Why isn’t an Award of Social Security Disability Benefits Acceptable to prove that I am Disabled Under My Long Term Disability Policy?
The problem with disability under the Social Security program does not imply that you are disabled under your Long Term Disability policy, why? The Social Security Administration uses a five step sequential evaluation including listed impairments and an age/education grouping which was designed to manage the high number Social Security Disability claims.
The Social Security program does not have any time limits on how long the benefits are paid regardless the cause of the disability, while your Social Security claim may be re-reviewed every 3 years, which much different than an ERISA claim.
An ERISA Long Term Disability policy is a contract and by the terms of the contract the benefits can be limited for a period of two years based on your inability to perform any occupation. Most policies will then have a change in policy definition that will require you to show that you are unable to engage in any occupation. Simply because the Social Security Administration has found that you are disabled, doesn’t necessarily mean that you meet the same disability requirements under your Long Term Disability policy.
However, that doesn’t mean that the Long Term Disability carrier can ignore the Social Security Administration’s award of benefits.
In Glenn v. MetLife, 128 s.coor. 2343 (2008), the United Supreme Court told Long Term Disability carriers that they do have to consider an award of Social Security Disability benefits in rendering their decisions.
If you have been awarded Social Security Disability benefits but the Long Term Disability carrier has denied your claim for Long Term Disability benefits, you have 180 days in which to appeal. Nancy Cavey, Tampa Bay based Long Term Disability attorney strongly suggests that you consult with an experienced Long Term Disability attorney to determine whether or not your Long Term Disability denial is justified based on your medical records, the Social Security Administration’s decision and the terms of your policy. Don’t delay!