Once you have filed a disability claim with your insurance company, how long does it take to get your long-term disability benefits?
It will typically take at least 45 days to receive the initial decision about your long-term disability claim. It could even take as long as three or four months. Unfortunately, the timeframe is not clear-cut and is based on various factors that may be out of your control.
It will typically take at least 45 days to receive the initial decision about your long-term disability claim.
Below we’ve covered some influencing factors that can affect how long it will take to receive benefits and how you can help to speed up the claim approval process.
Your policy’s elimination period
Almost all long-term disability insurance policies have an elimination period, also known as a waiting period. An elimination period is the time between the “onset date” when you become ill or injured and when you can start receiving your long-term disability benefits.
An elimination period for a long-term disability policy will typically last between 90 and 180 days. This timeframe coincides with the length of time you can receive benefits for short-term disability, so long-term disability typically picks up where short-term disability benefits leave off.
You must remain continuously disabled during the elimination period to be entitled to benefits. You will never be entitled to benefits before your policy’s elimination period ends.
An elimination period for a long-term disability policy will typically last between 90 and 180 days.
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 you purchased on your own, then the insurer usually has a “reasonable” timeframe to review and decide on your claim. What is considered “reasonable” is determined by state law.
- ERISA Disability: If you have an ERISA disability plan provided by your employer, your insurer must follow tight timelines. This timeline amounts to 45 days for the initial decision and two additional 30-day extensions if the insurance company thinks they need them. Therfore, it can take up to 105 days to receive your initial decision for an ERISA disability claim. An IDI disability claim can take even longer.
It can take up to 105 days to receive your initial decision for an ERISA disability claim. An IDI disability claim can take even longer.
Learn more: ERISA vs. Individual Disability Insurance
Additional requests from your insurance company
Your insurance company might request additional medical evidence or documentation to support your claim.
Under most disability insurance policies, the insurance company can request that you have an Independent Medical Exam (IME) or Functional Capacity Evaluation (FCE). If your insurance company requests that you take either of these tests, you should contact a lawyer immediately.
The appeal process for challenging a claim denial
If your insurer denies your original claim, you must challenge the denial. This process will only lengthen the period of time before your insurance pays your benefits. 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 decide. They can 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, so you can appeal or take the matter directly to court if you desire.
How to speed up the claim approval process
While many factors are outside your control regarding the approval of your claim, there are some steps you can take to help avoid any delays.
Be proactive in supplying all of your medical evidence
Because you are disabled due to an injury or illness, 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 your medical records as quickly as possible. Don’t wait for the insurance company to request them on their own.
Help your doctor help you
Your doctor’s support is the most critical 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 submit a timely response by ensuring 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.
Respond promptly and accurately to requests for information
If your application lacks key information, your claim could be delayed or denied.
If your application lacks 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. 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.
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.
Why you should consider hiring a lawyer to help you appeal
Are you appealing a denial under an ERISA disability plan? You have a much greater chance of success on appeal with the help of a long-term disability lawyer who is an expert in ERISA law.
If you make a mistake with your appeal, there is no way to correct it later.
The ERISA appeal process is complex and involves strict deadlines that are constantly changing. If you make a mistake with your appeal, there is no way to correct it later. Your appeal is the last time you will ever be able to submit evidence supporting your claim, with very few exceptions to this rule.
If your insurance company denies your appeal of a denied ERISA claim, you are allowed to seek judicial review. However, the court can only review the information 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.
An experienced disability attorney will know what to prepare for and can help by taking care of all the complicated details for you.
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, the type of policy you have, how long it takes for your insurance company to make a decision, and whether you need to appeal a denial.
With the support and guidance of an experienced disability lawyer, you’ll have a much greater chance for a swift, successful outcome.
Want help with staying on top of important deadlines for your claim or appeal? Reach out to Roy Law Group for support.