition. This is similar to the five-month waiting period to receive Social Security Disability insurance benefits and to a time-based deductible for a medical insurance plan. The theory is that you spend a certain amount of your own money or use short-term disability benefits prior to becoming eligible for any long-term disability benefits under the policy. Long-term disability insurance policies often contain many provisions that you might not be aware of, including elimination and waiting periods before entitlement to benefits begins. Bonnici Law Group has handled the claims of countless individuals who have encountered difficulties in procuring long-term disability benefits under their employers’ ERISA-governed insurance policies. We will protect your rights and advocate on your behalf throughout every stage of the claims process. Call our office at 619-259-5199 to set up an appointment to speak with us today.