Disability insurance termination ruled illogical

Wrongful policy terminations should be contested

A debilitating illness affects every facet a person's life. Not only can it have a significant impact on your personal life, but your work life as well. Research shows nearly 30 percent of all U.S. workers between the ages of 25 and 65 will suffer an accident or illness that will keep them out of work for at least three months.

Fortunately, disability insurance (DI) can help you recoup a good portion of your wages if you are unable to work because of a disability. There are several types of disability insurance, including government-sponsored Social Security Disability Insurance and DI that is available through your employer. Employer-supplied disability insurance comes in two forms:

  • Short-term disability coverage (STD) – This coverage provides employees with a specific percentage of pre-disability income (typically around 60 percent) once sick leave is all used up. STD typically lasts no longer than six months.
  • Long-term disability coverage (LTD) – Long-term coverage begins when STD and sick leave are both exhausted. LTD also typically covers about 60 percent of a person's pay and in some cases can last the rest of an employee's life. LTD is generally considered protection against a catastrophic injury or illness, but it often covers common medical conditions that worsen over time.

"Some employers will include STD, LTD or both in an employee's benefits package," explains attorney Martin Sweet of legal information website THELAW.TV. "However, employees often have to pay out of their own pockets for these plans. In many cases, the employer and employee will share the cost."

Unfortunately, when an employee becomes disabled and unable to work for a long period of time, disability insurance does not always work the way it's designed to work. A recent California case involved a California woman who was ruled to have been wrongfully denied long-term disability coverage. The woman suffered from Chronic Fatigue Syndrome, which was diagnosed in 2006. Her employer, AT&T, terminated her LTD even though she was still completely disabled. Last month, a U.S. District Court judge ruled that the coverage termination was "illogical."

"Insurance companies and employers are supposed to be unbiased in the administration of disability insurance policies, but we all know that's not always the case," stresses Sweet.

Sweet adds DI policyholders need to be vigilant and proactive. "If you believe a coverage decision is unfair, then you owe it to yourself to do everything you can to fight it."

If you feel your DI has been wrongfully terminated or denied, you should contact a lawyer who specializes in disability claims.

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