In Texas, one issue that can be costly in every conceivable way is if a person suffers an illness or injury that leaves them unable to earn a living for an extended period. In these circumstances, long-term disability insurance coverage can be a lifesaver.
However, people with this type of coverage are often blindsided by factors they were unprepared for or completely unaware of. Knowing the facts about this type of insurance can be essential not just when seeking benefits, but if there are delays or outright denials.
Understand long-term disability claims
When a person seeks payments through their insurer for an injury or illness, they must show that they are totally disabled. Next, they go through the waiting period before payments begin. To be categorized as totally disabled, they must not be able to do their job after their condition is certified by a credentialed medical professional.
The waiting period before benefits begin is 180 days. Workers are expected to use their entire allotment of sick days in all its forms before long-term disability can start. No payments will be made before then.
Workers will have an insured monthly salary. The insurer will pay 60% of that salary. The cap for the 60% threshold is those who make $10,000 per month. The most they can receive per month is $6,000. Some claimants receive benefits from other sources. For example, a workers’ compensation claim would pay a certain amount to the injured worker. There is an offset based on that and will impact the insurance payouts.
The injured or ill person can continue receiving the payments until they can get back to work. If it is an older person who is close to retirement age, then they will get the payments until they can receive Social Security.
Still, there are other rules. People who are disabled when they are at least 69 cannot receive payments for more than 12 months. Those who have mental conditions will be limited to 24 months unless they are deemed totally disabled, are receiving regular care from a medical professional or are institutionalized.
People have options when issues arise with long-term disability
Long-term disability insurance can give people a safety net to protect them if they find themselves injured or ill and unable to work. Even with this coverage, there can be disagreements and disputes.
