How Does Long Term Disability Work in Colorado? 2024

Long-term disability insurance offers support to those who suffer an injury and need financial support while they are unable to work. For residents of Colorado, this is a necessary benefit for those who are injured or suffer an illness. It’s important to understand how long-term disability works in Colorado in order to receive the compensation you need.

What Is Long-Term Disability?

Long-term disability is a type of insurance that allows workers to receive financial support if they suffer an injury or illness that prevents them from working. Usually, this insurance is covered by the person’s employer through the Employee Retirement Income Security Act (ERISA), but there are private options available that the individual can purchase on their own.

Insurance governed by ERISA is considered a welfare benefit and thus must meet certain requirements for the individual to qualify. The employee must be a full-time employee, must show proof of their disability and its hindrance on their ability to work, and must show proof after a period of time that the disability hinders them from working any job that they are qualified for.

Benefits do not cover 100% of an employee’s previous income but usually cover a portion of it. If you encounter issues with your benefits, consulting with a long-term disability lawyer can help ensure that your rights are protected and you receive the compensation you deserve.

Long-Term Disability Conditions

A person’s eligibility for long-term disability will depend on a number of factors. The terms of the individual’s policy will specifically outline requirements. Some common conditions that may result in the need for long-term disability include:

• Chronic back pain
• Arthritis
• Cancer
• Parkinson’s disease
• Lupus
• Crohn’s disease
• Traumatic brain injuries
• Schizophrenia
• Dementia
• Severe accidents (such as car or construction accidents) resulting in permanent injury
• Paralysis
• Amputations
• Loss of senses, such as blindness or deafness

Filing a Long-Term Disability Claim

If you have an illness or injury that prevents you from being able to work, you can file a long-term disability claim to receive benefits if you are eligible. Each insurer may have its own process, but generally speaking, it is similar for all providers. Consulting with a long-term care insurance lawyer can help you navigate the complexities of the claims process and ensure that you receive the benefits you are entitled to.

First, the applicant submits a form along with medical evidence of their condition and how it is affecting their ability to work. It may include documentation from the employer, such as job descriptions and performance reviews. The insurance company will evaluate the claim to see if it qualifies for compensation. They may request additional information or require additional testing, evaluations, or professional opinions.

Once they have all the information they need, they will either approve or deny the request. If approved, benefit payments can begin after the predetermined waiting period. If denied, there may be options available to appeal the decision, especially in cases of denied long-term disability claims, where a skilled attorney can help navigate the appeals process.

Appealing a Denied Claim

When a person’s disability claim is denied, they have a limited time to file an appeal under ERISA. Failing to do so within the necessary timeframe can result in an automatic dismissal of the case. Therefore, you should act as soon as you are aware of your denial.

Request full documentation of the denial. The insurance company can provide you with a detailed explanation of their decision. The explanation should include any missing information from you and/or any policies that are enforced at the company that outlines your disqualification, especially in cases of long-term disability benefits claim denial.

To make your appeal, collect all information that can help support your claim. This can include medical reports, professional opinions (such as medical professionals and any supervisors or coworkers that can attest that your disability would not be suitable for the job), and any other assessments that can be documented and submitted with your appeal.

Submitting the Appeal

Next, submit the appeal. In the appeal, you should include your reasoning by acknowledging the insurance company’s reasons for denial and supporting your claim with evidence. If you are seeking to get long-term disability coverage, it’s important to have the right documentation and legal support to strengthen your case.

You should consider hiring an attorney to assist you in this process. An attorney can look at all the facts of your condition and assist you with the most appropriate course of action. They can ensure that you submit all documentation on time and that you have as much evidence as you need to submit a strong appeal. They can also represent you if the insurer denies your appeal and you want to take the matter to court.

FAQs

What Conditions Automatically Qualify You for Disability in Colorado?

There is no one condition that will automatically qualify a person for disability in Colorado. The condition must be severe enough to impact a person’s ability to work. Examples can include late-term cancers, dementia, paralysis, traumatic brain injuries, and Parkinson’s. If a person has private disability insurance, their eligibility will depend on the specific terms of that insurance company.

What Are the Cons of Long-Term Disability?

While long-term disability is a benefit for those who need it, it does have its drawbacks. Long-term disability through a person’s employer will typically only cover a fraction of what the employee was making before. Therefore, this coverage may not be enough to sustain them financially, especially if they do not have supplemental options in place.

What Is the Average Disability Payment in Colorado?

The average monthly disability payment in Colorado can vary. The amount a person can receive depends on the person’s history of work and their previous work earnings. Long-term disability insurance covers a percentage of a person’s previous work earnings. Therefore, the exact amount will depend on the circumstances of your situation.

What Situation Would Most Likely Be Covered by Long-Term Disability Insurance?

Long-term disability insurance covers conditions and injuries that prevent a person from being able to work. An example would be if a construction worker develops multiple sclerosis and over time, has decreased independent mobility. Situations like this, that would drastically affect a person’s ability to work, would qualify for long-term disability insurance.

Contact McDermott Law, LLC to Get Legal Help with Long Term Disability Issues

If you have a condition or injury that is preventing you from working, and you need assistance in acquiring long-term disability insurance or would like to make an appeal of your denied claim, McDermott Law, LLC can help. Contact us today to get started. Our legal team has the acumen and resources necessary to help you.