What Happens When An Employee Goes On Long-Term Disability?

Published on: April 21, 2023

When an employee goes on long-term disability, they typically stop working due to an injury, illness, or medical condition that prevents them from performing their job duties. Depending on the employer's policies and the employee's contract, the employee may be entitled to certain benefits and protections while on disability leave.

The specific details of an employee's long-term disability leave will depend on their employer's policies and the terms of their employment contract. Generally, long-term disability benefits are designed to replace a portion of an employee's income while they are unable to work due to their medical condition.

In most cases, the employee will need to provide medical documentation to support their disability claim, and they may need to undergo periodic medical reviews to continue receiving benefits. The length of time an employee can receive disability benefits will depend on their specific policy and the severity of their medical condition.

It's important to note that an employee's job may not be guaranteed while they are on long-term disability. Depending on the terms of their contract, the employer may be able to terminate the employee's employment after a certain amount of time on disability leave, or if it becomes clear that the employee is unable to return to work. However, employers are generally required to make reasonable accommodations for employees with disabilities under the Americans with Disabilities Act (ADA), so it's important for employees to communicate with their employers and keep them updated on their medical condition and ability to work.

What is Long-Term Disability?

Long-term disability (LTD) refers to a type of insurance policy that provides income replacement to an individual who is unable to work due to a long-term illness, injury, or disability. Typically, LTD benefits become available to an individual after they have been unable to work for a certain period of time, such as 90 days or six months.

LTD benefits are designed to replace a portion of the individual's income while they are unable to work. The amount of income replacement will depend on the terms of the policy, but it is typically a percentage of the individual's pre-disability income.

In order to qualify for LTD benefits, the individual must meet the definition of disability as defined in the policy. This definition will vary depending on the specific policy, but generally, the individual must be unable to perform the duties of their own occupation or any other occupation for which they are qualified by education, training, or experience.

LTD insurance can be provided by an employer as part of a group benefits package or purchased individually. It is important for individuals to carefully review the terms of their policy to understand the specific benefits and requirements, such as waiting periods and proof of disability, in order to maximize their chances of receiving benefits if they become disabled.

Applying for ERISA Long-Term Disability

If you are applying for long-term disability (LTD) benefits under the Employee Retirement Income Security Act (ERISA), the process can be complex and may require the assistance of an experienced attorney.

Applying for ERISA Long-Term Disability

Here are some general steps to take when applying for ERISA long-term disability benefits:

  • Review your employer's disability policy: Your employer's disability policy should contain information about the benefits you are entitled to receive, the process for filing a claim, and any relevant deadlines. Make sure you understand the policy before you begin the application process.
  • Gather medical documentation: To support your claim, you will need medical documentation from your treating physicians and specialists. This documentation should include a detailed description of your condition, the treatments you have received, and the prognosis for your recovery.
  • File a claim with the insurance company: You will need to file a claim with the insurance company that administers your employer's disability policy. The claim should include a copy of your medical documentation, as well as any other relevant information about your disability.
  • Follow up on your claim: The insurance company may require additional information or documentation to support your claim. Be sure to follow up with the insurance company regularly to ensure that your claim is being processed in a timely manner.
  • Appeal if your claim is denied: If your claim is denied, you have the right to appeal the decision. You may need to provide additional medical documentation or other evidence to support your appeal.
  • Consider hiring an attorney: ERISA long-term disability claims can be complex and require a thorough understanding of the law. Consider hiring an attorney who specializes in ERISA claims to help you navigate the process and maximize your chances of receiving benefits.

Do You Have Job Protection While on Long-Term Disability?

Job protection while on long-term disability (LTD) will depend on a number of factors, including the employer's policies, the terms of the LTD insurance policy, and applicable laws.

Here are some general guidelines to keep in mind:

  • Employer policies: Some employers have policies in place that provide job protection for employees who are on LTD. This may include a guaranteed right to return to work after a specified period of time, or a requirement that the employer make reasonable accommodations for the employee upon their return to work.
  • LTD insurance policies: The terms of the LTD insurance policy may also provide job protection for the employee. For example, the policy may require the employer to hold the employee's job open for a certain period of time while they are on disability leave.
  • Applicable laws: The Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA) provide some job protection for employees with disabilities or serious medical conditions. The ADA requires employers to make reasonable accommodations for employees with disabilities, while the FMLA allows eligible employees to take up to 12 weeks of unpaid leave for their own serious health condition or to care for a family member with a serious health condition.

However, it's important to note that job protection is not guaranteed in all cases. Employers may be able to terminate an employee's employment if they are unable to return to work after a reasonable period of time or if their disability prevents them from performing the essential functions of their job even with reasonable accommodations.

If you are on LTD and are concerned about job protection, it's important to review your employer's policies and the terms of your LTD insurance policy, and to consult with an experienced attorney if necessary.





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