COVID-19 has created significant uncertainty surrounding group short and long term disability insurance benefits. Get answers about from NYC's top long term disability attorneys below.
It's possible. Here are some questions to ask yourself to see whether you’re still covered by your long term disability coverage if your hours are reduced, you’re placed on unpaid leave, or you’re furloughed:
An experienced long term disability attorney can review your plan document and advise you whether your coverage has been extended. You or your attorney may need to contact your insurer to determine whether any internal exceptions apply amid coronavirus.
Most group long term disability plans do not exclude coverage for pandemics like coronavirus. Check your plan document carefully.
You could lose or waive your coverage. Signing a severance agreement can be tempting when you’re uncertain of future income. However, before signing any severance agreements, here are a few things to keep in mind:
If your employer has permitted you to work from home due to COVID-19, there should be no change in your long term disability insurance coverage. This is because you are actively working amid coronavirus.
However, questions may arise as to how your work is generally performed. For example, your insurer will want to see that your medical condition prevents you from performing your duties as they were generally performed before the coronavirus pandemic (e.g., working in an office, traveling to/from clients, etc.). But your insurer may now also question whether your medical condition prevents you from performing that same work from home.
If your coverage ends amid COVID-19, your benefit plan’s continuation, conversion, and portability options may be triggered. Check the terms of your benefit plan.
Yes. Many people are experiencing increased symptoms of depression, anxiety, bipolar disorder, and other mental illnesses during the COVID-19 pandemic. You may qualify to receive short and/or long term disability benefits if your symptoms are severe and frequent enough to prevent you from working.
You may qualify for short and/or long term disability benefits due to mental illness if you’re struggling to:
These difficulties can have a substantial impact on your ability to work, in addition to affecting your personal life. Speak with a qualified long term disability attorney about whether your symptoms may qualify you for long term disability benefits during the coronavirus pandemic.
Maybe. Most short term disability benefit plans require you: (1) to be unable to work (either at your normal place of work or remotely); and (2) to experience an income loss due to a medical condition. Most disability insurers are instituting internal policies for handling short term disability claims for employees under quarantine.
No. A diagnosis of COVID-19 will not “automatically” qualify you to receive long term disability insurance benefits. You must still meet the disability plan’s definition of disability and satisfy all other requirements.
Generally, to qualify for long term disability benefits due to a diagnosis of coronavirus, you must:
An experienced long term disability attorney will argue that your pre-disability earnings should be based on your last day of active work before the furlough, temporary layoff, or reduction in hours/salary. How your insurer will react to this argument will depend heavily on the terms of your long term disability plan and your insurer’s internal coronavirus-related policies.
WATCH OUT: If your monthly premium has been reduced in proportion to your hours, your monthly long term disability benefit may be reduced accordingly. Check your paystub and speak with an attorney to determine whether your monthly premium has been reduced in proportion to your hours.
Most long term disability plans require you to submit medical certification and proof of claim from your doctor. Although the COVID-19 pandemic may make it difficult to satisfy these requirements, the insurers are not waiving them. You must still submit medical certification and/or proof of claim.
However, most insurers are becoming a little more flexible in how these requirements may be satisfied. For example, your insurer may be willing to accept verbal medical certification of disability from your doctor or a telemedicine appointment record.
Most long term disability insurance companies are still actively processing and reviewing claims, but certain protocols may have changed. For example, your insurance company may be requesting updated medical information less frequently, given your inability to physically see you doctor during COVID-19. Other insurers are still demanding updates -- often suggesting that telemedicine appointments are an option.
Do not ignore your insurance company's requests for updated information amid COVID-19. You may request extensions for additional time to fulfill the request, but outright ignoring it may result it termination of your long term disability benefits.
Each long term disability insurance company is dealing with COVID-19 differently. However, you can rest easy knowing that the long term disability insurance companies are actively processing benefit checks. We have not witnessed delays in long term disability benefit payments amid COVID-19.
Maybe. If you receive benefits under the Families First Coronavirus Act (FFCRA) for your own medical condition, your insurer may offset your short and/or long term disability benefits based on your particular circumstances and the terms of the benefit plan. If you receive benefits under FFCRA unrelated to your own medical condition (i.e., you take qualified leave time to care for a child or family member), those benefits will not likely create an offset.
New York has enacted a law that provides job protection and wage replacement benefits for qualifying New York employees who cannot work because they are subject to a mandatory or precautionary order of quarantine or isolation issued by New York State's Department of Health, local board of health, or any other authorized government entity. An employee may also qualify for paid leave to care for a family member diagnosed with COVID-19, or to care for a child.
The term “long haulers” has been used to describe those still coping with COVID-19 symptoms long after their first diagnosis.
The short answer is that yes, you may qualify for long term disability benefits as a COVID-19 long hauler-- depending on the severity of your medical condition. Our article Can COVID-19 Long Haulers Get Long Term Disability Benefits? examines the disabling symptoms commonly reported by long haulers, as well as how to determine whether you may be eligible for long term disability benefits if you are a COVID-19 long hauler.
There’s a lot of uncertainty surrounding COVID-19 right now. Things are changing and developing quickly. If you’re wondering about how your short and/or long term disability benefits may be affected, you should preemptively consult with a long term disability attorney to obtain guidance. An ERISA long term disability attorney can explain your options and guide you out of work protected.
If you’ve already been laid off or fired before filing your long term disability claim, you should consult with a qualified long term disability attorney as soon as possible. Your insurance may still cover you, but the process may be difficult and complicated. A qualified ERISA long term disability attorney can help increase your chances of claim approval.