Once you have filed a disability claim with your insurance company, how long does it take to get your long-term disability benefits?

Unfortunately, the answer is not clear cut and is based on a variety of factors. In most cases, it will take between 45-105 days for you to receive the initial decision about your claim.

Here we’ve covered some influencing factors that can affect how long it will take and how you can help to speed up the claim approval process.

Influencing factors

Your policy’s elimination period

To begin with, almost all disability insurance policies contain an elimination period. This is the period between when you become ill or injured and when you can start receiving your long-term disability benefits.

During this elimination period, you must remain continuously disabled in order to be entitled to benefits. In no event will you ever be entitled to benefits before the policy’s elimination period ends.

The application deadlines and timelines

In general, the timeline for processing your claim depends on the type of long-term disability coverage you have.

  • Individual Disability Insurance (IDI): If you have an IDI policy that you purchased on your own, then the insurer usually has a “reasonable” timeframe in which to review and make a decision on your claim.
  • ERISA Disability: If you have an ERISA disability plan, which is covered through your employer, your insurer must follow tight timelines. This amounts to up to 45 days for the initial decision, and two additional 30-day extensions if the insurance company thinks they need them.

This means it can take up to 105 days to receive your initial decision for an ERISA disability claim. For an IDI disability claim, it can take even longer.

Learn more: ERISA vs. Individual Disability Insurance

The process for challenging a claim denial

If your original claim is denied, you will need to challenge the denial. This will only lengthen the period of time before you are paid. Again, this will be based on the type of long-term disability plan you have.

If you have an ERISA disability plan, in order to challenge a claim denial, you must file an appeal. You only have 180 days to file your appeal. Once you file your appeal, the disability insurance company has 45 days to make a decision. They can then give themselves an additional 45 days if they need more time.

If you have an IDI policy, you usually do not have an appeal requirement like an ERISA disability plan. This means you can appeal or take the matter directly to court if you desire.

Read more: 3 Common Reasons Why Long-Term Disability Claims are Denied

Why you should consider hiring a lawyer to help you appeal

Are you appealing a denial under an ERISA disability plan? If so, then your appeal is the very last time you will ever be able to submit evidence in support of your claim.

If your insurance company denies your appeal, you are allowed to seek judicial review. However, the court is only allowed to review the information contained in the insurance company’s claim file.

Therefore, as a practical matter, preparing your disability appeal for the insurance company is identical to preparing your case for litigation in court. If you make a mistake at the appeal level, there is no way to correct it later.

If you make a mistake at the appeal level, there is no way to correct it later.

Further, while you may submit new evidence in court when litigating an IDI policy denial, litigation can be costly. You have a much greater chance of success on appeal with the help of an expert long-term disability lawyer.

Read more: 7 Tips to Help You Win Your ERISA Disability Appeal

How to speed up the claim approval process

Be proactive in supplying all of your medical information

You are disabled because of an injury or illness, so the insurance company will request and review your medical records. The more medical issues you have, the more records they will request.

You can speed up this process by obtaining and submitting these records as quickly as possible. Don’t wait for the insurance company to request them on their own.

Respond promptly and accurately to requests for information

If your application is missing any key information, your claim could be delayed or denied.

If your application is missing any key information, your claim could be delayed or denied.

It can also be delayed if you do not comply with the insurance company’s deadlines or requests for any additional information.

For example, most disability insurance policies allow the insurance company to request you have an Independent Medical Exam (IME) or Functional Capacity Evaluation (FCE). If you refuse to attend, your claim can be denied for failure to cooperate.

Any delays on your part mean that the insurance company could reasonably take a longer time to make a decision. They may also be entitled to make additional extensions of time as the law allows.

This is why it’s important that you stay on top of all requests for information. If you are falling behind, you should seriously consider talking to a long-term disability lawyer to make sure you are not putting your claim at risk.

Help your doctor help you

Your doctor’s support is the most important evidence in your long-term disability claim.

Insurance companies often request that doctors fill out an attending physician statement (APS) as part of the claim analysis. Any delay in these APS forms can impact how long it takes to get your initial decision.

You can help your doctor to submit a timely response by making sure you are keeping up with your treatment plan. Stay in communication with your doctor so they know your current medical condition(s) when filling out the APS form.

So, how long does it take to get disability benefits?

Unfortunately, there is no definitive answer to how long it will take to get your long-term disability benefits. It depends on your case, how long it takes for your insurance company to make a decision, and whether you need to appeal a denial.

You can expect the initial application to take up to a year for a decision. The appeals process can then take up to almost nine months (some plans will allow for a second appeal, but not all).

Want help with staying on top of important deadlines for your claim or appeal? Reach out to Roy Law Group for help.