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High-earning professionals face challenges with disability claims

On Behalf of | Feb 9, 2022 | Long-Term Disability

Many companies that employ skilled and educated professionals like physicians and accountants offer supplementary insurance as an employment benefit. Some employers offer comprehensive health insurance coverage, while others provide long-term disability benefits.

Such coverage is crucial for employees who earn more than the average weekly wage in Georgia. Programs like workers’ compensation will only cover up to two-thirds of what someone earns, and even that amount is subject to a maximum benefit based on the average wage in the state.

By offering higher-earning professionals long-term disability insurance benefits, employers help protect their financial stability in the event of an emergency. You may have never thought about your long-term disability benefits until your diagnosis with a life-altering medical condition. Unfortunately, now that you need those benefits, you may find is that the insurance company is eager to deny your claim.

Long-term disability claims are expensive

Insurance companies make money by taking in premiums for policy coverage and by reinvesting those funds. Their profit margins shrink when they have to pay big claims. Long-term disability claims made by highly-compensated professionals like engineers and surgeons can cost hundreds of thousands of dollars for an insurance provider.

While they may have received premium payments for years on that policy, the company will likely search for any excuse to deny, delay or minimize a long-term disability claim. Applicants often find themselves facing a rejected claim or red tape that makes it hard for them to comply with the company’s demands and get benefits.

Those with employer-sponsored coverage have appeal rights

The Employee Retirement Income Security Act of 1974 (ERISA) doesn’t just govern retirement benefits despite the name. It also applies to other employer-sponsored benefits, including long-term disability benefits.

The company providing the benefits subject to regulations, including rules about transparency regarding their decision-making process and policy paperwork. They also have to give those denied benefits the chance to appeal that decision.

The insurance company will likely invest time and effort in trying to deny you the benefits you need. You will require medical documentation about your condition and also evidence of how it affects your daily life or has prevented you from doing your job. Connecting with the right support while negotiating or litigating a long-term disability claim can help professionals get the benefits their employers promise them.


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