Problems and Solutions: Missing Deadlines in Long-Term Disability Claims
The long-term disability claims and appeals process has several important components. One of these components is adhering to filing deadlines. These deadlines exist during each stage of the LTD process.
Specific deadlines vary from policy to policy, but what happens if an LTD claimant misses one? Unfortunately, missing a deadline could result in a denial of an otherwise valid disability claim.
The Elements of the Case
In this scenario, a pharmacist develops a medical condition that prevents them from working. They must file for long-term disability benefits.
The other relevant elements of this case include:
- The medical condition: Chronic obstructive pulmonary disease (COPD)
- The insurance policy: A group policy with an “own occupation” definition of disability
- The insurance company: Unum Group—the largest disability insurer in the U.S.
The Problem: A Pharmacist Misses the Initial Filing Deadline
A pharmacist works for a large drugstore. They have a Unum group long-term disability policy through their employer. They begin to experience the early symptoms of COPD, which get progressively worse over time.
On the first of January, their condition worsens to the point that they can no longer work. This is the “date of disability” from which the pharmacist’s claim deadlines run.
There is a filing deadline for the “notice of claim” that begins the long-term disability filing process. The pharmacist’s policy stipulates that this notice must be filed with Unum within 60 days of the date of disability. However, the pharmacist is not aware of this deadline because they did not thoroughly read their policy.
Since they did not know that this deadline existed, they did not file the notice of claim within those 60 days. They think that, perhaps, they can get better on their own and potentially return to work—but this is not the case. Their COPD gets worse, and they finally file their notice of claim to Unum on March 7—of the following year.
As such, they receive a denial of their claim. Unum argues that it did not receive timely notice of the claim the pharmacist was filing.
The Solution
This hypothetical scenario shows how missing a filing deadline when submitting a long-term disability claim can be detrimental. The pharmacist committed a big, yet common, mistake right at the beginning of the process: they did not read their policy and missed their filing deadline by over a year.
It is vital to thoroughly read your policy and note all filing deadlines. These filing deadlines can be strict, and it is important to remember that there is no gray area with insurance companies like Unum.
If you miss a deadline, then they may deny your claim. Therefore, it is vital to file your LTD claim as soon as you can to ensure you meet all applicable deadlines during this process.
Call CCK Today for a Free Case Evaluation
Long-term disability claim denials are unfortunately common, so having an experienced disability attorney to help you is beneficial. CCK has been helping LTD claimants for over 20 years avoid common missteps such as missing deadlines and may be able to help you too. Whether you have an ERISA-governed policy or not, we may be able to help. Call us today at (800) 544-9144 for a free case evaluation with a member of our team.
