Long-term disability insurance may be available as a group policy through your employer or a private individual plan that you purchase on your own. The purpose of long-term disability insurance to provide you with a partial replacement of your income when you are unable to work due to a disability. In many cases, long-term disability insurance policies offer up to 60% of your regular income during any period in which you are unable to work. However, these policies do tend to contain many exclusions that sometimes can make it challenging to get the benefits you deserve.
On the other hand, long-term care insurance pays for some or all the costs of caregiving services that you need, whether you are still residing at home or residing in some facility. Generally, you incur these types of expenses when physical or mental impairment prevents you from living and caring for yourself entirely on your own. Covered expenses may range from home health care to assisted living facilities to skilled nursing care. For example, a policy may provide coverage for a specific number of days spent in a nursing home. Individuals purchase these policies privately, as they are not routinely part of group benefits available through an employer.
Another significant difference between long-term disability insurance policies and long-term care insurance policies is the laws that govern them. Most employer-sponsored long-term disability insurance policies must comply with ERISA or the Employee Retirement Income Security Act of 1974. ERISA sets forth very stringent timeframes and requirements of both individuals seeking benefits under these policies and insurers who provide this coverage. Plan administrators have timelines within which they must make decisions on claims for benefits, and applicants have deadlines by which they must appeal denials of benefits.
Long-term disability claims are complex matters that require intensive knowledge of ERISA laws and regulations. As a result, you will need experienced legal representation and advice to pursue an ERISA-governed disability claim. Bonnici Law Group is a law firm focusing on ERISA long-term disability benefits and bicycle injury cases in San Diego, CA. When you need effective legal representation, contact Bonnici Law Group at 619-259-5199 or email us at firstname.lastname@example.org.